Lessons learned? Changes in dietary behavior after a coronary event

A healthy diet is recommended for the prevention of coronary artery disease (CAD), but whereas patients with CAD adhere to a healthy diet is unclear. We aimed to assess the impact of a CAD event on dietary intake.

Prospective, population-based, observational study conducted between 2009 and 2017. Dietary intake was assessed using a validated food frequency questionnaire. Three comparisons were performed: 1) between participants with history of CAD and gender- and age-matched controls; 2) before and after the occurrence of a CAD event, and 3) between participants with an incident CAD event and gender- and age-matched controls.

In analysis 1), after multivariable adjustment, participants with history of CAD had a lower total energy intake than controls (adjusted mean ± standard error: 1833 ± 36 vs. 1940 ± 26 kcal/day, p = 0.022), while no difference was found for all other dietary markers. In analysis 2) (n = 87) total energy intake increased (1927 ± 593 vs. 2100 ± 700 kcal/day before and after the event, respectively, p = 0.029) and prevalence of low fat diet decreased (35.6% vs. 21.8%, p = 0.036), while no difference was found for all other dietary markers. In analysis 3), participants with incident CAD had higher vegetable protein intake (adjusted mean ± standard error 4.8 ± 0.1 vs. 4.5 ± 0.1% of total energy intake, p = 0.028), AHEI score (34 ± 1 vs. 31 ± 1, p = 0.032), and complied more frequently with vegetables guidelines [odds ratio and 95% confidence interval; 7.64 (1.06-55.2)] than controls, while no differences were found for all other dietary markers CONCLUSIONS: In Switzerland, secondary prevention of CAD by diet is seldom implemented.