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Sinclair J, Dillon S, Lowe NM, Melia A. Effects of a Nutrition Education Programme in Stage IV Cardiac Rehabilitation Patients: A 3-Arm Randomised Controlled Trial. Life (Basel) 2023; 14:63. [PMID: 38255678 PMCID: PMC10817625 DOI: 10.3390/life14010063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/23/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024] Open
Abstract
This trial examined the influence of two nutrition intervention programmes on health-related and nutritional intake indices pertinent to cardiovascular disease compared to usual care in stage IV cardiac rehabilitation patients. Sixty-six patients were recruited from the Heartbeat North-West cardiac rehabilitation centre in Preston (United Kingdom). Patients were randomly assigned to Usual care, Biggest loser or Nutrition education arms. Usual care undertook their usual two exercise classes per week without nutritional support, Biggest loser underwent weekly education sessions focussing on weight loss using the themes within the British Heart Foundation 'So You Want to Lose Weight for Good' guidelines, and Nutrition education followed the same themes as Biggest loser but in a more focussed manner informed by patient focus groups. In total, this was a 12-week trial in which patients spent 6 weeks engaged in their allocated intervention arm, after which all participants switched to Usual care. The primary outcome was systolic blood pressure, and secondary measures of anthropometric, blood biomarker, nutritional knowledge (via the Mediterranean Diet Assessment Tool) and nutritional intake indices were measured at baseline, 6 weeks, and 12 weeks (follow-up). Intention-to-treat analyses revealed no significant alterations in the primary outcome (Usual care: baseline = 130.45 mmHg, 6 weeks = 127.83 mmHg, and follow-up = 126.35 mmHg, Biggest loser: baseline = 133.50 mmHg, 6 weeks = 123.06 mmHg, and follow-up = 135.22 mmHg, or Nutrition education: baseline = 135.23 mmHg, 6 weeks = 129.20 mmHg, and follow-up = 126.26 mmHg) between arms. However, at 6 weeks, improvements in triglycerides were significantly greater in Usual care (baseline = 1.61 mmol/L and 6 weeks = 1.43 mmol/L) group compared to Nutrition education (baseline = 1.70 mmol/L and 6 weeks = 2.21 mmol/L). Improvements in nutrition knowledge were significantly greater in Nutrition education (baseline = 8.48, 6 weeks = 9.77, and follow-up = 10.07) compared to Usual care (baseline = 7.71, 6 weeks = 8.00, and follow-up = 8.00) and Biggest loser (baseline = 7.71, 6 weeks = 8.73, and follow-up = 8.36). At 6 weeks, the Biggest loser group (baseline = 4.75 g and 6 weeks = 3.83 g) exhibited significantly greater improvements in salt intake compared to Usual care (baseline = 4.87 g and 6 weeks = 4.28 g) and Nutrition education (baseline = 19.25 g and 6 weeks = 16.78 g) in saturated fatty acids compared to Usual care (baseline = 20.26 g and 6 weeks = 21.34 g). This trial shows the effectiveness of nutritional interventions for improving nutritional knowledge and dietary practices in stage IV cardiac rehabilitation, but the mechanisms and longer-term effects of increased triglyceride levels in the Nutrition education group requires further exploration.
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Affiliation(s)
- Jonathan Sinclair
- Centre for Global Development, School of Health, Social Work & Sport, University of Central Lancashire, Preston PR1 2HE, Lancashire, UK
- Research Centre for Applied Sport, Physical Activity and Performance, School of Health, Social Work & Sport, University of Central Lancashire, Preston PR1 2HE, Lancashire, UK
| | - Stephanie Dillon
- Research Centre for Applied Sport, Physical Activity and Performance, School of Health, Social Work & Sport, University of Central Lancashire, Preston PR1 2HE, Lancashire, UK
| | - Nicola M. Lowe
- Research Centre for Applied Sport, Physical Activity and Performance, School of Health, Social Work & Sport, University of Central Lancashire, Preston PR1 2HE, Lancashire, UK
| | - April Melia
- Centre for Global Development, School of Health, Social Work & Sport, University of Central Lancashire, Preston PR1 2HE, Lancashire, UK
- Research Centre for Applied Sport, Physical Activity and Performance, School of Health, Social Work & Sport, University of Central Lancashire, Preston PR1 2HE, Lancashire, UK
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Aljehani R, Aljehani G, Alharazi H, Horta PM, Kümmel Duarte C, Ghisi GLDM. The Mediterranean Diet Scale (MDS): Translation and validation of the Arabic version. PLoS One 2023; 18:e0287497. [PMID: 37616224 PMCID: PMC10449107 DOI: 10.1371/journal.pone.0287497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/26/2023] [Indexed: 08/26/2023] Open
Abstract
OBJECTIVES The self-administered version of the Mediterranean Diet Scale (MDS) has been developed to test the inherent characteristics of this dietary pattern in a quick and simple way, due to the need of this assessment in the clinical and research setting. This study aimed to translate and psychometrically validate the self-administered MDS in Arabic (CRBS-A). METHODS The original (English) version was originally translated to Arabic, followed by back-translation. Next, 10 healthcare providers, followed by 10 cardiovascular disease (CVD) patients rated the face and content validity (CV) of materials, providing input to improve cross-cultural applicability. Then, 200 patients from Saudi Arabia completed the questionnaire, of which factor structure, internal consistency, criterion and construct validity were assessed. RESULTS Content and face validity was supported based on experts and patients' reviews (ranges: CV scores 0.9-1.0/1.0 and clarity 3.5 to 4.5/5). Minor edits were made. Subsequent factor analysis revealed 4 factors consistent with the original version of the instrument, all internally consistent. Total CRBS-A α was 0.74. Criterion validity was confirmed by the significantly higher scores in patients who participated in CR. Construct validity was also established by significant associations between MDS scores and monthly family income, having the diagnosis of acute coronary syndrome or with a history of valve repair or replacement, being obese or having dyslipidemia. CONCLUSIONS Overall, these results confirm the validity and reliability of the MDS in Arabic-speaking patients.
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Affiliation(s)
- Raghdah Aljehani
- Rehabilitation Department, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Ghaidaa Aljehani
- Rehabilitation Department, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Hanaa Alharazi
- Cardiology Department, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Paula M. Horta
- Department of Nutrition, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Camila Kümmel Duarte
- Department of Nutrition, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Gabriela Lima de Melo Ghisi
- Department of Physical Therapy, University of Toronto, Toronto, Canada
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
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