Australian patients with coronary heart disease achieve high adherence to 6-month Mediterranean diet intervention: preliminary results of the AUSMED Heart Trial

Hannah Mayr, Audrey C Tierney, Teagan Kucianski, Colleen J Thomas, Catherine Itsiopoulos

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Abstract

Objective: It is unclear whether the cardioprotective Mediterranean diet (MedDiet) can be adhered to in non-Mediterranean populations. The aim of this study was to report preliminary results on adherence to a 6-mo ad libitum MedDiet intervention in multiethnic Australian patients with coronary heart disease, including maintenance at 12 mo. Methods: Participants (62 ± 9 y of age, 83% men) were randomized to the MedDiet (n = 34) or a low-fat diet (n = 31). Dietitian-led appointments occurred at 0, 3, and 6 mo with a follow-up phone review at 12 mo. Dietary intake was assessed via 7-d food diaries analyzed in FoodWorks8, and MedDiet adherence was measured by a validated 14-item questionnaire. Results: In the pooled cohort, the MedDiet adherence score was low at baseline (5.2 ± 2.1 of 14), with only 6.2% achieving a high score (≥9). MedDiet participants significantly improved the MedDiet adherence score compared with low-fat diet participants after 6 mo (+4.8 ± 2.7 versus +1.2 ± 2 points, respectively; P < 0.001). MedDiet participants significantly increased intake of olive oil, nuts, tomato, yogurt, legumes, and seafood and decreased intake of processed meats and added sugars compared with low-fat diet participants (P < 0.05). Maintenance of the MedDiet at 12 mo was high with 78% of MedDiet participants maintaining an adherence score ≥9; however, mean adherence score decreased by 1 ± 1.9 point (P = 0.01) between 6 and 12 mo. Conclusions: The MedDiet intervention in this pilot trial of Australian patients with coronary heart disease was well adhered to, improved diet quality, and could therefore provide a feasible alternative to a low-fat diet. Notably, improvement in adherence to the MedDiet was achieved through dietitian-led intervention and cross-cultural translation of dietary principles.

Original languageEnglish
Pages (from-to)21-31
Number of pages11
JournalNutrition
Volume61
Early online date3 Nov 2018
DOIs
Publication statusPublished - 1 May 2019
Externally publishedYes

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Mediterranean Diet
Coronary Disease
Fat-Restricted Diet
Nutritionists
Maintenance
Diet Records
Seafood
Yogurt
Nuts
Lycopersicon esculentum
Fabaceae
Meat
Appointments and Schedules

Cite this

Mayr, Hannah ; Tierney, Audrey C ; Kucianski, Teagan ; Thomas, Colleen J ; Itsiopoulos, Catherine. / Australian patients with coronary heart disease achieve high adherence to 6-month Mediterranean diet intervention: preliminary results of the AUSMED Heart Trial. In: Nutrition. 2019 ; Vol. 61. pp. 21-31.
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title = "Australian patients with coronary heart disease achieve high adherence to 6-month Mediterranean diet intervention: preliminary results of the AUSMED Heart Trial",
abstract = "Objective: It is unclear whether the cardioprotective Mediterranean diet (MedDiet) can be adhered to in non-Mediterranean populations. The aim of this study was to report preliminary results on adherence to a 6-mo ad libitum MedDiet intervention in multiethnic Australian patients with coronary heart disease, including maintenance at 12 mo. Methods: Participants (62 ± 9 y of age, 83{\%} men) were randomized to the MedDiet (n = 34) or a low-fat diet (n = 31). Dietitian-led appointments occurred at 0, 3, and 6 mo with a follow-up phone review at 12 mo. Dietary intake was assessed via 7-d food diaries analyzed in FoodWorks8, and MedDiet adherence was measured by a validated 14-item questionnaire. Results: In the pooled cohort, the MedDiet adherence score was low at baseline (5.2 ± 2.1 of 14), with only 6.2{\%} achieving a high score (≥9). MedDiet participants significantly improved the MedDiet adherence score compared with low-fat diet participants after 6 mo (+4.8 ± 2.7 versus +1.2 ± 2 points, respectively; P < 0.001). MedDiet participants significantly increased intake of olive oil, nuts, tomato, yogurt, legumes, and seafood and decreased intake of processed meats and added sugars compared with low-fat diet participants (P < 0.05). Maintenance of the MedDiet at 12 mo was high with 78{\%} of MedDiet participants maintaining an adherence score ≥9; however, mean adherence score decreased by 1 ± 1.9 point (P = 0.01) between 6 and 12 mo. Conclusions: The MedDiet intervention in this pilot trial of Australian patients with coronary heart disease was well adhered to, improved diet quality, and could therefore provide a feasible alternative to a low-fat diet. Notably, improvement in adherence to the MedDiet was achieved through dietitian-led intervention and cross-cultural translation of dietary principles.",
author = "Hannah Mayr and Tierney, {Audrey C} and Teagan Kucianski and Thomas, {Colleen J} and Catherine Itsiopoulos",
year = "2019",
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Australian patients with coronary heart disease achieve high adherence to 6-month Mediterranean diet intervention: preliminary results of the AUSMED Heart Trial. / Mayr, Hannah; Tierney, Audrey C; Kucianski, Teagan; Thomas, Colleen J; Itsiopoulos, Catherine.

