title: Physician advice, patient actions, and health-related quality of life in secondary prevention of stroke through diet and exercise.
abstract: OBJECTIVE
  Healthy diet and exercise are recommended for secondary prevention in stroke patients. We examined the prevalence of persons with stroke who received physician advice for, and engaged in, dietary change and exercise, and we also sought to determine whether engaging in these actions was associated with differences in health-related quality of life (HRQOL).
  
  
  METHODS
  Data are from 51 193 participants in the 1999 Behavioral Risk Factor Surveillance System, a state-based telephone survey. The participants noted whether they were advised to eat fewer high fat/high cholesterol foods and to exercise more and whether they engaged in these activities. HRQOL measures were the reported number of the preceding 30 days when physical health was not good, mental health was not good, usual activities were limited, and both physical and mental health were good (healthy days).
  
  
  RESULTS
  Overall, 2.4% of the participants reported a history of stroke. Sixty-one percent of those who reported a history of stroke had been advised to eat fewer high fat/high cholesterol foods, and 85.4% of those who had received such advice reported a dietary change compared with 56.0% of those who did not receive such advice. Almost 64% of those who reported a stroke had been advised to exercise more, and 76.5% of those who received such advice reported exercising more versus 38.5% of those who did not receive such advice. Persons with stroke who reported exercising had fewer limited activity days and days when physical health was not good and more healthy days than did persons who did not exercise. Dietary actions were not associated with differences in HRQOL.
  
  
  CONCLUSIONS
  Results highlight the importance of provider advice for secondary prevention among persons with stroke.
authors.affiliation: Cardiovascular Health Branch, Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga 30341, USA. keg9@cdc.gov
authors.forename: Kurt J
authors.initials: KJ
authors.lastname: Greenlund
authors.forename: Wayne H
authors.initials: WH
authors.lastname: Giles
authors.forename: Nora L
authors.initials: NL
authors.lastname: Keenan
authors.forename: Janet B
authors.initials: JB
authors.lastname: Croft
authors.forename: George A
authors.initials: GA
authors.lastname: Mensah
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003376:Counseling; D004032:Diet; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D011159:Population Surveillance; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000517:prevention & control*; D014481:United States / Q000453:epidemiology