Effects of Cardiac Rehabilitation and Diet Counselling on Adherence to the Mediterranean Lifestyle in Patients after Myocardial Infarction

• Published in: Nutrients Vol. 14; no. 19; p. 4048
• Main Authors: Novaković, Marko, Rajkovič, Uroš, Košuta, Daniel, Tršan, Jure, Fras, Zlatko, Jug, Borut
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 29.09.2022; MDPI
• Subjects: Cardiac Rehabilitation; Cardiology; Cardiovascular disease; Care and treatment; Cholesterol; Cholesterol, HDL; coronary artery disease; Counseling; Diet; Diet, Mediterranean; Disease prevention; Exercise; Female; Fitness training programs; Food; Glucose; Health risk assessment; Heart; Heart attack; Heart attacks; High density lipoprotein; Humans; Life Style; Lifestyles; lipid status; Management; Mediterranean diet; Mediterranean lifestyle; Middle Aged; Mortality; Myocardial Infarction; Nutrition counseling; Nutrition research; Patient compliance; Patient outcomes; Patients; Physical activity; Physical fitness; Physical training; Questionnaires; Rehabilitation; Risk factors; Smoking cessation; Triglycerides; Workshops; Slovenia; coronary artery disease; Mediterranean diet; Mediterranean lifestyle; myocardial infarction; lipid status; cardiac rehabilitation; physical activity
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu14194048

Adherence to the Mediterranean lifestyle—as captured by the Medlife Index Questionnaire (i.e., encompassing a Mediterranean diet as well as other aspects of healthy living, such as food preparation, physical activity, and socializing)—has been associated with reduced cardiovascular events in healthy individuals. In the present study, we sought to determine the adherence to, and the effect of comprehensive cardiac rehabilitation on, Mediterranean lifestyle adherence in patients after myocardial infarction. We included 121 patients (mean age, 55 years; women, 37%) undergoing comprehensive cardiac rehabilitation—i.e., exercise training 3 times per week for 12 weeks plus dedicated workshops promoting the Mediterranean lifestyle. Before and after cardiac rehabilitation, patients completed the Medlife Index Questionnaire. High baseline adherence was associated with favourable glucose (5.39 vs. 6.1 mmol/L; p < 0.001), triglycerides (1.1 vs. 1.5 mmol/L; p = 0.002), and HDL cholesterol levels (1.32 vs. 1.12 mmol/L; p = 0.032). More importantly, the Medlife Score significantly improved following comprehensive cardiac rehabilitation in patients with low baseline adherence (from 13.8 to 16.7 points; p < 0.001), but not in patients with high baseline adherence (from 19.4 to 18.8 points; p = 0.205). Our findings suggested that Mediterranean lifestyle promotion during cardiac rehabilitation improved adherence to the Mediterranean lifestyle, especially in low-adherence patients.