Cardiac rehabilitation patients may 'just say no' not only to obviously harmful dietary fat but also to beneficial fruits and vegetables, claims a small study published this month.
Researcher C. Jeffrey Frame, an assistant professor of nutrition, dietetics and food management at Murray State University in Kentucky, and colleagues followed patients who had been prescribed cardiac rehabilitation following coronary bypass operations, heart attacks or other heart problems.
They interviewed the patients at the start and end of a 12-week cardiac rehabilitation program and again two years later.
Patients attended a group education session for one hour each week and a dietitian worked individually with patients to develop nutrition and weight maintenance goals.
The researchers evaluated each patient based on the 'state-of-change' concept. This analysis includes five steps: pre-contemplation (not knowing or caring about a health risk); contemplation (knowing it, but not ready to do anything about it); preparation (getting ready to make an active effort); action (doing something positive for up to six months); maintenance (doing the right thing for more than six months and working to prevent relapse).
Frame commented that at the start of the rehab program, the impact of cardiac surgery or a heart attack led the majority of patients to take action on reducing dietary fat. By the end of the rehab program, 81 per cent were in the preparation, action or maintenance stages. Two years later, 87 per cent (105 out of 118) were in the maintenance stage alone.
But according to the study results, these same patients, who apparently did so well cutting down fat intake, made little progress during the same time toward eating five servings of fruits and vegetables a day. After two years, only 23 per cent were at the maintenance stage, while 59 per cent had slid down the ladder to the pre-contemplation or contemplation stages.
"There is no evidence that movement within the stages of change for one behavior was related to movement within the stages of change for the other food behavior," said Frame.
Frame's study of 118 patients, carried out at a cardiac rehabilitation unit in a hospital in Greensboro, N.C., appears in the July/August issue of the American Journal of Health Promotion.