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    Optimum nutritional strategies for cardiovascular disease prevention and rehabilitation (BACPR).

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    Authors
    Butler, Tom
    Kerley, Conor P
    Altieri, Nunzia
    Alvarez, Joe
    Green, Jane
    Hinchliffe, Julie
    Stanford, Dell
    Paterson, Katherine
    Issue Date
    2020-02-25
    Keywords
    cardiac rehabilitation
    DIABETES
    HYPERTENSION
    lipoproteins and hyperlipidaemia
    metabolic syndrome
    
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    Journal
    Heart (British Cardiac Society)
    URI
    http://hdl.handle.net/10147/629753
    DOI
    10.1136/heartjnl-2019-315499
    PubMed ID
    32098809
    Abstract
    Nutrition has a central role in both primary and secondary prevention of cardiovascular disease yet only relatively recently has food been regarded as a treatment, rather than as an adjunct to established medical and pharmacotherapy. As a field of research, nutrition science is constantly evolving making it difficult for patients and practitioners to ascertain best practice. This is compounded further by the inherent difficulties in performing double-blind randomised controlled trials. This paper covers dietary patterns that are associated with improved cardiovascular outcomes, including the Mediterranean Diet but also low-carbohydrate diets and the potential issues encountered with their implementation. We suggest there must be a refocus away from macronutrients and consideration of whole foods when advising individuals. This approach is fundamental to practice, as clinical guidelines have focused on macronutrients without necessarily considering their source, and ultimately people consume foods containing multiple nutrients. The inclusion of food-based recommendations aids the practitioner to help the patient make genuine and meaningful changes in their diet. We advocate that the cardioprotective diet constructed around the traditional Mediterranean eating pattern (based around vegetables and fruits, nuts, legumes, and unrefined cereals, with modest amounts of fish and shellfish, and fermented dairy products) is still important. However, there are other approaches that can be tried, including low-carbohydrate diets. We encourage practitioners to adopt a flexible dietary approach, being mindful of patient preferences and other comorbidities that may necessitate deviations away from established advice, and advocate for more dietitians in this field to guide the multi-professional team.
    Item Type
    Article
    Other
    Language
    en
    EISSN
    1468-201X
    ae974a485f413a2113503eed53cd6c53
    10.1136/heartjnl-2019-315499
    Scopus Count
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    Connolly Hospital

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