Dietetic guidelines: diet in secondary prevention of cardiovascular disease.

Abstract

To produce dietetic guidelines summarizing the systematic review evidence on dietary advice for secondary prevention of cardiovascular disease. The Cochrane Library, MEDLINE and EMBASE were comprehensively searched for systematic reviews on aspects of diet and heart health. Reviews were included if they searched systematically for randomised controlled trials relating to diet and secondary prevention of cardiovascular disease. Two members of the UK Heart Health and Thoracic Dietitians Group critically appraised each review. The quality and results of each review were discussed and summarized in a whole group meeting. The guidelines were trialled in seven dietetic departments and modified where necessary. Providing evidence-based dietary information (including increasing omega-3 fat plus fruit and vegetable intake) to all people after myocardial infarction will save more lives than concentrating dietary advice on those in need of weight loss or lipid lowering. The practice of prioritizing dietetic time to those with raised lipids is out of date since the advent of statin therapy. There is good systematic review evidence that dietary advice to those with cardiovascular disease can reduce mortality and morbidity as well as modify risk factors. Dietary advice that does this most effectively should be prioritized.