Effect of nutritional counselling and nutritional plus exercise counselling in overweight adults: a randomized trial in multidisciplinary primary care practice

• Published in: Family practice 2010-04, Vol.27 (2), p.143-150
• Main Authors: Molenaar, Esther A, van Ameijden, Erik JC, Vergouwe, Yvonne, Grobbee, Diederick E, Numans, Mattijs E
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Combined Modality Therapy; Counseling; Counselling; Exercise; Female; Humans; Life Style; lifestyle; Male; Medicine; Middle Aged; Nutrition; Nutrition Assessment; Obese people; obesity; Obesity - prevention & control; Outcome Assessment (Health Care) - methods; overweight; Overweight - diet therapy; primary care; Weight loss; Young Adult
• ISSN: 0263-2136; 1460-2229
• DOI: 10.1093/fampra/cmp104

Objective. To compare the effects of nutritional counselling with nutritional plus exercise counselling on body weight and waist circumference in overweight adults in a multidisciplinary primary care setting. Methods. One hundred and thirty-four overweight adults (body mass index 28–35) were randomly assigned to individual counselling sessions by a dietician (D) or counselling sessions by a dietician plus physiotherapist (D + E) during 6 months with one follow-up session at 12 months. Outcomes were assessed at baseline, 6 and 12 months. Difference in changes of outcome measures between groups were analysed using generalized estimating equations. Results. Weight reduced from baseline to 6 months in D [−2.2 (−3.1 to −1.4) kg] and D + E [−3.0 (−4.0 to −2.0) kg] and was sustained at 12 months [−2.0 (−3.1 to −1.4) kg and −3.1 (−4.5 to −1.6) kg, respectively]. The reduction in weight did not significantly differ between D and D + E (P = 0.48). In both groups, waist circumference decreased from baseline to 6 months [−2.1 (−3.3 to −0.8) cm for D; −3.7 (−5.1 to −2.3) cm for D + E] and was sustained at 12 months [−2.1 (−3.5 to −0.7) cm and −4.2 (−6.0 to −2.5) cm, respectively]. Participants in D + E tended to decrease their waist circumference more than those in D (P = 0.14). Discussion. Nutritional counselling by a dietician resulted in modest reductions in weight and waist circumference in overweight adults, which were sustained up to 12 months. Adding exercise counselling by a physiotherapist did not significantly enhance the effect on body weight. Exercise counselling may, however, further improve waist circumference.