Cardiovascular risk reduction and dietary compliance with a home-delivered diet and lifestyle modification program

Lack of adherence to diet contributes to ineffective dietary responsiveness and elevated cardiovascular risk factors in coronary heart disease (CHD) patients. Our purpose was to determine if home-delivered, heart-healthy meals and snacks, combined with telephone diet education, would be efficacious in improving dietary compliance, quality of life, and cardiovascular risk factors (primarily low-density lipoprotein [LDL] cholesterol and body weight) in CHD patients. Participants were 35 free-living subjects (21 men, 14 postmenopausal women) with a mean age of 62 (ranging from 40 to 79 years) in an 8-week diet intervention. A registered dietitian provided diet education over the telephone and weekly menus averaging 67% carbohydrate, 16% protein, 17% fat, 4% saturated fat, 5% monounsaturated fat, 128 mg cholesterol, and 25 g fiber. Lipid profiles, anthropometric measures, food records, and quality of diet, and life questionnaires were obtained at baseline, week 4, and week 8. Mean compliance-defined as percentage of prepared food energy consumed divided by percentage of prepared food energy provided-was 91% at 4 weeks and 88% at 8 weeks. After 8 weeks, significant reductions in weight (-3.7 kg), waist circumference (-2.0 in), hip circumference (-1.3 in), body mass index (-1.21 kg/m2), total cholesterol (-0.17 mmol/dL, -7.0 mg/dL), and LDL cholesterol (-0.19 mmol/dL, -7.5 mg/dL) (P<.05) were achieved without significant changes in high-density lipoprotein cholesterol (0.00 mmol/dL, 0.0 mg/dL) or triglycerides (+0.06 mmol/dL, +2.5 mg/dL). Significant improvements in quality of life and quality of diet (P<.05) were also demonstrated. This program could be a useful additive component to traditional medical nutrition therapy to improve dietary adherence.