Authors (including presenting author) :
Kwan WM(1), Ng WBG(1), Fung YSI(1), Chan NY(2)
Affiliation :
(1) Dietetic & Catering Department, Princess Margaret Hospital, (2) Department of Medicine & Geriatrics, Princess Margaret Hospital
Introduction :
It is well recognized that coronary heart disease is an important cause of death and disability worldwide, posing a significant economic burden to the health care system. International guidelines recommended use of multidisciplinary approach, and modifying lifestyle factors as the primary prevention for cardiovascular disease.
Objectives :
To evaluate the effectiveness of dietary intervention in cardiac rehabilitation (CR) program to improve cardiovascular risk factors, including lipid profile, blood glucose and body weight.
Methodology :
Data were collected from a prospective cohort of patients who enrolled in the CR program and attended dietitian group education class at Princess Margaret Hospital between August 2018 to January 2019. The CR program composed of multidisciplinary components, involving doctors, nurses, dietitian, physiotherapists, and occupational therapists. Dietitian provided a group education class at baseline, and subsequent individual follow ups for the high risk groups. Criteria for offering individual follow up were patients with obesity, abnormal lipid profile or diabetes. Within 6-month period, patients received up to three dietetic visits. Post intervention lipid profile and blood glucose were collected at 6 months (+/-3 months), and body weight was measured at each visit. Pre and post intervention data were compared using paired t-test and Wilcoxon signed-rank test as appropriate.
Result & Outcome :
A total of 51 patients with mean age 60 years old and mean body weight 72.9kg (mean BMI 27.1kg/m2) attended dietitian group education class at baseline, in which 88.2% were male, 25.5% had diabetes, and 45.1% had hyperlipidemia. Overall, 42.6%, 22.2% and 7.4% of them received one, two, or three dietetic visits respectively. Significant reduction in total cholesterol (-1.00+1.19, p< 0.001) and LDL-cholesterol [-1.10 (-1.80 to -0.40), p< 0.001] were observed while no significant effect on HDL-cholesterol, triglyceride, fasting blood glucose, and HbA1c were identified (p>0.05). Among all patients, no weight difference was detected between baseline and post intervention. However, sub-group analysis revealed overweight patients (n=9) had significant reduction in weight (-1.7+2.16, p=0.046) and BMI (-0.63+0.78, p=0.042) when received two dietetic visits. To conclude, dietary intervention is effective for improving clinical outcomes in CR program, in particular, more beneficial to overweight patients with increased number of dietetic visits. This pilot study provides insight for future resource allocation in CR program.
