An organizational model to translate nutritional recommendations into routine clinical practice in secondary prevention of coronary artery disease.

BACKGROUND

We hypothesized that nutritional risk factors can be reduced routinely in all patients with coronary artery disease (CAD) by modifying general hospital catering into "antiatherogenic catering" and providing patients with an education program.

METHODS

General nutritional rules were applied to transform the standard alimentary regimen of our catering service (lipids 30% energy) into antiatherogenic catering (lipids 20% energy). The educational program (EP) consisted of a nutritional manual and 4 h/week of lessons. Eighty male patients (pts) with CAD (54 +/- 13 years), 10 +/- 4 days after an acute coronary event, were randomly allocated by cardiologists to a lipids 30% energy (control group = 40 pts) or to a lipids 20% energy diet (previously deposited in our catering service) + EP (treatment group = 40 pts). Serum total cholesterol (T-Chol), HDL- (HDL-Chol), LDL- (LDL-Chol), triglycerides (Trig), and body mass index (BMI) were determined before and after the 21-day treatment.

RESULTS

Lipids 20% energy reduced T-Chol (P < 0.001), LDL-Chol (P < 0.001), and Trig (P < 0.05), while lipids 30% worsened T-Chol and LDL-Chol. The changes in the lipid parameters resulted in significant differences between the two groups.

CONCLUSIONS

Simple reorganization of hospital catering and an educational program may routinely reduce nutritional risk factors in CAD patients, without individual counseling by the nutrition team.

Copyright 2001 American Health Foundation and Elsevier Science (USA).