A dietitian-delivered group nutrition program leads to reductions in dietary fat, serum cholesterol, and body weight: the Worcester Area Trial for Counseling in Hyperlipidemia (WATCH)

UMMS Affiliation

Department of Medicine, Division of Preventive and Behavioral Medicine; Department of Medicine, Division of Cardiovascular Medicine

Publication Date


Document Type



Adult; Aged; Body Weight; Cholesterol; Cholesterol, LDL; Counseling; *Diet, Fat-Restricted; *Dietetics; Exercise; Female; Follow-Up Studies; Humans; Hyperlipidemias; Male; Massachusetts; Middle Aged; Motivation; *Nutrition Physiology; *Patient Education as Topic; Patient Selection; Social Support; *Weight Loss


Behavioral Disciplines and Activities | Dietetics and Clinical Nutrition | Health Services Research | Preventive Medicine


OBJECTIVE: To assess the effectiveness of a dietitian-based nutrition counseling and education program for patients with hyperlipidemia.

DESIGN: A 4-session program implemented as a complement to a randomized physician-delivered intervention.

SUBJECTS/SETTING: From 12 practice sites of the Fallon Clinic, 1,162 subjects with hyperlipidemia were recruited, 645 of whom had data sufficient for our primary analyses.

INTERVENTION: Two individual and 2 group sessions conducted over 6 weeks.

MAIN OUTCOME MEASURES: Total and saturated fat levels; serum low-density lipoprotein cholesterol levels; and body weight, measured at baseline and after 1 year.

STATISTICAL ANALYSES: Multiple linear regression was used to evaluate changes in outcome measures.

RESULTS: After 1 year, there were significant reductions in outcome measures for subjects attending 3 or 4 nutrition sessions vs subjects attending fewer than 3 sessions or those never referred to a nutrition session. Reductions (mean +/- standard error) in saturated fat (measured as percent of energy) were 2.7 +/- 0.5%, 2.1 +/- 0.5%, and 0.3 +/- 0.1%, respectively. These reductions correspond to roughly a 22% relative change from baseline in those attending 3 or 4 sessions. Corollary reductions were observed for total fat (measured as percent of energy): 8.2 +/- 1.4%, 5.0 +/- 1.4%, and 0.7 +/- 0.4%; low-density lipoprotein cholesterol: 0.48 +/- 0.11 mmol/L, 0.13 +/- 0.11 mmol/L, and 0.02 +/- 0.03 mmol/L; and body weight: 4.5 +/- 0.9 kg, 2.1 +/- 0.8 kg, and 1.1 +/- 0.2 kg. The specified changes were additive to those of the physician-delivered intervention.

APPLICATIONS/CONCLUSIONS: This investigation provides empirical data demonstrating the effectiveness of a dietitian-delivered intervention in the care of patients with hyperlipidemia.


J Am Diet Assoc. 1999 May;99(5):544-52.

Journal/Book/Conference Title

Journal of the American Dietetic Association

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Link to article in PubMed

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