Myocardial Infarction Survival and Diet Quality Interview with:
Shanshan Li, MD, MSc, ScD
Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
On behalf of Drs. Chuive, Flint, Pai, Forman, Hu, Willett, Mukamal and Rimm. What are the main findings of the study?

Answer: In our prospective study of diet quality among MI survivors, we found that a higher diet quality post-MI, measured by Alternative Healthy Eating Index 2010, was associated with 24% lower death rate and 26% lower death rate from cardiovascular disease. Greater improvement of diet quality from pre- to post-MI was associated with 30% lower death rate and 40% lower cardiovascular disease death rate. In addition to reducing the bad fats intake, for example, saturated and transfat intake, MI patients also tended to reduce the good healthy polyunsaturated fats. 
Were any of the findings unexpected?

Answer: Given the fact the MI patients in our study were health care professionals and they are likely to receive the best and up-to-date medical care, we were surprised to see how substantial the death rate could be further reduced  by eating a healthy diet.

In our study, we also found the associations between post-MI diet quality and improvements in diet quality from pre- to post-MI with mortality were stronger for women than for men, which is different from our previous studies of diet and primary prevention of CHD. This might be due to greater death rate among women, differences in MI clinical etiology and presentation. Future studies are needed to investigate this gender difference to confirm the results. What should clinicians and patients take away from your report?

Answer: For clinicians: Educate your patients about eating a healthy diet and making better dietary choices. Dietary recommendations for MI secondary prevention need to pay more emphasis on polyunsaturated fat intake, and reduce sugar-sweetened beverages and fruit juice consumption.

For patients:  Start eating a healthy diet now and it is never too late to make dietary changes. What recommendations do you have for future research as a result of this study?

Answer: In future, a large dietary secondary prevention trial is needed.


Better Diet Quality and Decreased Mortality Among Myocardial Infarction Survivors

Li S, Chiuve SE, Flint A, et al. Better Diet Quality and Decreased Mortality Among Myocardial Infarction Survivors. JAMA Intern Med. 2013;():-. doi:10.1001/jamainternmed.2013.9768.

Last Updated on December 21, 2014 by Marie Benz MD FAAD