Dissertação de Mestrado Nutrição Humana e Metabolismo 2023 Faculdade de Ciências Médicas, Universidade NOVA de Lisboa

Introduction: The Mediterranean dietary pattern is the standard recommended by the European Society of Cardiology for the atherosclerosis prevention. However, studies that evaluate dietary and nutritional intervention in cardiac rehabilitation programs are still scarce. Objective: The objective of this study was to compare the effectiveness of an intensive food and nutritional intervention program with a program consisting of only monthly appointments on predictive parameters of cardiovascular risk, including systolic blood pressure, lipid and glucose profile, as measured by the SMART tool Risk Score. Additionally, the study aimed to characterize the eligible individuals, evaluate the role of nutritional and intensive food monitoring in adherence to the Mediterranean dietary pattern, assess how adherence to this pattern improves body weight, body composition, and other health outcomes, including biochemical parameters and quality of life. Methodology: This 12-week randomised controlled clinical trial involving 21 individuals with acute myocardial infarction with ST-segment elevation undergoing primary angioplasty and referred to a cardiac rehabilitation programs, divided into two groups: intervention (n=11) and control (n=10). Both groups were subject to a food and nutritional intervention program with monthly nutrition consultations in which the adoption of the Mediterranean food pattern was promoted, and the intervention group also had telephone contacts, short text messages, consultation support tools, podcasts, free access short videos, cooking recipes and nutrition “workshops”. Blood and urine samples were collected at baseline and at the end of the study, while blood pressure was measured simultaneously. Adherence to the Mediterranean dietary pattern was evaluated using the MEDAS questionnaire, along with data on dietary intake from 24h recall. Additionally, the subject’s body composition was assessed using bioimpedance and their quality of life was measured with the EQ-5D-5L questionnaire at the start and conclusion of the study. Results: After 12 weeks, in both groups there was a decrease in the 10-year risk of developing acute myocardial infarction, cerebrovascular accident or vascular death, with this decrease being significant in the control group (p=0.016). A significant improvement in weight (p=0.008), body mass index (BMI) (p=0.008), waist circumference (p=0.001) and fat mass in the trunk region (p=0.022) was observed in the control group subjects and a significant improvement in the waist circumference was additionally found in the intervention group (p=0.036). MEDAS score increased significantly in both groups (p£0.001) and quality of life also increased, although the difference was not significant in either group