It’s hardly news that the leading cause of death here in USA is coronary heart disease (CHD). At present more than 13 million Americans have had and survived a heart attack or have been diagnosed with CHD. However, what is news is that these survivors are not mending their dietary ways.

According to a study done by researchers at the University of Massachusetts Medical School (UMMS), a substantial portion of heart attack patients do not adhere to the health diet guidelines prescribed by their doctors.

UMMS scientists assessed the diet of 555 CHD patients one year after they had had a diagnostic coronary angiography, using the Alternative Health Eating Index (See page 192) to determine dietary quality. In-a-word, the AHEI basically helps zero in on dietary components that are most strongly linked to CHD risk reduction. Of a maximum 80 points—which indicates the healthiest diet—the average AHEI score for the 555 CHD patients was 30.8!

To determine the quality of CHD patients’ diets, UMMS assistant professor of medicine Dr. Yunsheng Ma and colleagues collected data from a 24-hour dietary recall (one year after the participants’ CHD diagnoses). The dietary recall is administered by a dietitian who works with patient to explore his or her entire food intake from a specific 24-hour period, including complete food descriptions, how they were prepared and the amount consumed. This information produced nutrient scores from which the AHEI was calculated to determine dietary quality. The AHEI includes intake of fruits, vegetables, soy and nuts, the ratio of white to red meat, intake of cereal fiber, trans-fat, the ratio of polyunsaturated fat to saturated fat, and alcohol.

“This study found that CHD patients’ diets had not improved in the year after being diagnosed,” said Yunsheng Ma, MD, PhD, MPH, UMMS assistant professor of medicine and one of the study’s lead authors. “We know that a healthy diet is one of the most important components of a healthy lifestyle, especially for patients following a cardiac event, and yet patients are not acting on this knowledge.”

In a previous study by Dr. Ma and colleagues, the AHEI of several popular weight loss plans was calculated; the highest scoring diet was the Ornish Diet (AHEI = 64.6) and lowest scoring diet was the Atkins diet (AHEI= 42.3).  

o       12.4 percent of the study participants were consuming the optimal daily consumption of vegetables and 7.8 percent for fruit.

o       Only 5.2 percent of the participants limited their trans-fat intake to 0.5 percent of total calories or less.

o       Nearly 11 percent of calories were from saturated fat (less than 7 percent is the recommended intake level)

o       Total fiber was only 16.8 grams per day (25 grams or more per day is the recommended intake).

The researchers looked at each patient’s diet in relation to socio-demographic and clinical standings to see what might account for their low dietary quality. What they found was an association between low dietary quality and smoking, lower educational levels, high-fat intake, obesity and a lower calorie intake. According to the findings, on average study participants with education beyond high school scored three units higher than those with a high school education, while smokers scored six units lower than non-smokers, and obese participants scored four units lower than normal weight or overweight participants.

According to Barbara Olendzki, RD, MPH, a study co-author and UMassMemorialMedicalCenter registered dietitian and assistant professor of medicine at UMMS, “Physicians and health care providers should consider placing more of an emphasis on dietary counseling, along with exercise, for CHD patients. Nutrition counseling and patient dietary changes can lead to significant improvements in subsequent CHD risk and better quality of life.”

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The study titled “Dietary Quality 1 Year after Diagnosis of Coronary Heart Disease,” was published in the February issue of the Journal of the American Dietetic Association.

University of MassachusettsMedicalSchool (2008, February 1). Patients Diagnosed With Coronary Heart Disease Continue Poor Diets, Study Shows. ScienceDaily. Retrieved February 22, 2008, from http://www.sciencedaily.com­ /releases/2008/01/080130130617.htm