Can low-fat/cholesterol nutrition counseling improve food intake habits and hyperlipidemia of renal transplant patients?

摘要

OBJECTIVE: To assess the impact of low-fat/cholesterol nutrition counseling on food intake habits and blood lipid levels of renal transplant patients. DESIGN: Prospective practice-based outcome study. SETTING: Acute care hospital post-renal transplant outpatient clinic. PATIENTS: Forty-three renal transplant patients not on lipid-lowering medications referred to the renal dietitian for low-fat/cholesterol nutrition counseling between September 1994 and September 1997. INTERVENTION: Individual assessment and counseling using the Healthy Heart Nutrition Guidelines Step 1 diet (<30% of total calories from fat, <300 mg cholesterol, and <10% of total calories from saturated fatty acids). MAIN OUTCOME MEASURES: Three-day food records precounseling and 3-day food records (n = 13) or descriptive intake changes (n = 30) postcounseling (time interval: 2 to 8 months). Fasting/random serum total cholesterol, high-density lipoprotein-cholesterol (HDL-C), and low-density lipoprotein-cholesterol (LDL-C), as available. RESULTS: Total cholesterol (n = 43) and LDL-C (n = 22) decreased significantly (0. 54 mmol/L P <.000 and 0.53 mmol/L P <.000, respectively). There were no significant changes in HDL-C and triglycerides. Twenty percent of patients (n = 43) reached target levels of total cholesterol <5.2 mmol/L, and 35% of patients (n = 22) reached target levels of LDL-C <3.4 mmol/L. Percentage of total calories from fat decreased significantly (7.58% P <.03). Descriptive intake changes of lower fat choices were reported in the no post-food records group. CONCLUSION: Patients can make changes in food intake habits after nutrition counseling. Serum lipid levels can improve after nutrition counseling, but many patients may still require lipid lowering medications to reach target levels. Nutrition counseling should be considered for the initial treatment of hyperlipidemia in renal transplant patients.