营养师服务与改善患者预后相关，而MEDFICTS饮食评估问卷是心脏康复中合适的预后指标。

Dietitian services are associated with improved patient outcomes and the MEDFICTS dietary assessment questionnaire is a suitable outcome measure in cardiac rehabilitation.

作者信息

Holmes Anne Locklin, Sanderson Bonnie, Maisiak Richard, Brown Amanda, Bittner Vera

机构信息

Morrison Healthcare Food Services, South Fulton Medical Center, Atlanta, GA, USA.

出版信息

J Am Diet Assoc. 2005 Oct;105(10):1533-40; quiz 1549. doi: 10.1016/j.jada.2005.08.001.

DOI:10.1016/j.jada.2005.08.001

PMID:16183352

Abstract

OBJECTIVE

The purposes of this study were to (a) examine the effectiveness of registered dietitian (RD) education and counseling on diet-related patient outcomes compared with general education provided by the cardiac rehabilitation (CR) staff, and (b) evaluate the effectiveness of the Meats, Eggs, Dairy, Fried foods, In baked goods, Convenience foods, Table fats, Snacks (MEDFICTS) score as an outcome measure in CR.

METHODS

Observational study data examined from 426 CR patients discharged between January 1996 and February 2004. Groups were formed based on education source: (a) RD and (b) general education from CR staff. Baseline characteristics were compared between groups; pre/post diet-related outcomes (lipids, waist circumference, body mass index, MEDFICTS score) were compared within groups. Controlling for baseline measures and lipid-lowering medication, associations were examined between (a) RD education and diet-related outcomes and (b) ending MEDFICTS score and diet-related outcomes.

RESULTS

Mean age was 62+/-11 years, 30% of patients were female, and 28% were nonwhite. At baseline, the RD group (n=359) had more dyslipidemia (88% vs 76%), more obesity (47% vs 27%), a larger waist (40+/-6 vs 37+/-5 inches), a higher body mass index (calculated as kg/m(2); 30+/-6 vs 27+/-5), a higher diet score (32+/-28 vs 19+/-19), and lower self-reported physical activity (7+/-12 vs 13+/-18 metabolic equivalent hours) (all P<.05) than the general education group (n=67). RD education was associated with improved low-density lipoprotein (r=0.13; P=.04), triglycerides (r=0.48; P=.01), and MEDFICTS score (r=0.18; P=.01). Improvements in MEDFICTS scores were correlated with improved total cholesterol, triglycerides, and waist measurements (all r=0.19; P=.04).

CONCLUSIONS

Dietary education by an RD is associated with improved diet-related outcomes. The MEDFICTS score is a suitable outcome measure in CR.

摘要

目的

本研究的目的是：（a）与心脏康复（CR）工作人员提供的一般教育相比，研究注册营养师（RD）教育与咨询对饮食相关患者预后的有效性；（b）评估肉类、蛋类、乳制品、油炸食品、烘焙食品、方便食品、食用油脂、零食（MEDFICTS）评分作为CR中一项预后指标的有效性。

方法

对1996年1月至2004年2月间出院的426例CR患者的观察性研究数据进行分析。根据教育来源分组：（a）RD组；（b）CR工作人员提供的一般教育组。比较两组的基线特征；比较组内饮食相关预后（血脂、腰围、体重指数、MEDFICTS评分）的前后变化。在控制基线指标和降脂药物的情况下，研究（a）RD教育与饮食相关预后之间的关联，以及（b）最终MEDFICTS评分与饮食相关预后之间的关联。

结果

平均年龄为62±11岁，30%的患者为女性，28%为非白人。基线时，RD组（n = 359）与一般教育组（n = 67）相比，血脂异常更多（88%对76%），肥胖更多（47%对27%），腰围更大（40±6对37±5英寸），体重指数更高（以kg/m²计算；30±6对27±5），饮食评分更高（32±28对19±19），自我报告的体力活动更低（7±12对13±18代谢当量小时）（所有P <.05）。RD教育与低密度脂蛋白改善（r = 0.13；P =.04）、甘油三酯改善（r = 0.48；P =.01）和MEDFICTS评分改善（r = 0.18；P =.01）相关。MEDFICTS评分改善与总胆固醇、甘油三酯和腰围测量值改善相关（所有r = 0.19；P =.04）。