In: Nutrition, Vol. 61, 01.05.2019, p. 21-31.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Australian patients with coronary heart disease achieve high adherence to 6-month Mediterranean diet intervention: preliminary results of the AUSMED Heart Trial

AU - Mayr, Hannah

AU - Tierney, Audrey C

AU - Kucianski, Teagan

AU - Thomas, Colleen J

AU - Itsiopoulos, Catherine

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N2 - Objective: It is unclear whether the cardioprotective Mediterranean diet (MedDiet) can be adhered to in non-Mediterranean populations. The aim of this study was to report preliminary results on adherence to a 6-mo ad libitum MedDiet intervention in multiethnic Australian patients with coronary heart disease, including maintenance at 12 mo. Methods: Participants (62 ± 9 y of age, 83% men) were randomized to the MedDiet (n = 34) or a low-fat diet (n = 31). Dietitian-led appointments occurred at 0, 3, and 6 mo with a follow-up phone review at 12 mo. Dietary intake was assessed via 7-d food diaries analyzed in FoodWorks8, and MedDiet adherence was measured by a validated 14-item questionnaire. Results: In the pooled cohort, the MedDiet adherence score was low at baseline (5.2 ± 2.1 of 14), with only 6.2% achieving a high score (≥9). MedDiet participants significantly improved the MedDiet adherence score compared with low-fat diet participants after 6 mo (+4.8 ± 2.7 versus +1.2 ± 2 points, respectively; P < 0.001). MedDiet participants significantly increased intake of olive oil, nuts, tomato, yogurt, legumes, and seafood and decreased intake of processed meats and added sugars compared with low-fat diet participants (P < 0.05). Maintenance of the MedDiet at 12 mo was high with 78% of MedDiet participants maintaining an adherence score ≥9; however, mean adherence score decreased by 1 ± 1.9 point (P = 0.01) between 6 and 12 mo. Conclusions: The MedDiet intervention in this pilot trial of Australian patients with coronary heart disease was well adhered to, improved diet quality, and could therefore provide a feasible alternative to a low-fat diet. Notably, improvement in adherence to the MedDiet was achieved through dietitian-led intervention and cross-cultural translation of dietary principles.

AB - Objective: It is unclear whether the cardioprotective Mediterranean diet (MedDiet) can be adhered to in non-Mediterranean populations. The aim of this study was to report preliminary results on adherence to a 6-mo ad libitum MedDiet intervention in multiethnic Australian patients with coronary heart disease, including maintenance at 12 mo. Methods: Participants (62 ± 9 y of age, 83% men) were randomized to the MedDiet (n = 34) or a low-fat diet (n = 31). Dietitian-led appointments occurred at 0, 3, and 6 mo with a follow-up phone review at 12 mo. Dietary intake was assessed via 7-d food diaries analyzed in FoodWorks8, and MedDiet adherence was measured by a validated 14-item questionnaire. Results: In the pooled cohort, the MedDiet adherence score was low at baseline (5.2 ± 2.1 of 14), with only 6.2% achieving a high score (≥9). MedDiet participants significantly improved the MedDiet adherence score compared with low-fat diet participants after 6 mo (+4.8 ± 2.7 versus +1.2 ± 2 points, respectively; P < 0.001). MedDiet participants significantly increased intake of olive oil, nuts, tomato, yogurt, legumes, and seafood and decreased intake of processed meats and added sugars compared with low-fat diet participants (P < 0.05). Maintenance of the MedDiet at 12 mo was high with 78% of MedDiet participants maintaining an adherence score ≥9; however, mean adherence score decreased by 1 ± 1.9 point (P = 0.01) between 6 and 12 mo. Conclusions: The MedDiet intervention in this pilot trial of Australian patients with coronary heart disease was well adhered to, improved diet quality, and could therefore provide a feasible alternative to a low-fat diet. Notably, improvement in adherence to the MedDiet was achieved through dietitian-led intervention and cross-cultural translation of dietary principles.

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