Dietitians make the difference

Dietitians make the difference - A Systematic Review of the Effectiveness of Nutrition Counselling Interventions by Dietitians

In 2009, the Dietitians of Canada Consulting Dietitians Network conducted a systematic review of the literature to answer two research questions:

• What is the effectiveness of nutrition interventions by a dietitian in an outpatient setting for the prevention or treatment of the major chronic conditions – obesity, diabetes, cardiovascular and kidney disease?

• What is the effectiveness of health promotion interventions by dietitians in the workplace?

A two-page flyer that highlights the findings for consumers, employers and health plan providers was developed. The full review and a highlights of the review was also prepared.

For the review,interventions were considered that focused on improvement in clinical outcomes and reduced health care costs, and reduced employer costs (including reduction in absenteeism or disability or improvement in productivity).

Medline, CINAHL, Cochrane and Web of Science databases were searched to identify systematic literature reviews, meta-analyses, clinical practice guidelines and narrative reviews (from 2000 - 2008) and primary research articles (1995 – 2008 articles not included in literature reviews). The search was restricted to English language articles examining nutrition interventions in adults relevant to a Canadian outpatient setting (e.g. community health centre, ambulatory medical clinic) or workplace setting.

Based on the review, it was concluded that nutrition interventions that include nutrition counselling by a registered dietitian targeting at-risk groups, can improve health outcomes and be delivered at a low cost or be cost-effective. The strongest evidence was identified for diabetes in which intensive lifestyle intervention programs (including a combination of diet therapy and exercise to achieve weight loss), were effective at reducing diabetes risk in high-risk individuals and are cost-effective