Highlights
- •Medical nutrition therapy by a dietitian is effective for dyslipidemia.
- •Dietitian interventions led to improved lipid levels and blood pressure.
- •Benefits also reported when dietitian was part of a multidisciplinary health team.
Cardiovascular disease (CVD) is a leading cause of mortality in the United States.
Many primary risk factors, such as dyslipidemia and blood pressure, are modifiable
with diet and lifestyle interventions. Therefore, the objective of this systematic
review and meta-analysis was to evaluate the effectiveness of medical nutrition therapy
(MNT) interventions provided by registered dietitian nutritionists (RDN) or international
equivalents, compared to usual care or no MNT, on lipid profile and blood pressure
(secondary outcome) in adults with dyslipidemia. The databases MEDLINE, CINAHL, Cochrane
CENTRAL, and Cochrane Database of Systematic Reviews were searched for randomized
controlled trials (RCTs) published between January 2005 and July 2021. Meta-analyses
were performed using a random-effects model for lipid outcomes (seven RCTs, n=838), systolic blood pressure (SBP) (three RCTs, n=308), and diastolic blood pressure (DBP) (two RCTs, n=109). Compared to usual care or no intervention, MNT provided by RDNs improved total
cholesterol (total-C) [mean difference (95% CI): -20.84 mg/dL (-40.60, -1.07), P=0.04]; low-density lipoprotein cholesterol (LDL-C) [-11.56 mg/dL (-21.10, -2.03),
P=0.02]; triglycerides (TG) [–32.55 mg/dL (-57.78, -7.32), P=0.01];; and SBP [ -8.76 mm Hg (-14.06 lower to -3.45) P<0.01].High-density lipoprotein cholesterol (HDL-C) [1.75 mg/dl (-1.43, 4.92), P=0.28] and DBP [-2.9 mm Hg (-7.89 to 2.09), P=0.25] were unchanged. Certainty of evidence was moderate for total-C, LDL-C, and
TG, and low for HDL-C, SBP, and DBP. In conclusion, in adults with dyslipidemia, MNT
interventions provided by RDNs are effective for improving serum lipids/lipoproteins
and SBP levels.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: June 25, 2022
Accepted:
June 21,
2022
Received:
February 17,
2022
Identification
Copyright
© 2022 National Lipid Association. Published by Elsevier Inc. All rights reserved.
