Study shows effectiveness of Medical Nutrition Therapy in lowering hyperlipidemia
Cardiovascular disease is the number one cause of death in the United States with approximately 80% of patients having one of four risk factors – hypertension, dyslipidemia, diabetes and smoking. All of these factors can be modified through lifestyle changes. Dietitians are trained and uniquely qualified to effectively modify diets and lifestyle behaviors to reduce the risk for cardiovascular disease and their associated risk factors.
Based on information recently published in the February 2008 Journal of the American Dietetic Association (JADA), Registered Dietitians(RDs) were shown to have a major impact on cardiovascular risk reduction. In looking at data from a limited number of both high and neutral level studies, RD-delivered MNT visits (two – six planned visits) for patients with hypercholesterolemia, showed dietary reductions of 15-23% in total fat (from 32-36% to 25-28% of energy needs) and a reduction in saturated fat of 22 – 36% (from 11%-12% to 7-9% of total energy intake). This showed outcomes of a reduction in total cholesterol of 6-13% and reductions in LDL of 7-14%. Data on reductions in triglycerides and increases in HDL were inconsistent.
Data suggest that as the number of MNT visits increased, the greater the decrease in cholesterol and LDL. The number of visits was hampered by lack of insurance reimbursement. Currently insurances such as Medicare only reimburse MNT for diabetes and renal disease. Other insurances are variable in their reimbursement practices.
Lowering your lipids through MNT may mean you may not have to take cholesterol lowering medications, thus avoiding troublesome side-effects and saving money on drug costs.
All of the RDs in the study based their advice to their patients on the American Dietetic Association’s Medical Nutrition Therapy Hyperlipidemia Protocol. This called for education on limiting saturated and trans fats, increasing healthy monounsaturated fats (like olive oil), increasing soluble and insoluble fibers, consuming fish twice a week, increasing fruits and vegetables, regular exercise and healthy weight management, and information about label reading and dining out.
One of the researchers commented in conclusion that although many patients may already be eating a healthy diet, MNT can increase a patient’s knowledge of cardioprotective foods and assist them in individualizing the guidelines to their preference and lifestyle. Kathy Rhodes Ph.D., R.D. states
often we see heart patients who are on multiple cholesterol medications, but have never seen a dietitian. And even when a patient with high cholesterol does get to see an RD, their care team may not allow enough time to see how effective diet therapy is before they add additional treatments.
It is hoped that this study, despite the fact that more study is needed, will show the usefulness of MNT to patients, physicians and insurers.
Reference: JADA, Vol 108, No. 2, February 2008.
About the Author
Kathy Shattler received her Master of Science degree from Michigan State University in E. Lansing Michigan in Human Nutrition. Her twenty-two years of practice includes holding positions as a Lecturer, Chief Clinical Dietitian and Program Manager. Kathy is the Founder of Nutri-Care Consulting and is currently the Nutrition Director of www.CEU4U.COM, an online continuing education management company for Registered Dietitians and Dietetic Technicians.
