title: Cardiovascular risk reduction and dietary compliance with a home-delivered diet and lifestyle modification program.
abstract: Lack of adherence to diet contributes to ineffective dietary responsiveness and elevated cardiovascular risk factors in coronary heart disease (CHD) patients. Our purpose was to determine if home-delivered, heart-healthy meals and snacks, combined with telephone diet education, would be efficacious in improving dietary compliance, quality of life, and cardiovascular risk factors (primarily low-density lipoprotein [LDL] cholesterol and body weight) in CHD patients. Participants were 35 free-living subjects (21 men, 14 postmenopausal women) with a mean age of 62 (ranging from 40 to 79 years) in an 8-week diet intervention. A registered dietitian provided diet education over the telephone and weekly menus averaging 67% carbohydrate, 16% protein, 17% fat, 4% saturated fat, 5% monounsaturated fat, 128 mg cholesterol, and 25 g fiber. Lipid profiles, anthropometric measures, food records, and quality of diet, and life questionnaires were obtained at baseline, week 4, and week 8. Mean compliance-defined as percentage of prepared food energy consumed divided by percentage of prepared food energy provided-was 91% at 4 weeks and 88% at 8 weeks. After 8 weeks, significant reductions in weight (-3.7 kg), waist circumference (-2.0 in), hip circumference (-1.3 in), body mass index (-1.21 kg/m2), total cholesterol (-0.17 mmol/dL, -7.0 mg/dL), and LDL cholesterol (-0.19 mmol/dL, -7.5 mg/dL) (P<.05) were achieved without significant changes in high-density lipoprotein cholesterol (0.00 mmol/dL, 0.0 mg/dL) or triglycerides (+0.06 mmol/dL, +2.5 mg/dL). Significant improvements in quality of life and quality of diet (P < .05) were also demonstrated. This program could be a useful additive component to traditional medical nutrition therapy to improve dietary adherence.
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Mass 02111, USA. jaugustin@lifespan.org
authors.forename: Joi Augustin
authors.initials: JA
authors.lastname: Gleason
authors.forename: Kathy Lundburg
authors.initials: KL
authors.lastname: Bourdet
authors.forename: Karin
authors.initials: K
authors.lastname: Koehn
authors.forename: Sanja Y
authors.initials: SY
authors.lastname: Holay
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Schaefer
mesh_terms: D000328:Adult; D000368:Aged; D008078:Cholesterol, LDL / Q000097:blood; D003327:Coronary Disease / Q000097:blood / Q000178:diet therapy*; D004041:Dietary Fats / Q000008:administration & dosage; D004045:Dietary Services / Q000379:methods; D005260:Female; D005522:Food Services; D006699:Home Care Services; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011788:Quality of Life; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D008078:Cholesterol, LDL; D004041:Dietary Fats