The effect of dietary advice on nutrient intakes: evidence from the diet and reinfarction trial (DART)

Abstract

The effect of dietary advice on nutrient intakes was examined in a random subsample of 459 men who were taking part in a randomized controlled trial of secondary prevention of myocardial infarction. The trial is of factorial design, to examine the effect of three dieteary aims, alone and in combination: A reduction in total fat to 30% of energy, together with an increase in polyunsaturated/saturated fat ratio (P/S) to 1.0. An increase in fatty fish consumption to at least 300 g/week (3 g eicosapentaenoic acid (EPA)). An increase in cereal fibre intake to 18 g/day (total fibre 30 g/day). Men were randomly allocated to one of the eight regimens (fat, fish, fibre, fat plus fish, fat plus fibre, fish plus fibre, fat plus fish plus fibre, or none of these) and are being followed up for at least two years. Six months after the advice was given, nutrient intakes were assessed from 7‐d weighed intake records. Of those advised to reduce fat intake and increase P/S ratio, mean intakes were 31% of energy and 0.85, respectively. This compared with 35% of energy and 0.45 for those not given this advice. Mean EPA intake was 2.5 g/week for the fish advice group and 0.79 g/week for the no fish advice group. Mean cereal fibre intake of the fibre advice group was 15 g/d (26 g/d total fibre) compared with 9 g/d (20 g/d total fibre) for the no fibre advice group. Thus for each of the dietary aims, the advice had a substantial effect on intakes.

The long-term effect of dietary advice in men with coronary disease: follow-up of the Diet and Reinfarction trial (DART)

“…Percentages of linoleic acid and eicosapentaenoic acid in plasma total fatty acids were measured by gas chromotography in a subset of the men. The differences were consistent with the reported dietary changes (Burr et al, 1989a,b;Fehily et al, 1989). In June 1989 at the end of the study subjects were sent a letter outlining the results of the study, recommending that they continue with their allocated diet and advising all men to eat more fatty fish.…”

“…The recruitment and methods of the Diet and Reinfarction Trial (DART) have been described in detail previously (Burr et al, 1989a,b;Fehily et al, 1989). Briefly, between 1983 and1987 2033 men aged under 70 who had survived a myocardial infarction were enrolled in the study.…”

“…We followed up former participants in the Diet and Reinfarction Trial (DART) (Burr et al, 1989a,b;Fehily et al, 1989) to determine their current diet and subsequent mortality.…”

The long-term effect of advice to eat more fish on blood pressure in men with coronary disease: results from the Diet and Reinfarction Trial

“…[3][4][5] Briefly, from January 1983 until January 1987, 2033 men aged under 70 who had sur-vived a myocardial infarction were enrolled in the study. They were recruited from 21 hospitals in South Wales and the South West of England.…”

Wheat Bran, Whole Grain, and Food Synergy

“…Fiber intake was low, only ϳ17 g/day in those advised to increase fiber. Although the reports do not explicitly break out dietary source of fiber, it is clear that as much as half of the fiber came from wheat bran (12).…”