Background/Purpose: Patients with systemic lupus erythematosus (SLE) are at a high risk for developing cardiovascular disease (CVD) due to increased prevalence of traditional and nontraditional CVD risks factors. The purpose of this study was to evaluate the 6-month effect of individualized nutrition counseling (INC) on SLE patients participating in an ongoing CVD prevention counseling program (PCP).
Methods: SLE patients attending a free-of-charge CVD PCP have been referred to a registered dietitian for INC following an assessment of their CVD risk factors. The INC incorporates patient-centered methods (tailored nutrition education, goal setting, and motivational interviewing) to facilitate dietary changes. In a preliminary 6-month analysis, we evaluated changes in select nutrients (calories, sodium, fat, saturated fat, cholesterol, omega-3 and omega-6 fatty acids, fiber, sugar and folate), diet habits, anthropometric measures (weight and BMI), and clinical outcomes (lipid levels and blood glucose levels). A one sample t-test on the difference in the means between baseline and 6-month data was conducted for nutrient, anthropometric measures, and clinical measures. A chi-squared analysis was conducted for categorical variables depicting dietary habits.
Results:
From March 2009 to June 2011, 41 patients (female: 88%; mean age: 40.7 ± 12.6; African American/Hispanic: 73%; mean disease duration: 12.2 ± 8.2) attended INC (out of 71 referred). Hyperlipidemia was present in 18% of the patients, diabetes in 10%, and hypertension in 56%. Average weight was 85.98 kg±20.21, and BMI was 31.3 ±7.56. In 6-month follow-up, patients: a) reduced their intake of sodium, total calories, and percent calories from fat and saturated fat (Table); b) had decreased weight (-1.64 kg, p = 0.025); and c) reported increases in eating a diet rich in fruits and vegetables (p < 0.001), a high fiber diet (p = 0.011), ≥ 2 servings of fish/week (p = 0.002), and a low cholesterol diet (p = 0.034). The analysis of patients with abnormal lipids, and/or glucose levels, at baseline did not show a clinically significant improvement.
|
|
Baseline Mean (SD) |
6-monthb Mean (SD) |
Mean difference (SD) |
p-value |
|
Calories (kcals) |
1687.64 (SD = 515.59) |
1522.91 (SD = 440.78) |
-164.73 (SD: 568.71) |
.071 |
|
%Calories from fat |
32.93 (SD = 8.71) |
28.18 (SD =8.24) |
-4.13 (SD: 9.88) |
.011 |
|
%Calories from saturated fat |
10.37 (SD = 4.19) |
9.22 (SD = 3.32) |
-1.15 (SD = 3.91) |
.068 |
|
Cholesterol (mgs) |
277.71 (SD = 204.23) |
231.38 (SD =149.74) |
-46.34 (SD = 225.32) |
.195 |
|
Sodium (mgs) |
2518.28 (SD =883.53) |
2009.94 (SD = 977.74) |
-508.34 (SD = 1359.82) |
.006 |
|
Omega-6 Fatty Acids (grams) |
9.02 (SD =4.97) |
8.53 (SD =8.24) |
-.49 (SD = 6.78) |
.647 |
|
Omega-3 Fatty Acids (grams) |
0.33 (SD =.66) |
.29 (SD = .43) |
.04 (SD = .81) |
.739 |
|
Fiber (grams) |
18.04 (SD = 8.62) |
18.38 (SD = 9.33) |
.34 (SD = 9.33) |
.823 |
|
Sugar (grams) |
82.52 (SD = 53.17) |
76.72 (SD = 38.93) |
-5.80 (SD = 51.93) |
.479 |
|
Folate (mcg) |
365.16 (SD = 193.66) |
334.89 (SD = 211.13) |
-30.27 (SD = 261.11) |
.462 |
Conclusion: Our 6-month preliminary analysis suggest that individualized nutrition counseling using patient-centered methods is an effective method for promoting changes in nutrient intake, diet habits and, possibly, in anthropometric measures. The three-year longitudinal analysis of the patients receiving individualized nutrition counseling will determine the effectiveness of individualized nutrition counseling and if it can reduce prevalence of CVD risk factors.
Disclosure:
S. Everett,
None;
V. Haiduc,
None;
M. C. Richey,
None;
D. Erkan,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-short-term-effect-of-individualized-nutrition-counseling-on-nutrients-and-select-cardiovascular-risk-factors-in-patients-with-systemic-lupus-erythematosus/