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Effects of a Web-Based Nutrition Counseling on Food Intake and Serum Lipids in Hyperlipidemic Patients

웹기반 영양상담이 고지혈증 환자의 식사섭취 및 혈청 지질에 미치는 영향

  • Kim, Jong-Suck (Dept. of Food Science and Nutrition, Pusan National University) ;
  • Han, Ji-Sook (Dept. of Food Science and Nutrition, Pusan National University)
  • 김종숙 (부산대학교 식품영양학과) ;
  • 한지숙 (부산대학교 식품영양학과)
  • Published : 2004.10.01

Abstract

The purpose of this study was to investigate whether a web-based nutrition counseling could lead to beneficial outcomes in food intake and serum lipids of patients with hyperlipidemia. Forty hyperlipidemic patients, twenty of them were hypercholesterolemia and the other twenty were hypertriglyceridemia, participated in a web-based nutrition counseling program. At the first nutrition counseling, the patients were counselled through interview and then follow up nutrition counseling was accomplished four times during eight weeks through a web-based internet program. Various markers of disease risk including anthropometric indices, food intakes and serum lipid levels were measured before and after the web-based nutrition counseling. After nutrition counseling, body mass index significantly decreased in both groups and waist to hip ratio significantly decreased in male hypercholesterolemic patients (p<0.05). Total-cholesterol decreased from 262.2 mg/dL to 234.9 mg/dL, LDL-cholesterol decreased from 186.8 mg/dL to 160.5 mg/dL in hypercholesterolemic patients, triglyceride decreased from 288.6 mg/dL to 211.9 mg/dL and total-cholesterol decreased from 217.2 mg/dL to 198.7 mg/dL in hypertriglyceridemic patients after nutrition counseling. Anthropometric value and nutrient intakes were improved after nutrition counseling. Energy, fat and saturated fatty acid intakes decreased significantly in both groups (p<0.05). Therefore, this study shows that the web-based nutrition counseling is effective in improving food habit and influences positively in serum lipid levels of the patients. In addition, these results indicate that internet presents us with potential as a new medium for nutrition counseling in informationized society.

본 웹기반 영양상담 프로그램은 전보(17)에서 개발된 고지혈증환자를 위한 영양상담 프로그램에 환자들의 추후관리를 위해 재진상담 프로그램을 개발하여 삽입하였다. 개발된 재진상담 프로그램은 식습관 조사, 식품섭취빈도 조사 및 온라인 상담 파일로 구성되었으며 온라인 상담 파일에 채팅룸을 두어 환자들과 실시간으로 상담할 수 있도록 하였다. 8주간의 웹을 이용한 영양상담 후 신체계측치의 변화에서 체질량지수는 고콜레스테롤혈증군과 고중성지방혈증군 모두에서 감소하였고, 허리/엉덩이 둘레비는 고콜레스테롤혈증군 중 남자에게서 유의하게 감소하였다(p<0.05). 혈청 지질의 변화는 고콜레스테롤혈증군은 총콜레스테롤과 LDL-콜레스테롤이 영양상담 후에 유의하게 감소하였고(p<0.01), 고중성지방혈증군은 중성지방이 유의하게 감소하였으며(p<0.01), HDL-콜레스테롤은 유의하게 증가하였다(p<0.05). 영양소 섭취의 변화는 두군 모두에서 영양상담 후에 에너지 섭취량이 감소하였고 특히 열량영양소 중 지방의 섭취량이 51.9∼52.5 g에서 영양상담 후 32.5∼33.3 g으로 유의하게 감소하였다(p<0.01). 그러나 1,000 kcal당 영양소 섭취량을 비교하여 보면 영양상담 후 환자들은 열량은 낮으면서 영양소 밀도가 높은 식품을 선택하여 비타민 B$_1$과 B$_2$는 유사하게 섭취하였으며 비타민 C, 칼슘 및 철분은 오히려 높게 섭취하였다. 지방산 섭취의 변화는 영양상담 후 두군 모두에서 포화지방산의 섭취량이 유의하게 감소하였으며, 이로 인해 포화지방산, 단일불포화지방산, 다가불포화지방산의 섭취비율이 고지혈증 치료지침의 권장비율에 속하였다. 콜레스테롤 섭취량 역시 영양상담 후에 유의하게 감소하였다(p<0.01). 이러한 연구의 결과로 웹상에서의 재진상담을 통하여 지속적이고 반복적인 추후관리가 효율적으로 이루어짐 에 따라 고지혈증 환자에게 바람직한 식사섭취형태가 정착되고, 혈청 지질에도 긍정적인 효과를 줌으로서 정보화 시대에 맞는 새로운 영양상담 매체로서의 인터넷의 가능성을 제시하였다.

Keywords

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