Modifying dietary patterns in cardiothoracic transplant patients to reduce cardiovascular risk: the AMEND-IT Trial

Abstract

Cardiovascular disease (CVD) is common after cardiothoracic transplantation. In a pilot intervention we assessed feasibility and potential effectiveness of dietary interventions to reduce CVD risk. We recruited patients from a tertiary hospital and randomly allocated them to a Mediterranean or low-fat diet for twelve months. Feasibility was measured by patient participation, retention and adherence. Changes in weight, body mass index (BMI), heart rate, blood pressure, glucose markers and blood lipids were assessed using longitudinal Generalized Estimating Equation regression models with 95% confidence intervals. Of 56 heart and 60 lung transplant recipients, 52 (45%) consented, 41 were randomised and 39 (95%) completed the study with good adherence to randomized diets. After 12 months, changes in many risk factors were seen in the Mediterranean and low-fat diet groups respectively including mean BMI (-0.5 vs. 0.0kg/m2 ), systolic/diastolic blood pressure +0.5/+0.1 vs -4.4/-3.5 mmHg; fasting glucose -0.26 vs -0.27 mmol/L; total cholesterol -0.56 vs -0.40 mmol/L. Changes in BMI and systolic/diastolic blood pressure in 49 eligible patients who did not take part were +0.7 kg/m2 and +2.5/+1.8 mmHg. Thus such dietary interventions in cardiothoracic transplant patients are feasible, and potentially beneficial. A definitive nutritional intervention study in these high-risk patients is warranted.