investigation to determine the nutritional adequacy and individuals experience of a very low fat diet used to treat type V hypertriglyceridaemia

• Published in: Journal of human nutrition and dietetics Vol. 22; no. 3; pp. 232 - 238
• Main Authors: Whitfield-Brown, L, Hamer, O, Ellahi, B, Burden, S, Durrington, P
• Format: Journal Article
• Language: English
• Published: Oxford, UK Oxford, UK : Blackwell Publishing Ltd 01.06.2009; Blackwell Publishing Ltd; Blackwell
• Subjects: Adult; Biological and medical sciences; blood lipids; body mass index; communication skills; diet; diet counseling; Diet Surveys; Diet, Fat-Restricted - psychology; diet-related diseases; dietary advice; dietary energy sources; dietary fat; Dietary Fats; dietetic treatment; dietitians; eating habits; emotional barriers; Energy Intake; fat; fat intake; Feeding. Feeding behavior; Female; food choices; Fundamental and applied biological sciences. Psychology; health information; Humans; Hyperlipoproteinemia Type V - diet therapy; hypertriglyceridemia; information dissemination; interpersonal relationships; lifestyle; low fat diet; Male; men; Middle Aged; middle-aged adults; nutrition information; nutritional adequacy; nutritional intervention; patient compliance; Patient Compliance - psychology; social barriers; triacylglycerols; Vertebrates: anatomy and physiology, studies on body, several organs or systems; women; Dietetics; Human; dietetic treatment; Nutrition; Metabolic diseases; Lipids; Hyperlipoproteinemia; Lipoprotein; Triglyceride; Enzymopathy; Feeding; Treatment; Diet; Hypertriglyceridemia; Low fat diet; Fat; Dyslipemia; dietary advice
• ISSN: 0952-3871; 1365-277X
• DOI: 10.1111/j.1365-277X.2009.00945.x

The management of Type V hypertriglyceridaemia at some centres involves the use of a very low fat diet (15% energy as fat). There is no published research examining compliance with, or nutritional adequacy, of this treatment. This study assesses the nutritional adequacy of the diet and examines barriers and enablers to adherence. Fifty-four eligible patients were invited to take part. Eight males and one female agreed to participate. One male later withdrew. The mean age of participants was 49.4 years (SD 12.9 years), their mean BMI was 30.4 kg m−2 (SD 3.4 kg m−2) and their mean triglyceride level was 8.5 mmol L−1 (SD 5.6 mmol L−1). To assess nutritional adequacy and compliance, 3-day dietary records and telephone based diet histories were used and analysed using CompEat. Patients' experience was investigated using semi-structured telephone based qualitative interviews. Qualitative data was recorded, transcribed and analysed using thematic analysis to allow elucidation of emerging themes. Fat accounted for 22.5% of dietary energy and compliance was considered difficult. Barriers included lack of accessible nutritional information, increased patient burden defined as inconvenience and the persistent awareness of potential or actual ill health, lack of appropriate food choices, other peoples' ignorance, lack of flavour and variety, a desire to broaden the palate, cost, social pressure and prior negative experiences with dietitians. Enablers to compliance included nutritional awareness, desire to maintain good health, building on their nutritional knowledge base, behaviour and lifestyle modification, developing a routine, the support of family and friends and supportive eating environments. Compliance could be improved through extensive education on labelling, eating during special occasions such as Christmas, birthdays and eating out.