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The effects of a Mediterranean-style diet in heart disease patients running a cardiac rehabilitation program
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ABSTRACT
Introduction: The Mediterranean dietary pattern is the standard recommended by
the European Society of Cardiology for the atherosclerosis prevention. However,
studies that evaluate dietary and nutritional intervention in cardiac rehabilitation
programs are still scarce.
Objective: The objective of this study was to compare the effectiveness of an intensive
food and nutritional intervention program with a program consisting of only monthly
appointments on predictive parameters of cardiovascular risk, including systolic
blood pressure, lipid and glucose profile, as measured by the SMART tool Risk Score.
Additionally, the study aimed to characterize the eligible individuals, evaluate the role
of nutritional and intensive food monitoring in adherence to the Mediterranean
dietary pattern, assess how adherence to this pattern improves body weight, body
composition, and other health outcomes, including biochemical parameters and
quality of life.
Methodology: This 12-week randomised controlled clinical trial involving 21 individuals
with acute myocardial infarction with ST-segment elevation undergoing primary
angioplasty and referred to a cardiac rehabilitation programs, divided into two groups:
intervention (n=11) and control (n=10). Both groups were subject to a food and
nutritional intervention program with monthly nutrition consultations in which the
adoption of the Mediterranean food pattern was promoted, and the intervention
group also had telephone contacts, short text messages, consultation support tools,
podcasts, free access short videos, cooking recipes and nutrition “workshops”. Blood
and urine samples were collected at baseline and at the end of the study, while blood
pressure was measured simultaneously. Adherence to the Mediterranean dietary
pattern was evaluated using the MEDAS questionnaire, along with data on dietary
intake from 24h recall. Additionally, the subject’s body composition was assessed
using bioimpedance and their quality of life was measured with the EQ-5D-5L
questionnaire at the start and conclusion of the study.
Results: After 12 weeks, in both groups there was a decrease in the 10-year risk of
developing acute myocardial infarction, cerebrovascular accident or vascular death,
with this decrease being significant in the control group (p=0.016). A significant
improvement in weight (p=0.008), body mass index (BMI) (p=0.008), waist
circumference (p=0.001) and fat mass in the trunk region (p=0.022) was observed in
the control group subjects and a significant improvement in the waist circumference
was additionally found in the intervention group (p=0.036). MEDAS score increased
significantly in both groups (p£0.001) and quality of life also increased, although the
difference was not significant in either group.
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Palavras-chave
Mediterranean