The Transplant Centre, University Hospital of South Manchester, Manchester, M23 9LT, UK.
Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD, 4006, Australia.
Nutr J. 2018 Feb 14;17(1):22. doi: 10.1186/s12937-018-0337-y.
Heart and lung transplant recipients are at a substantially increased risk of cardiovascular disease (CVD). Since both low-fat and Mediterranean diets can reduce CVD in immunocompetent people at high risk, we assessed adherence among thoracic transplant recipients allocated to one or other of these diets for 12 months.
Forty-one transplant recipients (20 heart; 21 lung) randomized to a Mediterranean or a low-fat diet for 12 months received diet-specific education at baseline. Adherence was primarily assessed by questionnaire: 14-point Mediterranean diet (score 0-14) and 9-point low-fat diet (score 0-16) respectively, high scores indicating greater adherence. Median scores at baseline, 6 months, 12 months, and 6-weeks post-intervention were compared by dietary group. We further assessed changes in weight, body mass index (BMI) and serum triglycerides from baseline to 12 months as an additional indicator of adherence.
In those randomized to a Mediterranean diet, median scores increased from 4 (range 1-9) at baseline, to 10 (range 6-14) at 6-months and were maintained at 12 months, and also at 6-weeks post-intervention (median 10, range 6-14). Body weight, BMI and serum triglycerides decreased over the 12-month intervention period (mean weight - 1.8 kg, BMI -0.5 kg/m, triglycerides - 0.17 mmol/L). In the low-fat diet group, median scores were 11 (range 9-14) at baseline; slightly increased to 12 (range 9-16) at 6 months, and maintained at 12 months and 6 weeks post-intervention (median 12, range 8-15). Mean changes in weight, BMI and triglycerides were - 0.2 kg, 0.0 kg/m and - 0.44 mmol/L, respectively.
Thoracic transplant recipients adhered to Mediterranean and low-fat dietary interventions. The change from baseline eating habits was notable at 6 months; and this change was maintained at 12 months and 6 weeks post-intervention in both Mediterranean diet and low-fat diet groups. Dietary interventions based on comprehensive, well-supported education sessions targeted to both patients and their family members are crucial to success. Such nutritional strategies can help in the management of their substantial CVD risk.
The IRAS trial registry ( ISRCTN63500150 ). Date of registration 27 July 2016. Retrospectively registered.
心肺移植受者患心血管疾病（CVD）的风险显著增加。由于低脂饮食和地中海饮食都可以降低高危免疫人群的 CVD 风险，我们评估了接受 12 个月的地中海饮食或低脂饮食的胸科移植受者的依从性。
41 名接受地中海饮食或低脂饮食（12 个月）的移植受者在基线时接受了特定饮食的教育。通过问卷主要评估依从性：地中海饮食 14 分（0-14 分）和低脂饮食 9 分（0-16 分），分数越高表示依从性越好。通过饮食组比较基线、6 个月、12 个月和干预后 6 周的中位数得分。我们还评估了从基线到 12 个月体重、体重指数（BMI）和血清甘油三酯的变化，作为依从性的额外指标。
在接受地中海饮食的随机分组中，中位数得分从基线时的 4 分（范围 1-9）增加到 6 个月时的 10 分（范围 6-14），并在 12 个月时保持不变，在干预后 6 周时也保持不变（中位数 10，范围 6-14）。体重、BMI 和血清甘油三酯在 12 个月的干预期间下降（平均体重-1.8 公斤，BMI-0.5 公斤/平方米，甘油三酯-0.17 毫摩尔/升）。在低脂饮食组，基线时中位数评分为 11 分（范围 9-14）；6 个月时略有增加至 12 分（范围 9-16），并在 12 个月和干预后 6 周时保持不变（中位数 12，范围 8-15）。体重、BMI 和甘油三酯的平均变化分别为-0.2 公斤、0.0 公斤/平方米和-0.44 毫摩尔/升。
胸科移植受者遵循地中海饮食和低脂饮食干预。从基线饮食习惯的改变在 6 个月时就很明显；并且这种改变在 12 个月和干预后 6 周的地中海饮食和低脂饮食组中都得到了维持。针对患者及其家属的全面、有充分依据的教育课程的饮食干预对成功至关重要。这种营养策略有助于管理他们的 CVD 风险。
IRAS 试验注册（ISRCTN63500150）。注册日期 2016 年 7 月 27 日。回顾性注册。
