Abstract 17960: Influence of a Weight Management Intervention for Overweight and Obese Cardiac Rehabilitation Patients on Macronutrient Dietary Intake and Use of Weight Loss Strategies

Abstract

Introduction: The majority of cardiac patients who enter cardiac rehabilitation (CR) are overweight. However, few patients lose enough weight to reduce their risk for heart disease. Purpose: To examine the influence of a weight management (WM) intervention for overweight and obese CR patients on the outcomes of dietary macronutrient (protein, carbohydrate, and fat) intake and use of WM strategies. Methods: Overweight or obese CR patients were randomized to a 12-week WM intervention (n=22) or usual care (UC) (n=21) group. Baseline, 4- and 6-month data were obtained after cardiac revascularization [coronary artery bypass surgery (CABS) or percutaneous coronary intervention (PCI)]. The 3-day diet diary, analyzed with the Minnesota Nutrition Data System V5.0, measured dietary macronutrient intake. The Diet and Exercise Self-Management survey measured subjects’ use of WM strategies. Results: Using RM ANCOVA, there were no significant group * time interactions controlling for % of calories from dietary fat, carbohydrate or protein intake at baseline. There were significant main effects by group, with the WM group having a significantly [F(1, 38)=4.2, p=.04] lower % intake of calories from dietary fat (29.9% compared to 34.1% for the UC group); and a significantly [F(1,38)=8.5, p=.006] higher % intake of calories from protein intake (23.7% compared to 19.9% for the usual care group). At 4-months after CABS or PCI, the WM group reported significantly higher use of WM diet behavior strategies for self-monitoring diet intake [F(1,38)=11.3, p=.002], planning [F(1,38)=9.7, p=.003], preparing and buying [F(1,38)=12.2, p=.001], and portion control [F(1,38)=7.8, p=.008]. Conclusions: The WM intervention influenced percentages of macronutrient dietary intake consistent with heart healthy diet recommendations. The WM intervention had an impact on improving reported use of weight loss strategies. Findings support the importance of a WM intervention for overweight and obese cardiac patients to improve weight outcomes not achieved in CR participation alone. Further research in a larger, controlled study is needed to examine how WM strategies can be integrated as an augmented intervention into standard CR.