Barzi F, Woodward M, Marfisi R M, Tavazzi L, Valagussa F, Marchioli R
Department of Clinical Pharmacology, Consorzio Mario Negri Sud, Santa Maria Imbaro, Italy.
Eur J Clin Nutr. 2003 Apr;57(4):604-11. doi: 10.1038/sj.ejcn.1601575.
To ascertain whether simple dietary advice to increase the consumption of Mediterranean foods, given in a clinical setting, leads to reduced mortality after a myocardial infarction.
Data were used from the GISSI-Prevenzione clinical trial, analysed as a cohort study with adjustment for treatment allocation.
A total of 172 centres in Italy.
A total of 11323 men and women with myocardial infarction. All subjects received advice to increase their consumption of fish, fruit, raw and cooked vegetables and olive oil.
The intakes of the five foods were assessed at baseline, 6, 18 and 42 months. Associations of food intakes, a combined dietary score, and the risk of death over 6.5 y were estimated adjusting for several non-dietary variables, using pooled logistic regression.
Subjects generally improved their diet according to the advice given. All foods were associated with a significant reduction in risk of death. Compared with people in the worst dietary score quarter, the odds ratio for those in the best score quarter was 0.51 (95% CI 0.44-0.59). A good diet had a protective effect in sub-groups defined by age, sex, smoking, randomized treatment and concomitant drug therapy.
Myocardial infarction patients can respond positively to simple dietary advice, and this can be expected to lead to a substantial reduction in the risk of early death. Regardless of any drug treatment prescribed, clinicians should routinely advise patients with myocardial infarction to increase their frequency of consumption of Mediterranean foods.
确定在临床环境中给出的增加地中海食物摄入量的简单饮食建议是否会降低心肌梗死后的死亡率。
使用GISSI-Prevenzione临床试验的数据，作为队列研究进行分析，并对治疗分配进行调整。
意大利共172个中心。
共11323名心肌梗死男性和女性。所有受试者均收到增加鱼类、水果、生熟蔬菜和橄榄油摄入量的建议。
在基线、6个月、18个月和42个月时评估这五种食物的摄入量。使用汇总逻辑回归，在调整了几个非饮食变量后，估计食物摄入量、综合饮食评分与6.5年期间死亡风险之间的关联。
受试者总体上按照所给建议改善了饮食。所有食物都与死亡风险的显著降低相关。与饮食评分最差的四分之一人群相比，饮食评分最好的四分之一人群的优势比为0.51（95%可信区间0.44-0.59）。良好的饮食在按年龄、性别、吸烟、随机治疗和伴随药物治疗定义的亚组中具有保护作用。
心肌梗死患者对简单的饮食建议能做出积极反应，这有望大幅降低早期死亡风险。无论开了何种药物治疗，临床医生都应常规建议心肌梗死患者增加食用地中海食物的频率。
