Having a heart attack is apparently not sufficient reason for most people to

change to a heart-healthy diet, a new study finds. "We found that diet quality is poor after a coronary heart disease event," said study author Yunsheng Ma, MD, PhD, an assistant professor of medicine at the University of Massachusetts Medical School, in Worcester.

He warned, however, that patients' failure to eat healthier puts them at risk for another cardiac event.

"Coronary heart disease is the number one cause of mortality in Americans," the study noted. An estimated 13 million Americans have survived a heart attack or have coronary heart disease (CHD) symptoms, the researchers added.

The Study

Dr. Ma's team surveyed 555 patients averaging 61 years of age, 60% of whom were men. All were diagnosed with coronary heart disease and had already experienced a heart attack, angina (chest pain or arrhythmia (abnormal heart rhythm). The researchers queried the patients on their diets one year after they had undergone coronary angiography (a procedure to see how well blood is flowing through the heart) linked to some kind of coronary event.


According to the researchers, only 12.4% of the patients met the recommended consumption of vegetables. Similarly, only about 8% met daily fruit intake recommendations and just 8% were getting a heart healthy amount of cereal fiber. Little more than 5% were limiting their intake of dangerous trans fats to recommended levels, the team said.

Compounding this, the researchers found that worst diets were associated with smoking and obesity. Poor diets were also closely correlated with lower levels of education.

Recommendations For A Heart-Healthy Diet

Research has confirmed that fruit and vegetable consumption is associated with a lowered risk for heart disease, the researchers noted. The American Heart Association currently recommends an overall healthy diet" that is rich in fruits and vegetables, high-fiber foods and limited amounts of saturated fat and trans fats, with an eye to maintaining a healthy weight.

The study concluded that it may be helpful for physicians and health care providers to refer CHD patients to behavioral interventions that include both diet and physical activity components, such as cardiac rehabilitation." Rehab by itself might not be enough, the study adds, urging consultation with registered dietitians to learn about how to make the necessary changes in diet.

Dr. Ma said that currently about 80% of patients do not go to rehabilitation after a coronary heart disease event, such as angina, arrhythmia or heart attack. But even if patients do enter rehabilitation, many of these programs do not include dietary modifications, he added.

Expert Commentary

Alice Lichtenstein, DSc of Tufts University's Friedman School of Nutrition, helped to craft the American Heart Association's dietary recommendations. She questioned whether the new study produced truly conclusive results, noting that the study subjects may have underreported their consumption of unhealthy foods. That's because the participants' mean calorie intake was a relatively healthy 1,775 calories but their average body mass index (a ratio of weight to height) was 30, which is in the obese range, Dr. Lichtenstein noted.

She said that instead of trying to calculate the exact amount of fat or saturated fat in their diet, it may be easier for people to simply concentrate on the types of healthy foods they should be eating-items such as fruits, vegetables, grains, beans and fish. Americans have a wide range of such foods to choose from, so it is easier now to consume a diet consistent with a heart-healthy pattern than it's ever been before," Dr. Lichtenstein added.

Time to Can the Soda!

Drinking just one 12-ounce soft drink a day-either regular or diet-increases the risk for metabolic syndrome by about 50%. Metabolic syndrome comprises at least three of the following symptoms-increased waistline...elevated blood pressure...elevated blood sugar levels...elevated triglycerides (a type of blood fat)...and reduced HDL (good) cholesterol. All of these symptoms are risk factors for heart disease and diabetes.

Aortic Aneurysm: What Every Women Should Know

Abdominal aortic aneurysm (AAA)—which A forms when a weak area of the aorta (the largest artery) expands or bulges-occurs four times more often among women who are or were smokers than among nonsmokers and 3.6 times more often among women who have had a heart attack, heart bypass surgery or coronary angioplasty. Women who develop an AAA are more likely than men to die from internal bleeding if the aneurysm ruptures. AAA is usually detected during a routine checkup and confirmed with a noninvasive ultrasound. Surgery can repair an AAA before it ruptures.

Aspirin Defense Ignored

Heart disease risk can be reduced by taking aspirin regularly. Yet only 41% of adults over age 40 use aspirin and only 33% say they have discussed aspirin use with their doctors. Regular aspirin use can prevent a heart attack in men and women who already have heart disease--and can reduce heart disease risk for people who have high cholesterol, diabetes and high blood pressure. Many doctors say the limited time they have available during office visits makes it difficult to discuss aspirin use and other preventive measures.

Self-defense: Ask your doctor about taking aspirin regularly to prevent heart disease.

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