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

Ness, A.R., Hughes, J., Elwood, P.C., Whitley, E. , Smith, G.D. and Burr, M.L. (2002) The long-term effect of dietary advice in men with coronary disease: follow-up of the diet and reinfarction trial (DART). European Journal of Clinical Nutrition, 56(6), pp. 512-518.

Abstract

OBJECTIVE:To assess the long-term effect of dietary advice on diet and mortality after a randomised trial of men with a recent history of myocardial infarction.<p></p> DESIGN: Questionnaire survey and mortality follow-up after a trial of dietary advice.<p></p> SETTING: Twenty-one hospitals in south Wales and south-west England.<p></p> SUBJECTS: Former participants in the Diet and Reinfarction Trial.<p></p> MAIN OUTCOME MEASURES: Current fish intake and cereal fibre intake. All-cause mortality, stroke mortality and coronary mortality.<p></p> RESULTS: By February 2000, after 21147 person years of follow-up, 1083 (53%) of the men had died. Completed questionnaires were obtained from 879 (85%) of the 1030 men alive at the beginning of 1999. Relative increases in fish and fibre intake were still present at 10 y but were much smaller. The early reduction in all-cause mortality observed in those given fish advice (unadjusted hazard 0.70 (95% CI 0.54, 0.92)) was followed by an increased risk over the next 3 y (unadjusted hazard 1.31 (95% CI 1.01, 1.70). Fat and fibre advice had no clear effect on coronary or all-cause mortality. The risk of stroke death was increased in the fat advice group-the overall unadjusted hazard was 2.03 (95% CI 1.14, 3.63).<p></p> CONCLUSIONS: In this follow-up of a trial of intensive dietary advice following myocardial infarction we did not observe any substantial long-term survival benefit. Further trials of fish and fibre advice are feasible and necessary to clarify the role of these foods in coronary disease.<p></p>

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Whitley, Dr Elise
• Authors: Ness, A.R., Hughes, J., Elwood, P.C., Whitley, E., Smith, G.D., and Burr, M.L.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
• Journal Name: European Journal of Clinical Nutrition
• ISSN: 0954-3007
• ISSN (Online): 1476-5640