Dietary habits and compliance with dietary guidelines in patients with established cardiovascular disease

期刊论文
发表日期：

2024年5月27日

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Nadia E. Bonekamp,
Johanna M. Geleijnse,
Yvonne T. van der Schouw,
Jannick A. N. Dorresteijn,
Manon G. van der Meer,
Ynte M. Ruigrok,
Martin Teraa,
Frank L. J. Visseren,
Charlotte Koopal,
M. J. Cramer,
H. M. Nathoe,
M. G. van de Meer,
G. J. de Borst,
M. Teraa,
M. L. Bots,
M. van Smeden,
M. H. Emmelot-Vonk,
P. A. de Jong,
A. T. Lely,
N. P. van der Kaaij,
L. J. Kappelle,
Y. M. Ruigrok,
M. C. Verhaar,
J. A. N. Dorresteijn,
F. L. J. Visseren

摘要

Background

Unhealthy dietary habits are an important risk factor for cardiovascular disease (CVD) and adopting a healthy diet is a central recommendation in CVD prevention. This study assessed the dietary habits of patients with established CVD, their compliance to dietary guidelines, and the relationship between guideline-compliance and recurrent cardiovascular event risk.

Methods

2656 patients with established CVD from the Utrecht Cardiovascular Cohort-Secondary Manifestations of ARTerial disease (UCC-SMART) prospective cohort study, were included between 1996 and 2022. Data on dietary intake was retrospectively collected for all participants in December 2022 using a 160-item food frequency questionnaire. Compliance with dietary guidelines was quantified using an amended version of the Dutch Healthy Diet 2015 (DHD-15) index (range: 0–135). Cox proportional hazard models were used to quantify the relationship with cardiovascular events (stroke and myocardial infarction).

Results

Among 2656 CVD patients (77% male, mean age 59 ± 9 years), median energy intake was 1922 [IQR: 1536–2351] kcal/day. The median DHD-15 index was 81.7 [IQR 71.2–92.0], with high compliance scores for recommendations on legumes and fish, and low scores for recommendations on whole grains, red meat, processed meat, and dairy. A higher DHD-15 score was associated with lower stroke risk (HR 0.78, 95% CI 0.66–0.92 per 10-point increase) but not with myocardial infarction.

Conclusion

Compliance with dietary guidelines was suboptimal in patients with established CVD. High compliance was associated with a clinically significant reduction in stroke risk in patients with established CVD, emphasizing the importance of dietary counseling.