An organizational model to translate nutritional recommendations into routine clinical practice in secondary prevention of coronary artery disease.
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.
Aquilani
Roberto
R
Service of Metabolic and Nutritional Pathophysiology, Clinic of Labour and Rehabilitation, IRCCS, Scientific Institute of Montescano, Piazza Botta 11, 27100 Pavia, Italy.
Boni
Stefano
S
Verdirosi
Sandro
S
Pastoris
Ornella
O
Assandri
Jole
J
Rossi
Angelo
A
Paganini
Vincenzo
V
Riccardi
Roberto
R
Cajelli
Alberto
A
Pernice
Marcello
M
Verri
Manuela
M
Dossena
Maurizia
M
Cobelli
Franco
F
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
D002784:Cholesterol