Chronic Diseases and Conditions

Telephone advice on how to manage eating behavior can improve adherence to a cholesterol-lowering diet

About one third of all U.S. adults are candidates for cholesterol-lowering diets. However, fewer than half follow the recommended dietary guidelines. A new study, supported in part by the Agency for Healthcare Research and Quality (HS08891), found that patients with high low-density lipoprotein-cholesterol (LDL-C) who received a telephone call every 2 weeks from a nurse with advice on how to manage their eating behavior improved their adherence to a low-cholesterol diet and lowered their LDL-C.

Researchers randomized 65 men and women diagnosed with high cholesterol to usual care (follow-up visits with the doctor and/or lipid measurements every 3-6 months) or to the intervention treatment, which consisted of six telephone sessions with a nurse every 2 weeks over the course of 3 months. In the sessions, the patient set a goal for the next 2 weeks and reviewed self-monitoring notes from the prior 2 weeks. The nurse provided reinforcement and encouraged patients to achieve the next goal.

Over a 3-month period, the intervention group significantly reduced their intake of total fat, saturated fat, and cholesterol, while the usual care group increased their consumption of all three. Also, the intervention group reduced their serum LDL-C by 6 percent compared to a 1.3 percent increase in the usual care group. The intervention group did not feel any more competent to manage their diet, but did so anyway.

See "Improving adherence to a cholesterol-lowering diet: A behavioral intervention study," by Lora E. Burke, M.N., Jacqueline Dunbar-Jacob, Ph.D., R.N., Trevor J. Orchard, M.B.B.Ch., M.Med.Sci., and Susan M. Sereika, Ph.D., in the April 2005 Patient Education and Counseling 57, pp. 134-142.

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