Nutrition is capable of altering the cardiovascular health of the general population. However, the ideal food and nutritional interventions for the secondary prevention of cardiovascular brain disease and for cardiac rehabilitation are still far from being defined, given the lack of scientific evidence in this specific population of individuals with atherosclerotic disease. This work aims to demonstrate that an intensive program will improve cardiovascular risk predictor parameters, such as high systolic blood pressure, altered lipid and glucose profile, used in the SMART Risk Score tool. In this 12-week clinical study with two arms running in parallel, individuals referred to a cardiac rehabilitation program will receive either an intensive food and nutrition intervention program with nutrition consultations, in which the adoption of the Mediterranean diet is promoted, with contacts telephone calls, short text messages, consultation support tools, podcasts, free access short videos, culinary medicine sessions and nutrition "workshops", or the standard of care program recommended in the Nutritional Support Protocol of the Cardiac Rehabilitation Program. At the beginning of the study, at 4 weeks, at 8 weeks and at 12 weeks, blood and urine samples will be collected, body composition, blood pressure, adherence to the Mediterranean dietary pattern will be assessed, by applying the PREDIMED questionnaire and the dietary intake of 24h previous. The quality of life of individuals will be assessed by the EQ-5D-5L questionnaire at the beginning and at the end of the study. It is expected that the increased intensity and support from the intensive program will have a significant impact on the various metabolic and inflammatory markers predictive of cardiovascular risk and that these observed changes will result in a decreased 10-year risk of developing acute myocardial infarction, stroke or vascular death. On the other hand, the intervention is intended to improve quality of life, improve weight control and assess the impact it has on adherence to the Mediterranean dietary pattern.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
21
The intervention will consist of an intensive food and nutrition intervention program to improve adherence to the Mediterranean dietary pattern. In addition to individual and face-to-face nutrition consultations, other strategies will be used, such as telephone contacts, short text messages, consultation support tools, podcasts, short open access videos, nutrition workshops and nutrition sessions for caregivers of participants in the study.
The usual care group will only have access to face-to-face and individual nutrition consultations in order to improve adherence to the Mediterranean dietary pattern.
NOVA Medical School | Universidade NOVA de Lisboa Campo Mártires da Pátria, 130
Lisbon, Portugal
Change in SMART Risk Score
Difference between the intervention and control group in the change in SMART Risk Score from baseline to the end of follow-up.
Time frame: baseline to 12 weeks
Self-reported quality of life
Difference between the intervention and control group in the EQ-5D-5L questionnaire from baseline to the end of follow-up.
Time frame: baseline to 12 weeks
Adherence to the Mediterranean dietary pattern
Difference between the intervention and control group in MEDAS questionnaire from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
Change in weight
Difference between the intervention and control group in the change of weight (kg) from baseline to 12 weeks.
Time frame: baseline to 12 weeks
Change in body fat
Difference between the intervention and control group in the change of body fat (%) from baseline to 12 weeks.
Time frame: baseline to 12 weeks
Change in fat free mass
Difference between the intervention and control group in the change of fat free mass (kg) from baseline to 12 weeks.
Time frame: baseline to 12 weeks
Change in total body water
Difference between the intervention and control group in the change of total body water (kg) from baseline to 12 weeks.
Time frame: baseline to 12 weeks
Change in systolic blood pressure
Difference between the intervention and control group in the change of systolic blood pressure from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
Change in diastolic blood pressure
Difference between the intervention and control group in the change of diastolic blood pressure from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
Change of insulin
Difference between the intervention and control group in the change of insulin from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
Change of fasting blood glucose
Difference between the intervention and control group in the change of fasting blood glucose from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
Change of glycosylated hemoglobin (HbA1c)
Difference between the intervention and control group in the change of glycosylated hemoglobin (HbA1c) from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
Change of type 1 insulin-like growth factor (IGF-1)
Difference between the intervention and control group in the change of type 1 insulin-like growth factor (IGF-1) from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
Change of LDL cholesterol
Difference between the intervention and control group in the change of LDL- cholesterol from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
Change of HDL cholesterol
Difference between the intervention and control group in the change of HDL- cholesterol from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
Change of triglycerides
Difference between the intervention and control group in the change of triglycerides from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
Change of apolipoprotein B
Difference between the intervention and control group in the change of apolipoprotein B from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
Change of apolipoprotein A1
Difference between the intervention and control group in the change of apolipoprotein A1 from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
Change of liporprotein(a)
Difference between the intervention and control group in the change of liporprotein(a) from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
Change of high sensitivity C-reactive protein
Difference between the intervention and control group in the change of high sensitivity C-reactive protein from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
change of myeloperoxidase
Difference between the intervention and control group in the change of myeloperoxidase from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
Change of interleukin 1
Difference between the intervention and control group in the change of interleukin 1 from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
Change of interleukin 6
Difference between the intervention and control group in the change of interleukin 6 from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
Change of tumor necrosis factor alpha (TNF-α)
Difference between the intervention and control group in the change of tumor necrosis factor alpha (TNF-α) from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
Change of trimethylamine N-oxide (TMAO)
Difference between the intervention and control group in the change of trimethylamine N-oxide (TMAO) from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
Change of L-carnitine
Difference between the intervention and control group in the change of L-carnitine from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
Change of urinary hydroxytyrosol
Difference between the intervention and control group in the change of urinary hydroxytyrosol from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
Change of plasma proportion of alpha linolenic acid
Difference between the intervention and control group in the change of plasma proportion of alpha linolenic acid from baseline to 4 weeks, 8 weeks and 12 weeks.
Time frame: baseline, 4 weeks, 8 weeks and 12 weeks
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