Behavior change outcomes in an outpatient cardiac rehabilitation program.
OBJECTIVE
To evaluate the effectiveness of nutrition education within an outpatient cardiac rehabilitation program.


METHODS
Subjects were assigned, according to participation in cardiac rehabilitation programs in two community hospitals within an integrated healthcare system, to either a treatment (n=54), or a control group (n=50).


METHODS
One hundred four men and women, age range 35 to 85 years, participating in a 6-week cardiac rehabilitation program. Most were men (80%) and overweight. The majority presented with the diagnosis of myocardial infarction followed by coronary artery bypass surgery or percutaneous transluminal coronary angiography procedure.


METHODS
Subjects in the control group received usual nonindividualized nutrition education from cardiac rehabilitation therapists. Subjects in the treatment group attended two group nutrition education classes and one individual diet counseling session, all led by the same dietitian.


METHODS
Changes in fat, saturated fat, cholesterol, and carbohydrate intake, and restaurant eating habits as assessed by the Diet Habit Survey; changes in cardiac diet self-efficacy; and changes in health-related quality of life. Statistical analyses performed Group-by-time analysis of variance with repeated measures, chi2 test.


RESULTS
The treatment group had greater improvement in Restaurant and Recipes scores on the Diet Habit Survey (2.6 vs 1.0) and a greater cardiac diet self-efficacy mean score (4.3) compared with the control group (3.8), with the greatest change in items related to eating in restaurants, away from home, or when alone. From entry into the program to discharge, the cholesterol-saturated fat index decreased significantly in the control group (from 57 to 48), and in the treatment group (from 51 to 42). The percent of energy from carbohydrate increased significantly in the control group (from 51% to 55%) and in the treatment group (from 53% to 57%). There were no differences between groups over the 3 time periods (baseline, 6 weeks, and 3-month follow-up) (n=39 for control group and n=47 for treatment group for all 3 time periods).


CONCLUSIONS
Nutrition education within an outpatient cardiac rehabilitation program can improve dietary choices at restaurants and boost self confidence in the ability to adhere to a lipid-lowering diet.
Timlin
Maureen T
MT
University of Minnesota, Department of Food Science and Nutrition, St. Paul 55108, USA.
Shores
Kevin V
KV
Reicks
Marla
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D001521:Behavior Therapy / Q000379:methods*; D000072038:Cardiac Rehabilitation; D002318:Cardiovascular Diseases / Q000178:diet therapy; D001026:Coronary Artery Bypass / Q000534:rehabilitation; D004041:Dietary Fats / Q000008:administration & dosage*; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000178:diet therapy / Q000534:rehabilitation; D052756:Nutritional Sciences / Q000193:education*; D010353:Patient Education as Topic; D015397:Program Evaluation; D011788:Quality of Life; D012147:Restaurants; D020377:Self Efficacy; D016896:Treatment Outcome
D004041:Dietary Fats