Dietitians were better than doctors at lowering blood cholesterol in the short to medium term, but there was no evidence that they were better than self-help resources. There was no evidence that dietitians provided better outcomes than nurses.The results should be interpreted with caution as the studies were not of good quality and the analysis was based on a limited number of trials.
Management of type IV hyperlipoproteinemia. Evaluation of practical clinical approaches.
A lipid intervention clinic screened 4000 employees (89% participation) and identified 150 type IV subjects (top 5 percentile triglyceride values, 100% initial participation, 6% drop out). The 150 healthy type IV subjects, ages 20 to 49, were randomly divided into treatment subgroups: A, treatment by clinic nutritionist and physician with the National Heart and Lung Institute's type IV diet for 6 weeks, then diet plus clofibrate for 18 weeks; B, same treatment by private physician; C, no intervention for 24 weeks, subjects advised of abnormality. The group A mean fasting serum triglyceride of 407 mg/dl declined 50% at 6 weeks, 61% at 12 weeks, and was unchanged at 24 weeks (P less than 0.0005 at 6, 12, 24 weeks). Group B triglyceride decreased 42%, 50%, 41% (P less than 0.0005 at 6, 12, 24 weeks). Group C triglyceride declined 20%, 1st to 24th week. Body weight decreased 8% (A) and 4% (B) at 6 weeks (P less than 0.0005) and was unchanged at 24 weeks. The maximum cholesterol decrease (A) was 11% (P less than 0.0005). Type IV hyperlipoproteinemia can readily be identified in a working population; treatment by clinic or private physician will markedly lower fasting serum triglyceride values in apparently healthy type IV subjects for at least 24 weeks.