Does nutrition counselling combined with a cooking program improve blood vessel function for patients with vascular disease?

Participants randomised to the intervention arm will attend a student led nutrition service. The nutrition care process will be delivered in four stages, (1) an initial assessment (for both intervention and control), (2) an individualised 30 minute education session (intervention only), (3) a cooking skills and education program delivered via six sessions over 12 weeks (intervention only), and (4) review and discharge (for both intervention and control). The assessment will incorporate anthropometry (e.g. height, weight, waist circumference) and a diet history. Students will report their findings at a team meeting and then an individualised education session that focusses on realistic dietary modification to improve diet quality consistent with established evidence for preventing progression of PVD will occur. A cooking skills and education program will be delivered by a dietetic student under the supervision of an Accredited Practicing Dietitian, using a small group format (6-10 participants per group) fortnightly over 12 weeks with hands-on interactive sessions focussed on cooking skills, cooking methods, dietary fat and fibre, dietary sodium, antioxidants and the benefits of seasonal produce, energy balance and label reading, and dietary supplements. Each session will be 2-3 hours duration and will consist of an education session followed by a hands-on cooking session and will finish with participants gathering to eat what has been cooked during the session, Attendance will be recorded for all cooking sessions, baseline and post-intervention clinic visits. The cooking skills and education program will be evaluated post-program for changes in cooking skills, knowledge and confidence The review and discharge session will incorporate a review of improvements made, any questions arising from the cooking skills and education program will be addressed and strategies discussed to make changes long term and sustainable. The assessment, individualised education session and review/discharge session will be supervised by an academic Accredited Practising Dietitian of Flinders University who will progressively reduce their input as student competence increases. The cooking skills program will be supervised by an Accredited Practising Dietitian employed by SPROUT cooking school. Follow up Peripheral vascular disease progressions will be monitor in all participants through a medical record audit. Any data on hospital admissions, revascularisation procedures and other related examinations and procedures (e.g. blood tests and angiogram results) will be extracted from medical records. 1. Laboratory assessment. Fasting blood samples will be collected by a trained phlebotomist. Samples will be analysed for High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL), triglycerides, total cholesterol, C-reactive protein, absolute neutrophils and lymphocytes. LDL-C concentrations will be calculated using the Friedewald equation. 2. Other assessment (e.g. radiological). Blood pressure (systolic and diastolic blood pressure) measurements will be taken using a sphygmomanometer. Flow mediated dilation tests will be conducted using a sphygmomanometer and ultrasound equipment. Both measurements and tests will be conducted by a trained researcher. 3. Monitoring adverse effects (e.g. emotional, psychological and physical): Staff will be required to undergo full immunisation screening and criminal history check to ensure no risk is placed to this vulnerable population group. Staff and participants will undergo an induction, consisting of occupational health and safety training prior to the cooking and nutrition classes at Sprout cooking school. As there is no pharmacological drug being tested in this research study, there are negligible chances of any adverse effect. Any harm to a participant should be reported to a member of the research team immediately.