Is Cardiac Rehabilitation Equally Effective in Improving Dietary Intake in All Patients with Ischemic Heart Disease?

OBJECTIVE: To investigate the association between sociodemographic characteristics and changes in dietary intake in patients with ischemic heart disease who were following a cardiac rehabilitation program. METHODS: Longitudinal study among patients with first-time admission to outpatient cardiac rehabilitation after ST-elevation myocardial infarction, non-ST-elevation myocardial infarction, unstable angina pectoris or stable angina pectoris. We used a validated self-administered food frequency questionnaire to assess the dietary intake before rehabilitation, post rehabilitation and 6 months after baseline. The intake was summarized into a fat and fish-fruit-vegetable score for both sexes. To assess the within-patient differences in dietary scores, a paired t-test was applied. Regression analyses were performed to assess the association between sociodemographic characteristics and changes in diet. RESULTS: 186 patients completed two measurements, 157 patients completed all three measurements. Fat and fish-fruit-vegetable scores increased statistically significantly and improvements remained statistically significant at follow-up. Fat scores increased less in employed men than in retired men (-11 (95% CI -17; -5)). Fish-fruit-vegetable scores increased less in men with a bachelor degree than in men with a vocational education (-8 (95% CI -13; -3)) as well as in retired women compared with employed women (-18 (95% CI -32; -4)). CONCLUSIONS: Patients statistically significantly improved their dietary intake and improvements remained at follow-up. Dietary improvements were sensitive to marital status, living arrangements and employment status. Unemployed and retired women did not seem to improve their diet as much as employed women. Additional dietary intervention may become relevant in some patient groups defined by sociodemographic characteristics. (250).

Educational level and living arrangements are associated with dietary intake of red meat and fruit/vegetables: A Danish cross-sectional study.

Aims: To evaluate the association between education and living arrangements and the intake of fish, red meat and fruit and vegetables.Methods: The study design was cross-sectional and conducted in Denmark in 2013. Participants filled in questionnaires about their educational level and living arrangements (living alone or with others) and dietary intake including fish, red meat, fruit and vegetables. Regression analyses were performed to assess the associations within 85,456 randomly sampled healthy men and women who were at least 25 years old.Results: Length of education was statistically significant and positively associated with the intake of fruit and vegetables and negatively associated with the intake of red meat for both men and women. Men with a high level of education had a 187g/week (95% confidence interval: 199-175g/week) lower intake of red meat and a 109g/day (95% confidence interval: 102-117g/day) higher intake of fruit and vegetables than men with a low level of education. Women with a high level of education had a 175g/week (95% confidence interval: 186-164g/week) lower intake of red meat and a 106g/day (95% confidence interval: 97-114g/day) higher intake of fruit and vegetables than women with a low level of education. Living with others was statistically significant and positively associated with the intake of red meat, and fruit and vegetables. There were no clear associations between education, living arrangements and intake of fish.Conclusions: Men and women with a high educational level ate more fruit and vegetables but less red meat than men and women with a low educational level. Men and women living with others ate more red meat, fruit and vegetables than men and women living alone.

Validation of the HeartDiet questionnaire.

INTRODUCTION: Reliable dietary information is crucial for measuring the habitual diet of healthy participants and patients with dyslipidaemia and/or coronary heart disease (CHD). Even so, methods are often complicated and time-consuming for everyone involved. We aimed to validate the new food frequency questionnaire (FFQ) named HeartDiet by comparing it to a validated 198-item FFQ and biomarkers. METHODS: Healthy local participants (n = 100) and participants with CHD from Aalborg University Hospital (n = 100) randomly completed HeartDiet and the 198-item FFQ. Biomarkers were analysed in a random sample of 50 healthy participants. Scatter plots and Spearman's rank correlation coefficient were used for statistics. RESULTS: We found a highly significant statistical correla-tion between the intake of fruit (ρ = 0.70; 95% confidence interval (CI): 0.62-0.76), vegetables (ρ = 0.54; 95% CI: 0.44-0.64), fish (ρ = 0.75; 95% CI: 0.68-0.81) and saturated fatty acids (ρ = -0.51; 95% CI:-0.61--0.40) measured by the HeartDiet and the 198-item FFQ. Also, correlations between the HeartDiet and serum ß-carotene and serum n-3 polyunsaturated fatty acids were statistically significant (fruit and vegetables: ρ = 0.59; 95% CI: 0.37-0.74, and fish: ρ = 0.45; 95% CI: 0.19-0.65). CONCLUSIONS: HeartDiet is well aligned with results from a semi-quantitative FFQ and biomarkers, and it is a practical, easy and quick-to-use tool to describe and monitor if a diet is heart-healthy or not. FUNDING: The study was supported by the Danish Heart Association. TRIAL REGISTRATION: not relevant.