Metabolic syndrome and related dietary intervention among patients with coronary and peripheral arterial disease attending cardiovascular rehabilitation programs

Aim of the study: To provide estimates of the prevalence of metabolic syndrome (MS) among patients with coronary artery disease (CAD) or peripheral arterial obstructive disease (PAOD) attending cardiac rehabilitation (CR) programs, as well as related dietary needs targeted on the single core components of the syndrome. Methods: Observational study enrolling 209 patients (males 75%, mean age 65±8 yrs.) referred to a CR facility because of silent ischemia (11%), chronic stable angina (28%), acute coronary syndrome (41%), or peripheral arterial disease (20%). The MS was diagnosed according to the 2005-modified NCEP ATP III criteria. Dietary regimens were classified into four areas of intervention (weight control, lipid control, glycaemic control, and blood pressure control) and compared in patients with and without MS. Results: MS accounted for 26% of all patients, with the highest prevalence (31%) among those admitted after acute coronary syndromes. All four dietary regimens were significantly more prescribed (p< 0.001) among patients with MS as compared to controls, with low sodium (95%) and low fat (90%) diets as the most represented patterns. All patients with MS were prescribed multiple dietary patterns, with adoption of a comprehensive low energy, low fat, and low glucose diet in up to one fifth of cases. Conclusion: Patients with CAD or PAOD referred to CR programs often display an high cardiometabolic risk and need a broad regimen of dietary modification.