A Dietitian-Delivered Group Nutrition Program Leads to Reductions in Dietary Fat, Serum Cholesterol, and Body Weight: The Worcester Area Trial for Counseling in Hyperlipidemia (WATCH)

Objective To assess the effectiveness of a dietitian-based nutrition counseling and education program for patients with hyperlipidemia. Design A 4-session program implemented as a complement to a randomized physician-delivered intervention. Subjects/setting From 12 practice sites of the Fallon Clinic, 1,162 subjects with hyperlipidemia were recruited, 645 of whom had data sufficient for our primary analyses. Intervention Two individual and 2 group sessions conducted over 6 weeks. Main outcome measures Total and saturated fat levels; serum low-density lipoprotein cholesterol levels; and body weight, measured at baseline and after 1 year. Statistical analyses Multiple linear regression was used to evaluate changes in outcome measures. Results After 1 year, there were significant reductions in outcome measures for subjects attending 3 or 4 nutrition sessions vs subjects attending fewer than 3 sessions or those never referred to a nutrition session. Reductions (mean± standard error) in saturated fat (measured as percent of energy) were 2.7±0.5%, 2.1±0.5%, and 0.3±0.1%, respectively. These reductions correspond to roughly a 22% relative change from baseline in those attending 3 or 4 sessions. Corollary reductions were observed for total fat (measured as percent of energy): 8.2±1.4%, 5.0±1.4%, and 0.7±0.4%; low-density lipoprotein cholesterol: 0.48±0.11 mmol/L, 0.13±0.11 mmol/L, and 0.02±0.03 mmol/L; and body weight: 4.5±0.9 kg, 2.1±0.8 kg, and 1.1±0.2 kg. The specified changes were additive to those of the physician-delivered intervention. Applications/conclusions This investigation provides empirical data demonstrating the effectiveness of a dietitian-delivered intervention in the care of patients with hyperlipidemia. J Am Diet Assoc. 1999;99:544–552.