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The long-term effect of dietary advice in men with coronary disease: follow-up of the Diet and Reinfarction trial (DART)
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.Design Questionnaire survey and mortality follow-up after a trial of dietary advice.Setting Twenty-one hospitals in south Wales and south-west England.Subjects Former participants in the Diet and Reinfarction Trial.Main outcome measures Current fish intake and cereal fibre intake. All-cause mortality, stroke mortality and coronary mortality.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).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.
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“Follow-up of DART-1 at 5y also showed increased rates of CVD in the fish/fish oil group that did not persist through the 10y assessment (202).”
From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [202]
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Metadata
- Authors
- Ness, A., Hughes, J., Elwood, P., Whitley, E., Smith, G., & Burr, M.
- Affiliations
- University Hospital Llandough (GB)
- University of Bristol (GB)
- ORCID
- Whitley, E
- Venue
- European Journal of Clinical Nutrition
- Published
- 2002-05-24
- Volume
- 56
- Issue
- 6
- Pages
- 512-518
- ISSN
- 0954-3007 (ISSN-L)
- 1476-5640
- OpenAlex
- W2101683206
- Cited by
- 111
- References
- 14
- Citations by year
- 2026: 1 · 2024: 2 · 2022: 2 · 2021: 3 · 2020: 2 · 2019: 2 · 2018: 7 · 2017: 2 · 2016: 3 · 2015: 2 · 2014: 5 · 2013: 3 · 2012: 6
- FWCI
- 9.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- dietary recommendations, myocardial infarction, coronary disease, fish consumption, all-cause mortality, stroke mortality, coronary heart disease mortality, long-term follow-up, men
- MeSH terms
- Animals, Edible Grain, Coronary Disease, Diet Surveys, Dietary Fats, Dietary Fiber, Fishes, Follow-Up Studies, Humans, Male, Myocardial Infarction, Patient Compliance, Surveys and Questionnaires, Recurrence, Risk Factors, Survival Analysis, Seafood, Stroke
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