Both the American Heart Association and the American College of Cardiology endorse the idea that a patient diagnosed with heart disease or recovering from a heart attack or any cardiothoracic surgery will benefit from a cardiac rehabilitation program. Cardiac diet education is always a vital component of the rehab program. Because diet modifications are challenging, it is the job of the nutrition educator to increase the patients’ knowledge.
Features

Cardiac patients learn about the “Heart Healthy” diet, introduced in 2006 by the American Heart Association. They are advised to consume a diet rich in fruits and vegetables, choose high-fiber foods, consume fish at least twice a week, limit their intake of saturated fat to less than 7 percent of energy and trans fats to less than 1 percent of energy by choosing lean meats and dairy products, minimize intake of beverages and foods with added sugars, choose and prepare foods with little to no salt and consume alcohol only in moderation.
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The registered dietitian is the most qualified professional for nutrition education and care. When working with a heart disease patient, a dietitian begins medical nutrition therapy with an initial dietary assessment, which includes anthropometric measurements, and a survey of the patient’s knowledge and eating habits. After objective assessment and interpretation, the dietitian will define, in collaboration with the patient, therapeutic dietary changes and expected results. The initial patient education session can involve multiple teaching components. Examples include verbal advice, written diet prescriptions, providing educational pamphlets and books, and behavioral counseling.
Expert Insight

Only 22 percent of heart disease patients follow their recommended therapeutic dietary advice, according to a 2005 study conducted by the Centers of Disease Control and Prevention. Follow-up counseling with a dietician can be crucial for patient success. The American Dietetic Association defines nutrition counseling as, “a supportive process to set priorities, establish goals, and create individualized action plans that acknowledge and foster responsibility for self care,” which should ideally be carried ou monthly.
Considerations

Cardiac rehabilitation programs are effective. Successful dietary changes have been correlated with a 46 percent reduction in cardiac mortality, according to the French researcher C. Froger-Bompas and colleagues at the Cardiovascular Prevention Center in Rennes. Following a heart healthy diet is only one piece in the rehabilitation puzzle. Obesity, physical inactivity, and cigarette smoking are leading health behaviors contributing to the prevalence of global heart disease. The Surgeon General recommends smoking cessation and at least 30 minutes of moderate-intensity exercise most days of the week for secondary heart disease prevention.
Potential

Most of the responsibility lies in the hands of the patient for successful behavioral change. Educators can direct patients to numerous tools available online, including diet trackers and journals, physical activity meters, healthy recipes and heart healthy tips for dining out.
References

* American Heart Association: Cardiac rehabilitation
* “Circulation”, Diet and Lifestyle Recommendations Revision,Lichtenstein et al, June 2006
* PubMed.,ov: Nutritional Care in the Cardiac ,Rehabilitation Program,
* “Archives Cardiovascular Disease”, Sustained positive impact of a rehabilitation program on diet,
* American Dietetic Association:, Nutrition Counseling Evidence ,Analysis Project