Tracking of Dietary Patterns in the Secondary Prevention of Cardiovascular Disease after a Nutritional Intervention Program-A Randomized Clinical Trial.

Amanda Gonçalves Lopes Coura, Adélia da Costa Pereira de Arruda Neta, Rafaela Lira Formiga Cavalcanti de Lima, Ângela Cristine Bersch-Ferreira, Bernardete Weber, Rodrigo Pinheiro de Toledo Vianna

Journal: Nutrients 2022;14(22):4716

PMID: 36432401

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Plain Language Summary

The likelihood of developing cardiovascular disease (CVD) is associated with eating patterns that are considered unhealthy (i.e., excessive intake of sodium and processed foods; added sugars; unhealthy fats; low intake of fruits and vegetables, whole grains, fibre, legumes, fish and nuts), along with a lack of exercise, overweight and obesity, stress, alcohol consumption and smoking. The aim of this study was to compare dietary patterns between the control group and the experimental group before and after the intervention of the BALANCE program. This is a sub-study of the multicentre randomised clinical trial Brazilian Cardioprotective Food Program, (BALANCE). The population considered for this sub-study was composed of study participants at the initial time (baseline year), after one year and after two years of the intervention of the BALANCE program. Results showed that both groups had improvements in eating habits, especially in the first year of follow-up. The greater increase in adherence to the traditional and cardioprotective dietary patterns in the experimental group justifies the initiative of the BALANCE program. Authors conclude that knowledge of consumption patterns makes it possible to adjust the necessary interventions in the long term; however, only a longer follow-up can confirm the protective effect of these interventions.

Abstract

Individuals with a history of previous cardiovascular events have an increased risk of mortality and morbidity, so adherence to a healthy dietary pattern is essential. We aimed to evaluate and compare dietary patterns between the control and the experimental group from the BALANCE Program. A total of 2360 individuals aged 45 years or older with previous cardiovascular disease were included. The individuals were randomized into two groups: intervention (dietary prescription with nutritional recommendations, nutritional education program based on playful strategies, suggestions of typical and accessible Brazilian foods and intensive monitoring) and control (conventional nutritional counseling). The dietary patterns were identified using factor analysis with the principal component extraction method, and the t-Student tests and ANOVA test were performed to evaluate the associated factors. Four dietary patterns were identified for both groups: "Traditional", "Snack", "Western", "Cardioprotective". There was an increase in the variances of the "Cardioprotective" pattern in both groups. Regarding the "Western" pattern, there was a significant reduction in the variances of the experimental group (10.63% vs. 8.14%). Both groups had improvements in eating habits, especially in the first year of follow-up. The greater increase in adherence to the traditional and cardioprotective pattern in the experimental group justifies the initiative of the BALANCE program.

Address: Postgraduate Program in Nutrition Sciences, Federal University of Paraíba, João Pessoa 58059-900, Brazil.; Research Institute-HCor, São Paulo 04004-030, Brazil.

DOI: 10.3390/nu14224716