Factors affecting dietary compliance in coronary patients included in a secondary prevention programme

Nutrient intake was altered favourably in the diets of 38 cardiac patients who were followed up for 1 year as part of a rehabilitation programme. Total energy intake was reduced from 3540 kcal (14.9 MJ) to 2484 kcal (10.4 MJ). Fat intake was reduced from 41 to 37 per cent of energy intake with an accompanying increase in P : S ratio from 0.18 to 0.60. Cholesterol intake was reduced from 564 to 332 mg. Carbohydrate was increased from 38 to 41 per cent of energy intake with an increase in fibre intake from 18 to 24 g. The energy contributed by alcohol was reduced from 6 to 5 per cent. Patients varied in their compliance but all patients made some changes in their dietary intake. Changes in body weight, serum cholesterol levels, cigarette-smoking status and levels of physical activity tended to correspond with the recorded changes in nutrient intake. A low level of education, low socio-economic group, lack of understanding of the illness by the patient and inadequate communication were associated with reduced compliance. Initial motivation and anxiety levels in hospital had less effect on compliance.