Living with a very low fat diet

Abstract

Aims: This study investigated compliance with the very low fat diet used by some clinics in the UK to treat severe hypertriglyceridemia and the patients’ experience of the diet. Methodology: Eight adults with severe hypertriglyceridemia attending the Lipid Clinic at Manchester Royal Infirmary, Manchester, UK took part in the study. Compliance with the therapeutic diet was assessed by analysis of telephone based diet histories and diet diaries using dietary assessment software. The patients’ experience of the diet was investigated using telephone based semi-structured qualitative interviews and analysed using thematic analysis. Main findings: The diet histories revealed the mean percentage energy contribution from fat was 22.5%. This is significantly higher than the target of 15% prescribed by the very low fat diet. The qualitative interviews revealed that patients considered complete compliance difficult. The patients understood the health benefits of the diet. Their level of adherence was affected by their perception of vulnerability to the health consequences of non-adherence. Barriers to adherence included lack of accessible nutritional information, increased patient burden, lack of appropriate food choices, other peoples’ ignorance with regard to the diet, lack of flavour and variety in the diet, a desire to broaden the palate, cost, social pressure to conform and negative experiences with dietitians. Enablers to compliance included nutritional awareness, desire to maintain good health, building on their nutritional knowledge base, behaviour and lifestyle modification, developing a routine, the support of family and friends and supportive eating environments. Conclusions: Compliance with the very low fat diet could be improved through extensive education on labelling, eating during special occasions such as Christmas, birthdays and eating out of home. Dietetic professionals need to work with food retailers and outlets to promote clear disclosure of the nutritional content of food to facilitate adherence to therapeutic diets.