The effect of brief versus individually tailored dietary advice on change in diet, lipids and blood pressure in patients with inflammatory joint disease

Background: Patients with inflammatory joint diseases (IJD) have an increased risk of cardiovascular disease (CVD) compared to the general population. Nutritional advice has been shown to influence CVD risk factors. Our objective was to evaluate whether an individually tailored dietary counselling versus a brief standardised advice on heart-friendly diet had comparable effect on change in diet, lipids and blood pressure (BP) in patients with IJD. Methods: Thirty-one patients with IJD aged 40-80 years received a brief standardised advice (4 min) on heart-friendly diet by a physician. Sixteen of the patients were randomised to receive an additional, individually tailored, heart-friendly dietary counselling session (60 min) by a dietitian. Change in dietary habits, measured by a validated questionnaire (SmartDiet), lipids, BP and C-reactive protein (CRP) were assessed after 8 weeks of follow-up. Results: After 8 weeks, the average increase in SmartDiet score was 5.1 and 5.7 points in the diet group (DG) and the control group (CG), respectively (p = 0.65). Low-density lipoprotein cholesterol (LDL-c) was reduced by 12.6% in the DG versus 2.4% in the CG (p = 0.05). There were no significant differences between the two groups regarding change in BP, lipids or CRP. Conclusion: Individually tailored dietary counselling resulted in more heart-friendly food choices in patients with IJD. However, the change in SmartDiet score was comparable for IJD patients receiving a brief nutritional advice and individually tailored heart-friendly dietary counselling. Further studies evaluating the longitudinal effects of dietary advice on CVD outcome in patients with IJD are warranted.