Arcand Jo Anne L, Brazel Sandra, Joliffe Courtney, Choleva Marlene, Berkoff Frances, Allard Johane P, Newton Gary E
Division of Cardiology, Department of Medicine, Mount Sinai Hospital, University of Toronto, Ontario, Canada.
Am Heart J. 2005 Oct;150(4):716. doi: 10.1016/j.ahj.2005.02.016.
Multidisciplinary heart failure (HF) programs reduce hospital readmission and improve clinical outcomes. Although dietitians are often members of such teams, no randomized studies have demonstrated the independent benefit of dietitian-administered dietary counseling for patients with HF. The purpose of this study was to evaluate the effect of dietitian education on adherence to a sodium-restricted diet in ambulatory patients with stable HF.
Patients with HF (left ventricular ejection fraction < 35%) were randomized into a dietitian education group (n = 23) or a usual care group (n = 24), then observed for 3 months. Both groups received a 2 g/d dietary sodium prescription. The usual care group received nutrition advice by way of self-help literature, whereas the dietitian education group returned for 2 counseling sessions with a dietitian.
Dietitian education resulted in a significant decrease in sodium intake at 3 months (2.80 +/- 0.30 to 2.14 +/- 0.23 g/d, P < .05). In contrast, there was no change in sodium intake in the usual care group (3.00 +/- 0.31 to 2.74 +/- 0.35 g/d, P = ns).
Dietitian-administered counseling was more effective than providing literature in reducing dietary sodium intake in patients with stable HF.
多学科心力衰竭(HF)项目可减少医院再入院率并改善临床结局。尽管营养师通常是此类团队的成员,但尚无随机研究证明营养师提供的饮食咨询对HF患者有独立益处。本研究的目的是评估营养师教育对稳定型HF门诊患者遵守限钠饮食的影响。
将HF患者(左心室射血分数<35%)随机分为营养师教育组(n = 23)或常规护理组(n = 24),然后观察3个月。两组均接受每日2克的饮食钠处方。常规护理组通过自助文献获得营养建议,而营养师教育组则返回与营养师进行2次咨询会议。
营养师教育使3个月时的钠摄入量显著降低(从2.80±0.30降至2.14±0.23克/天,P<.05)。相比之下,常规护理组的钠摄入量没有变化(从3.00±0.31降至2.74±0.35克/天,P =无显著性差异)。
在降低稳定型HF患者的饮食钠摄入量方面,营养师提供的咨询比提供文献更有效。