Highlights
- •Medical nutrition therapy by registered dietitian is effective for dyslipidemia.
- •Multiple individual sessions with dietitian were clinically and cost beneficial.
- •Dietitian intervention led to improved lipids, glucose, weight, and blood pressure.
- •Dietitian intervention led to reductions in need for lipid-lowering medications.
- •Benefits also reported when dietitian was part of a multidisciplinary health team.
Background
Faced with increasing health care costs, it is incumbent to discern whether managing
dyslipidemia with medical nutrition therapy (MNT) by a registered dietitian nutritionist
(RDN) is clinically and cost effective.
Objective
To systematically examine evidence on the clinical effectiveness and cost benefit
of MNT by an RDN for the treatment of dyslipidemia.
Methods
English and full-text research articles published between January 2003 and October
2014 were identified using PubMed, MEDLINE, and the Worldcat.org site to identify literature specific to clinical and cost effectiveness of MNT for
dyslipidemia. Studies were required to have at least one outcome measure of dyslipidemia:
total cholesterol (Total C), low-density lipoprotein cholesterol, triglycerides, high-density
lipoprotein cholesterol, and/or metabolic syndrome.
Results
This systematic review identified 34 primary studies with 5704 subjects. Multiple
individual face-to-face MNT sessions by an RDN over 3 to 21 months led to significant
improvements in lipid profile, body mass index, glycemic status, and blood pressure.
Results were summarized as mean differences with 95% confidence intervals when meta-analysis
was possible. In a pooled analysis, MNT interventions lowered low-density lipoprotein
cholesterol, total C, triglycerides, fasting blood glucose, hemoglobin A1c, and body
mass index compared to a control group. Cost effectiveness and economic savings of
MNT for dyslipidemia showed improved quality-adjusted life years and cost savings
from reduced medication use.
Conclusion
Evidence from this systematic review and meta-analysis demonstrates that multiple
MNT sessions by an RDN are clinically effective and cost beneficial in patients with
dyslipidemia and cardiometabolic risk factors.
Keywords
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Article info
Publication history
Published online: July 03, 2018
Accepted:
June 27,
2018
Received:
February 1,
2018
Identification
Copyright
© 2018 National Lipid Association. All rights reserved.
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- The value of incorporating medical nutrition therapy by a registered dietitian nutritionist in clinical practiceJournal of Clinical LipidologyVol. 12Issue 5
- PreviewIn this issue of the journal, Sikand et al.1 present important information for clinicians, insurers, and patients. This systematic review demonstrates the effectiveness of medical nutrition therapy (MNT) for management of dyslipidemia and other atherosclerotic cardiovascular disease (ASCVD) risk factors. Lifestyle therapies, including MNT provided by a registered dietitian nutritionist (RDN), are considered the cornerstone of treatment in multiple professional organization guidelines and recommendations for dyslipidemia and primary and secondary management of ASCVD.
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