Fruits, vegetables overlooked by healing heart patients

August 25, 2003

Even after the jolt of a heart attack or bypass operation, some cardiac rehabilitation patients may "just say no" not only to obviously harmful dietary fat but also to beneficial fruits and vegetables.

These contradictory responses mean that different approaches are needed to change overall eating habits and reduce the risk of future heart problems, say C. Jeffrey Frame, Ph.D., R.D., and colleagues.

Their study of 118 patients, carried out at a cardiac rehabilitation unit in a hospital in Greensboro, N.C., appears in the July/August issue of the American Journal of Health Promotion.

Frame, an assistant professor of nutrition, dietetics and food management at Murray State University in Kentucky, and colleagues followed patients who had been prescribed cardiac rehabilitation following coronary bypass operations, heart attacks or other heart problems. They interviewed the patients at the start and end of a 12-week cardiac rehabilitation program and again two years later.

During the rehab program, a dietitian worked individually with patients to develop nutrition and weight maintenance goals. The patients attended a group education session for one hour each week. There they learned about reducing fat, salt and sugar in their diets; increasing dietary fiber and fruits and vegetables; using herbs and spices to make food taste better; methods for healthier food preparation; and recommended food choices when dining out.

The researchers evaluated each patient based on the "state-of-change" concept. This analysis includes five steps: pre-contemplation (not knowing or caring about a health risk); contemplation (knowing it, but not ready to do anything about it); preparation (getting ready to make an active effort); action (doing something positive for up to six months); maintenance (doing the right thing for more than six months and working to prevent relapse).

The sobering effect of cardiac surgery or a heart attack clearly moved many people to take action on reducing dietary fat by the start of the rehab program, Frame says. By the end of the rehab program, 81 percent were in the preparation, action or maintenance stages. Two years later, 87 percent (105 out of 118) were in the maintenance stage alone.

But these same patients, who apparently did so well cutting down fat intake, made little progress during the same time toward eating five servings of fruits and vegetables a day. After two years, only 23 percent were at the maintenance stage, while 59 percent had slid down the ladder to the pre-contemplation or contemplation stages.

"There is no evidence that movement within the stages of change for one behavior was related to movement within the stages of change for the other food behavior," Frame says.

The findings about dietary fat, while encouraging, still left Frame concerned. For one thing, similar research on fat in the general population shows that most subjects remained in the ignorant or apathetic stages. In addition, what appears to be better results in reducing fat intake may be partially due to "deliberate misrepresentations by patients to avoid criticism and gain social conformity and social approval" from doctors, dietitians, family and friends, Frame says.

The problem may be due to the notions of the two different kinds of foods that patients bring with them to the rehab program. Fat was already seen as not a heart-healthy choice.

"But many patients perceived little or no relationship between fruit and vegetable intake and cardiovascular health," says Frame.

Funding for this project was provided by the Institute of Nutrition, University of North Carolina-Chapel Hill, and by the Committee on Institutional Service and Research, Murray State University.
-end-
BY AARON LEVIN, SCIENCE WRITER
HEALTH BEHAVIOR NEWS SERVICE

FOR MORE INFORMATION:
Health Behavior News Service: 202-387-2829 or www.hbns.org.
Interviews: Contact Sherry McClain, News Bureau Director, Murray State University, 270-762-3156.
E-mail: sherry.mcclain@murraystate.edu.
American Journal of Health Promotion: Call 248-682-0707 or visit www.healthpromotionjournal.com.

Center for Advancing Health

Related Heart Attack Articles from Brightsurf:

Top Science Tip Sheet on heart failure, heart muscle cells, heart attack and atrial fibrillation results
Newly discovered pathway may have potential for treating heart failure - New research model helps predict heart muscle cells' impact on heart function after injury - New mass spectrometry approach generates libraries of glycans in human heart tissue - Understanding heart damage after heart attack and treatment may provide clues for prevention - Understanding atrial fibrillation's effects on heart cells may help find treatments - New research may lead to therapy for heart failure caused by ICI cancer medication

Molecular imaging identifies link between heart and kidney inflammation after heart attack
Whole body positron emission tomography (PET) has, for the first time, illustrated the existence of inter-organ communication between the heart and kidneys via the immune system following acute myocardial infarction.

Muscle protein abundant in the heart plays key role in blood clotting during heart attack
A prevalent heart protein known as cardiac myosin, which is released into the body when a person suffers a heart attack, can cause blood to thicken or clot--worsening damage to heart tissue, a new study shows.

New target identified for repairing the heart after heart attack
An immune cell is shown for the first time to be involved in creating the scar that repairs the heart after damage.

Heart cells respond to heart attack and increase the chance of survival
The heart of humans and mice does not completely recover after a heart attack.

A simple method to improve heart-attack repair using stem cell-derived heart muscle cells
The heart cannot regenerate muscle after a heart attack, and this can lead to lethal heart failure.

Mount Sinai discovers placental stem cells that can regenerate heart after heart attack
Study identifies new stem cell type that can significantly improve cardiac function.

Fixing a broken heart: Exploring new ways to heal damage after a heart attack
The days immediately following a heart attack are critical for survivors' longevity and long-term healing of tissue.

Heart patch could limit muscle damage in heart attack aftermath
Guided by computer simulations, an international team of researchers has developed an adhesive patch that can provide support for damaged heart tissue, potentially reducing the stretching of heart muscle that's common after a heart attack.

How the heart sends an SOS signal to bone marrow cells after a heart attack
Exosomes are key to the SOS signal that the heart muscle sends out after a heart attack.

Read More: Heart Attack News and Heart Attack Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.