Author/Authors :
Mosharraf، Soheila نويسنده General Practitioner, Mobarakeh Health Center, Isfahan University of Medical Sciences, Isfahan, Iran , , Sharifzadeh، Gholamreza نويسنده Epidemiologist, Birjand University of Medical Sciences, Birjand , , Darvishzadeh-Boroujeni، Pariya نويسنده MSc Student, Department of Food Technology and Nutrition, Lund University, Lund, Sweden , , Rouhi-Boroujeni، Hojjat نويسنده Member of Student Research Committee, Medical Plants Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran ,
Abstract :
BACKGROUND: The impact of different nutritional regimens on long-term prognosis and
outcome in diabetic patients with coronary artery disease (CAD) has been questioned.
Therefore, the objective of the present study was to determine the effects of different nutritional
components of Mediterranean regimen on long-term cardiovascular events in diabetic patients
with CAD in the Iranian population.
METHODS: In a prospective cohort study, we recruited 233 consecutive patients with the diagnosis
of type 2 diabetes mellitus and with at least 6 months of documented CAD. Nutritional assessment
was obtained by a validated semi-quantitative food frequency questionnaire (FFQ) and the diet
score was calculated on the basis of the Mediterranean diet quality index (Med-DQI). For
Assessing long-term CAD prognosis, the patients were followed by telephone for one year. The
study endpoint was long-term major adverse cardiac and cerebrovascular event (MACCE).
RESULTS: Death was observed in 19 patients (8.2%) during the one-year follow-up. Two patients
(0.9%) suffered non-fatal myocardial infarction and 14 (6.0%) needed revascularization within 1
year after discharge from hospital. Overall MACCE within one year in the study population was
12.4%. There were significant differences between number of deaths and dietary scores of
saturated fatty acid, cholesterol, meats, fish, and fruit and vegetables (P < 0.05). Moreover,
significant differences were found between MACCE rate and dietary scores of saturated fatty
acid, cholesterol, and fruit and vegetables (P < 0.05). Using multivariate logistic regression
models, Mediterranean dietary regimen could effectively predict long-term death as well as
MACCE adjusted for gender and age variables.
CONCLUSION: Mediterranean dietary regimens, including low level of cholesterol and saturated
fatty acid, can effectively improve long-term outcome including death and MACCE in diabetic
patients with CAD.
