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Dietary advice for reducing cardiovascular risk

Brunner, E. J., Thorogood, M., Rees, K. and Hewitt, Gillian 2005. Dietary advice for reducing cardiovascular risk. Cochrane Database of Systematic Reviews 2005 (4) 10.1002/14651858.CD002128.pub2

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Background: Changes in population diet are likely to reduce cardiovascular disease and cancer, but the effect of dietary advice is uncertain. Objectives: To assess the effects of providing dietary advice to achieve sustained dietary changes or improved cardiovascular risk profile among healthy adults. Search strategy: We searched the Cochrane Controlled Trials Register on The Cochrane Library (Issue 2 2000), MEDLINE (January 1966 to December 2000), EMBASE (January 1985 to December 2000), DARE (December 2000), CAB Health (December 1999), dissertation abstracts, and reference lists of articles. We contacted researchers in the field. Selection criteria: Randomised studies with no more than 20% loss to follow-up, lasting at least three months involving healthy adults comparing dietary advice with no advice or less intensive advice. Trials involving children, trials to reduce weight or those involving supplementation were excluded. Data collection and analysis: Two reviewers independently assessed trial quality and extracted data. Study authors were contacted for additional information. Main results: Twenty-three trials with 29 intervention arms (comparisons) comparing dietary advice with no advice were included in the review. Dietary advice reduced total serum cholesterol by 0.13 mmol/l (95% CI 0.03 to 0.23) and LDL cholesterol by 0.13 mmol/l (95% CI 0.01 to 0.25) after 3-12 months. Mean HDL cholesterol levels were unchanged. Dietary advice reduced blood pressure by 2.10 mmHg systolic (95% CI 1.37 to 2.83) and 1.63 mmHg diastolic (95% CI 0.56 to 2.71) and 24-hour urinary sodium excretion by 44.2 mmol (95% CI 33.6 to 54.7) after 3-36 months. Plasma triglycerides, ß-carotene and red cell folate were each measured in one small study which suggested no significant effect. Self-reported dietary intake may be subject to reporting bias, and there was significant heterogeneity in all the following analyses. Compared to no advice, dietary advice increased fruit and vegetable intake by 1.24 servings/day (95% CI 0.43 to 2.05). Dietary fibre intake increased with advice by 7.22 g/day (95% CI 2.84 to 11.60), while total dietary fat as a percentage of total energy intake fell by 6.18 % (95% CI 4.00 to 8.36) with dietary advice and saturated fat intake fell by 3.28 % (95% CI 1.92 to 4.64). Authors' conclusions: Dietary advice appears to be effective in bringing about modest beneficial changes in diet and cardiovascular risk factors over approximately 9 months but longer term effects are not known.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer)
Social Sciences (Includes Criminology and Education)
Subjects: H Social Sciences > HV Social pathology. Social and public welfare
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Additional Information: Pdf uploaded in accordance with publisher's policy at (accessed 07/03/2014).
Publisher: Wiley-Blackwell
ISSN: 1469-493X
Date of First Compliant Deposit: 30 March 2016
Last Modified: 04 Jun 2017 06:16

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