title: Sustained positive impact of a coronary rehabilitation programme on adherence to dietary recommendations.
abstract: BACKGROUND
  Nutrition has a major influence after coronary events but long-term adherence to dietary advice is poorly evaluated.
  
  
  OBJECTIVE
  To evaluate if a cardiovascular rehabilitation programme including dietary counselling has a positive impact on adherence to dietary recommendations.
  
  
  METHODS
  Two groups of coronary patients were compared in an observational non-randomized study. Group I included 32 patients at the acute phase of a coronary syndrome and group II included 104 patients between six months and three years after completing a cardiovascular rehabilitation programme. The evaluation was performed with (1) a validated 14-item food frequency questionnaire (FFQ), which gives scores for the consumption of saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), Omega-6 and Omega-3 polyunsaturated fatty acids (PUFA), fruits and vegetables, and a global cardiovascular protective dietary score; and (2) biological markers.
  
  
  RESULTS
  SFA score was higher in group I vs II (7.4+/-2.8 vs 4.4+/-2.1, p<0.001) whereas Omega-3 PUFA (2.2+/-2.0 vs 4.7+/-2.1, p<0.001), fruit and vegetables score (3.3+/-1.4 vs 4.3+/-1.7, p=0.001) and global dietary score (-1.1+/-4.5 to 7.0+/-4.9, p<0.001) were higher in group II. The Omega-6:Omega-3 PUFA ratio was higher in group I (14.2+/-12.7 vs 6.3+/-5.4, p<0.001). Biological markers showed higher plasma contents of Omega-3 PUFA (4.05+/-1.70% vs 2.80+/-1.07%, p<0.001), folate (19.7+/-12.2 nmol/L vs 13.0+/-5.0 nmol/L, p<0.001) and vitamin C (7.60+/-3.99 mg/L vs 4.18+/-3.46 mg/L, p<0.001), and a higher erythrocyte membrane Omega-3 PUFA content (6.60+/-2.19% vs 5.38+/-2.17%, p=0.016) in group II vs I.
  
  
  CONCLUSIONS
  Using a short FFQ, this study showed sustained improvement in dietary habits in patients with coronary heart disease who receive nutritional education during a cardiovascular rehabilitation programme.
authors.affiliation: Cardiovascular Prevention Center, Cardiology Department, CHU Pontchaillou, 2, rue Henri-le-Guilloux, 35033 Rennes cedex 9, Rennes, France.
authors.forename: Christèle
authors.initials: C
authors.lastname: Froger-Bompas
authors.forename: Bruno
authors.initials: B
authors.lastname: Laviolle
authors.forename: Pascal
authors.initials: P
authors.lastname: Guillo
authors.forename: Catherine
authors.initials: C
authors.lastname: Letellier
authors.forename: Karine
authors.initials: K
authors.lastname: Ligier
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Daubert
authors.forename: François
authors.initials: F
authors.lastname: Paillard
mesh_terms: D000328:Adult; D001205:Ascorbic Acid / Q000097:blood; D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000178:diet therapy* / Q000534:rehabilitation*; D003376:Counseling; D004910:Erythrocyte Membrane / Q000737:chemistry; D005231:Fatty Acids, Unsaturated / Q000097:blood; D005247:Feeding Behavior; D005492:Folic Acid / Q000097:blood; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D010349:Patient Compliance; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D040242:Risk Reduction Behavior; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D005231:Fatty Acids, Unsaturated; D008055:Lipids; D005492:Folic Acid; D001205:Ascorbic Acid