The effect of nutrition counseling using patient-centered counseling methods on nutrient intake in patients with systemic lupus erythematosus (SLE)

摘要

The purpose of this study was to evaluate the effect of individualized nutrition counseling using patient-centered methods on cardiovascular disease (CVD) risk factors in patients with systemic lupus erythematosus (SLE) participating in a CVD patient counseling program at the Hospital for Special Surgery in New York City. From March 2009 to June 2011, 41 patients were referred and attended nutrition counseling, and 30 patients were referred but did not attend.;Over a 6-month period, patients that attended individualized nutrition counseling reported significantly lower percent calories from fat (p = 0.011), sodium intake (p = 0.006), and weight (p = 0.025), and marginally lower total calories (p = 0.071), percent calories from saturated fat (p = 0.068), and BMI levels (p = 0.070). These patients also reported significant increases in eating a diet rich in fruits and vegetables (p < 0.001), a high fiber diet (p = 0.011), ≥ 2 servings of fish per week (p = 0.002), and a low cholesterol diet (p = 0.034). Nutrition counseling did not significantly change clinical values in patients with SLE. Keeping food diaries (i.e. self-monitoring), more frequent visits with the registered dietitian, years since SLE diagnosis, and being positive for antiphospholipid antibodies (aPL+) were modestly or significantly associated with many of the outcomes of interest. Most demographic variables and comorbid conditions were not associated with the outcomes of interest.;When compared to those patients who were referred to nutrition counseling but did not attend, the group who attended nutrition counseling reported significantly greater changes in diet habits and weight, although the significant change in weight was attenuated after controlling for baseline differences in weight between the groups.;This study suggests that individualized counseling using patient-centered methods may be effective at promoting changes in nutrients, diet habits, and anthropometric measures in patients with SLE. Future studies are needed in larger samples to better understand whether a longer duration, more intensive nutrition intervention or a population with more severe baseline lipid profiles would influence changes in lipid levels.