Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Av. Menendez Pidal s/n, 14004, Cordoba, Spain.
CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
Eur J Nutr. 2020 Aug;59(5):2099-2110. doi: 10.1007/s00394-019-02059-5. Epub 2019 Jul 24.
Adherence to a healthy dietary pattern positively influences clinical outcomes in cardiovascular prevention, but long-term adherence is difficult to maintain. We evaluated 5-year changes in dietary habits, adherence achieved, and its maintenance in a cohort of coronary patients from the CORDIOPREV study.
1002 coronary patients were randomized to a Mediterranean diet (n = 502) or a low-fat diet (n = 500) and received individual-group-telephone visits and personalized dietary advice. A validated food-frequency questionnaire, a 14-point Mediterranean diet adherence screener, and a 9-point low-fat diet adherence score were used. Dietary adherence was categorized into Low, Medium, and High Adherence. Changes in nutrient intake, food consumption, and adherence were analyzed on a yearly basis. The maintenance of long-term dietary adherence was evaluated using data after the first year and fifth year.
From baseline to 5 years, significant increases were observed in overall dietary adherence (Mediterranean diet from 8.9 to 11.4; low-fat diet from 3.9 to 7.1) and in the percentage of patients considered High Adherence (Mediterranean diet from 41 to 89%; low-fat diet from 4 to 67%). When we evaluated the maintenance of adherence, patients considered Low and Medium Adherence at 1 year increased their adherence at the 5 years with both diets and patients considered High Adherence maintained their adherence with a Mediterranean diet, but decreased their adherence with a low-fat diet.
A comprehensive dietary intervention results in an overall long-term improvement and maintenance of adherence to the Mediterranean and low-fat diets. In our population, the Mediterranean diet group achieved a high level of adherence in the short term which was maintained in the long term.
健康的饮食模式对心血管预防的临床结局有积极影响，但长期坚持是困难的。我们评估了 CORDIOPREV 研究中一组冠心病患者 5 年内饮食习惯的变化、达到的依从性及其维持情况。
1002 例冠心病患者随机分为地中海饮食组（n=502）和低脂饮食组（n=500），并接受个体-团体-电话访视和个性化饮食建议。使用经过验证的食物频率问卷、14 点地中海饮食依从性筛查器和 9 点低脂饮食依从性评分。将饮食依从性分为低、中、高依从性。每年分析营养素摄入、食物消耗和依从性的变化。使用第一年和第五年的数据评估长期饮食依从性的维持情况。
从基线到 5 年，总体饮食依从性（地中海饮食从 8.9 分提高到 11.4 分；低脂饮食从 3.9 分提高到 7.1 分）和高依从性患者的比例（地中海饮食从 41%提高到 89%；低脂饮食从 4%提高到 67%）均显著增加。当我们评估依从性的维持时，1 年时被认为是低和中依从性的患者在 5 年内增加了对两种饮食的依从性，而被认为是高依从性的患者维持了对地中海饮食的依从性，但降低了对低脂饮食的依从性。
综合饮食干预可长期改善并维持对地中海饮食和低脂饮食的依从性。在我们的人群中，地中海饮食组在短期内达到了较高的依从性，并在长期内得以维持。
