CONCORDANCE OF DIET WITH THE RECOMMENDED CHOLESTEROL-LOWERING DIET INPATIENTS WITH CORONARY HEART-DISEASE

Objective: The aim was to examine the concordance of diet with the rec ommended cholesterol lowering diet in Coronary Heart Disease (CHD) pat ients receiving usual care. Design: CHD patients were selected for a s urvey from hospital records at least six months after hospitalization. Four patient groups divided according to the severity of disease were examined in cross-sectional setting. Food records and fatty acid comp osition of serum lipids were used to assess dietary intake. Subjects: The study population consisted of 109 patients with coronary bypass gr afting, 106 patients with balloon angioplasty, 101 patients with acute myocardial infarction and 99 patients with acute myocardial ischemia. Results: Concordance of the diet with the cholesterol lowering diet w as similar in the patient groups. One third of the patients achieved t he recommended fat intake and only one fourth achieved the recommended saturated fat intake. Concordance was better in the patients who also used lipid lowering drugs, but previous myocardial infarction did not affect dietary intake of fat and saturated fat. Diabetic or obese pat ients tended to have a higher intake of saturated fat. Myristic acid i n cholesterol esters, triglycerides and phospholipids and also palmiti c and linoleic acids in triglycerides were markers of dietary saturate d fat intake. Conclusions: Concordance of the diet with the recommende d cholesterol lowering diet in CHD patients was moderate. Concordance was not affected by disease severity or previous myocardial infarction and was slightly worse in CHD patients who had diabetes or were obese or did not use lipid lowering drugs.