Beneficial Lipid Outcome of Medical Nutrition Therapy for Men with Combined Hyperlipidemia in an Ambulatory Setting

• Published in: Journal of the American Dietetic Association Vol. 97; no. 9; p. A11
• Main Authors: Sikand, G., Yang, I., Kashyap, M.L., Wong, N., Hsu, J.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.09.1997
• ISSN: 0002-8223; 1878-3570
• DOI: 10.1016/S0002-8223(97)00360-X

LEARNING OUTCOME: To quantify the effect of medical nutrition therapy in men with combined hyperlipidemia in an ambulatory setting We asked if medical nutrition therapy (MNT) by registered dietitians could lead to a beneficial clinical outcome in men diagnosed with combined hyperlipidemia (hypercholesterolemia and hypertriglyceridemia) [CHL]. We conducted a retrospective chart review of 73 men diagnosed with CHL who were being considered for a lipid lowering drug study. Subjects participated in an 8-week nutrition intervention program as a qualifying requirement prior to initiating pravastatin therapy. Patient records were reviewed to determine the beginning and ending plasma lipid concentrations and the number and length of dietitian sessions. Complete information was available on 43 subjects, mean±SD 60.7±10.1 years. Total dietitian intervention time was 168.8±18.5 minutes in 2.7±0.6 sessions (range=2 to 4) during 6.5±2.2 weeks of MNT (range=4 to 8 weeks). MNT lowered total cholesterol (T-C) 11%, low density lipoprotein cholesterol (LDL-C) 9%, triglyceride (TG) 22% and body mass index (BMI) 2% and raised high density lipoprotein cholesterol (HDL-C) 4%. Pre and post treatment lipids were: T-C 259.5±36.6 vs 230.7±36.2 mg/dl (p<0.001); LDL-C 171.0±29.6 vs 147.1±33.6 mg/dl (p<0.001), TG 368.0±182.3 vs 268.0±142 mg/dl (p<0.001), HDL-C 32.7±8.3 vs 33.4±8.0 mg/dl (NS) and T-C/HDL-C ratio 8.35±2.05 vs 7.23±1.79 (p<0.0001). Based on the National Cholesterol Education Program treatment guidelines algorhythm, 50% (30 vs 15) were no longer eligible for a cholesterol lowering medication post treatment. Not including the cost of monitoring, the direct cost savings (in 1997 dollars) from discontinuing pravastatin eligibility for 6.5 weeks was $40.50 on a per case basis or $324.85 annually. For the entire sub-group (n=15) the annual cost savings is $4,872.75. We conclude that 3 individualized dietitian visits of 56 minutes/visit over 7 weeks has a beneficial effect in treating patients with combined hyperlipidemia.