Evaluation of dietetic advice for modification of cardiovascular disease risk factors in renal transplant recipients

• Published in: Journal of renal nutrition Vol. 21; no. 6; p. 462
• Main Authors: Orazio, Linda K, Isbel, Nicole M, Armstrong, Kirsten A, Tarnarskyj, Jodie, Johnson, David W, Hale, Rachael E, Kaisar, Mohamed, Banks, Merrilyn D, Hickman, Ingrid J
• Format: Journal Article
• Language: English
• Published: United States 01.11.2011
• Subjects: Adult; Aged; Anthropometry; Australia; Blood Pressure; Cardiovascular Diseases - etiology; Cardiovascular Diseases - prevention & control; Diet, Mediterranean; Dietary Fats - administration & dosage; Dietetics; Energy Intake; Feeding Behavior; Female; Follow-Up Studies; Food, Organic; Glucose Intolerance - complications; Glucose Intolerance - prevention & control; Humans; Kidney Transplantation - adverse effects; Life Style; Male; Middle Aged; Motor Activity; Obesity - complications; Obesity - prevention & control; Patient Compliance; Risk Factors
• ISSN: 1532-8503
• DOI: 10.1053/j.jrn.2010.12.002

To investigate the effect of dietitian involvement in a multidisciplinary lifestyle intervention comparing risk factor modification for cardiovascular disease with standard posttransplant care in renal transplant recipients (RTR) with abnormal glucose tolerance (AGT). Randomized controlled trial. Hospital outpatient department. Adult RTR with AGT. RTR with AGT were randomized to a lifestyle intervention that consisted of either regular consultations with the dietitian and multidisciplinary team or standard care. Dietary intake, physical activity (PA) levels, cardiorespiratory fitness (CF), and anthropometry. Total fat and percent saturated fat intake rates were significantly lower in the intervention group as compared with the control group at 2-year follow-up, 54 g (16 to 105 g) versus 65 g (34 to 118 g), P = .01 and 10% (5% to 17%) versus 13% (4% to 20%), P = .05., respectively. There was a trend for an overweight (but not obese) individual to lose more weight in the intervention group (4% loss vs. a gain of 0.25% at the 2-year follow-up). Overall, RTR were significantly less fit than age- and gender-matched controls, mean peak oxygen uptake was 19.42 ± 7.09 mL/kg per minute versus 28.35 ± 8.80 mL/kg per minute, P = .000. Simple exercise advice was not associated with any improvement in total PA or CF in either group at the 2-year follow-up. Dietary advice can contribute to healthier eating habits and a trend for weight loss in RTR with AGT. These improvements in conjunction with multidisciplinary care and pharmacological treatment can lead to improvements in cardiovascular risk factors such as lipid profile. Simple advice to increase PA was not effective in improving CF and other measures are needed.