title: An organizational model to translate nutritional recommendations into routine clinical practice in secondary prevention of coronary artery disease.
abstract: BACKGROUND
  We hypothesized that nutritional risk factors can be reduced routinely in all patients with coronary artery disease (CAD) by modifying general hospital catering into "antiatherogenic catering" and providing patients with an education program.
  
  
  METHODS
  General nutritional rules were applied to transform the standard alimentary regimen of our catering service (lipids 30% energy) into antiatherogenic catering (lipids 20% energy). The educational program (EP) consisted of a nutritional manual and 4 h/week of lessons. Eighty male patients (pts) with CAD (54 +/- 13 years), 10 +/- 4 days after an acute coronary event, were randomly allocated by cardiologists to a lipids 30% energy (control group = 40 pts) or to a lipids 20% energy diet (previously deposited in our catering service) + EP (treatment group = 40 pts). Serum total cholesterol (T-Chol), HDL- (HDL-Chol), LDL- (LDL-Chol), triglycerides (Trig), and body mass index (BMI) were determined before and after the 21-day treatment.
  
  
  RESULTS
  Lipids 20% energy reduced T-Chol (P < 0.001), LDL-Chol (P < 0.001), and Trig (P < 0.05), while lipids 30% worsened T-Chol and LDL-Chol. The changes in the lipid parameters resulted in significant differences between the two groups.
  
  
  CONCLUSIONS
  Simple reorganization of hospital catering and an educational program may routinely reduce nutritional risk factors in CAD patients, without individual counseling by the nutrition team.
authors.affiliation: Service of Metabolic and Nutritional Pathophysiology, Clinic of Labour and Rehabilitation, IRCCS, Scientific Institute of Montescano, Piazza Botta 11, 27100 Pavia, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Aquilani
authors.forename: Stefano
authors.initials: S
authors.lastname: Boni
authors.forename: Sandro
authors.initials: S
authors.lastname: Verdirosi
authors.forename: Ornella
authors.initials: O
authors.lastname: Pastoris
authors.forename: Jole
authors.initials: J
authors.lastname: Assandri
authors.forename: Angelo
authors.initials: A
authors.lastname: Rossi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Paganini
authors.forename: Roberto
authors.initials: R
authors.lastname: Riccardi
authors.forename: Alberto
authors.initials: A
authors.lastname: Cajelli
authors.forename: Marcello
authors.initials: M
authors.lastname: Pernice
authors.forename: Manuela
authors.initials: M
authors.lastname: Verri
authors.forename: Maurizia
authors.initials: M
authors.lastname: Dossena
authors.forename: Franco
authors.initials: F
authors.lastname: Cobelli
mesh_terms: D002784:Cholesterol / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000178:diet therapy / Q000517:prevention & control*; D018752:Diet, Fat-Restricted; D005521:Food Service, Hospital / Q000458:organization & administration*; D006801:Humans; D007558:Italy; D008297:Male; D017146:Models, Organizational; D018673:Nutrition Policy; D010353:Patient Education as Topic / Q000458:organization & administration*; D010865:Pilot Projects
chemical_list: D002784:Cholesterol