title: The long-term effect of dietary advice in men with coronary disease: follow-up of the Diet and Reinfarction trial (DART).
abstract: OBJECTIVE
  To assess the long-term effect of dietary advice on diet and mortality after a randomised trial of men with a recent history of myocardial infarction.
  
  
  METHODS
  Questionnaire survey and mortality follow-up after a trial of dietary advice.
  
  
  METHODS
  Twenty-one hospitals in south Wales and south-west England.
  
  
  METHODS
  Former participants in the Diet and Reinfarction Trial.
  
  
  METHODS
  Current fish intake and cereal fibre intake. All-cause mortality, stroke mortality and coronary mortality.
  
  
  RESULTS
  By February 2000, after 21147 person years of follow-up, 1083 (53%) of the men had died. Completed questionnaires were obtained from 879 (85%) of the 1030 men alive at the beginning of 1999. Relative increases in fish and fibre intake were still present at 10 y but were much smaller. The early reduction in all-cause mortality observed in those given fish advice (unadjusted hazard 0.70 (95% CI 0.54, 0.92)) was followed by an increased risk over the next 3 y (unadjusted hazard 1.31 (95% CI 1.01, 1.70). Fat and fibre advice had no clear effect on coronary or all-cause mortality. The risk of stroke death was increased in the fat advice group-the overall unadjusted hazard was 2.03 (95% CI 1.14, 3.63).
  
  
  CONCLUSIONS
  In this follow-up of a trial of intensive dietary advice following myocardial infarction we did not observe any substantial long-term survival benefit. Further trials of fish and fibre advice are feasible and necessary to clarify the role of these foods in coronary disease.
authors.affiliation: Department of Social Medicine, University of Bristol, Bristol, UK. Andy.Ness@bris.ac.uk
authors.forename: A R
authors.initials: AR
authors.lastname: Ness
authors.forename: J
authors.initials: J
authors.lastname: Hughes
authors.forename: P C
authors.initials: PC
authors.lastname: Elwood
authors.forename: E
authors.initials: E
authors.lastname: Whitley
authors.forename: G D
authors.initials: GD
authors.lastname: Smith
authors.forename: M L
authors.initials: ML
authors.lastname: Burr
mesh_terms: D000818:Animals; D003327:Coronary Disease / Q000178:diet therapy* / Q000401:mortality; D004034:Diet Surveys; D004041:Dietary Fats / Q000008:administration & dosage*; D004043:Dietary Fiber / Q000008:administration & dosage*; D002523:Edible Grain; D005399:Fishes; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000178:diet therapy* / Q000401:mortality; D010349:Patient Compliance; D012008:Recurrence; D012307:Risk Factors; D017747:Seafood; D020521:Stroke / Q000178:diet therapy / Q000401:mortality; D011795:Surveys and Questionnaires; D016019:Survival Analysis
chemical_list: D004041:Dietary Fats; D004043:Dietary Fiber