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

Timothy R Entwistle; Kyoko Miura; Brian G Keevil; Julie Morris; Nizar Yonan; Matthew Pohl; Adele C Green; James E Fildes

doi:10.1111/ctr.14186

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

Timothy R Entwistle, Kyoko Miura, Brian G Keevil, Julie Morris, Nizar Yonan, Matthew Pohl, Adele C Green, James E Fildes

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Cardiovascular disease (CVD) is common after cardiothoracic transplantation and causes substantial morbidity.

AIMS: To assess feasibility and potential effectiveness of dietary interventions to reduce CVD risk.

MATERIALS AND METHODS: In a pilot intervention, we recruited patients from a tertiary hospital and randomly allocated them to a Mediterranean or low-fat diet for 12 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.

RESULTS: Of 56 heart and 60 lung transplant recipients, 52 (45%) consented, 41 were randomized, 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. 0.0 kg/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.

DISCUSSION: Dietary interventions in cardiothoracic transplant patients are feasible and potentially beneficial.

CONCLUSION: A definitive nutritional intervention study in these high-risk patients is warranted.

Original language	English
Article number	e14186
Journal	Clinical Transplantation
Volume	35
Issue number	2
DOIs	https://doi.org/10.1111/ctr.14186
Publication status	Published - 25 Feb 2021

Keywords

cardiothoracic transplantation
cardiovascular risk
feasibility
low-fat diet
mediterranean diet

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/ctr.14186

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title = "Modifying dietary patterns in cardiothoracic transplant patients to reduce cardiovascular risk: The AMEND-IT Trial",

abstract = "BACKGROUND: Cardiovascular disease (CVD) is common after cardiothoracic transplantation and causes substantial morbidity.AIMS: To assess feasibility and potential effectiveness of dietary interventions to reduce CVD risk.MATERIALS AND METHODS: In a pilot intervention, we recruited patients from a tertiary hospital and randomly allocated them to a Mediterranean or low-fat diet for 12 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.RESULTS: Of 56 heart and 60 lung transplant recipients, 52 (45%) consented, 41 were randomized, 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. 0.0 kg/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.DISCUSSION: Dietary interventions in cardiothoracic transplant patients are feasible and potentially beneficial.CONCLUSION: A definitive nutritional intervention study in these high-risk patients is warranted.",

keywords = "cardiothoracic transplantation, cardiovascular risk, feasibility, low-fat diet, mediterranean diet",

author = "Entwistle, {Timothy R} and Kyoko Miura and Keevil, {Brian G} and Julie Morris and Nizar Yonan and Matthew Pohl and Green, {Adele C} and Fildes, {James E}",

note = "Funding Information: The authors are grateful to Dr William Critchley and Philip Foden for their assistance with statistical analyses and to Dr Christina Nagle for very helpful comments on manuscript drafts. This study was funded through a research grant from the New Start Charity (registered charity number 1049067). The funding body played no role in the study's conduct. Extra-virgin olive oil was supplied by Odysea Foods Ltd. Publisher Copyright: {\textcopyright} 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd",

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doi = "10.1111/ctr.14186",

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T1 - Modifying dietary patterns in cardiothoracic transplant patients to reduce cardiovascular risk

T2 - The AMEND-IT Trial

AU - Entwistle, Timothy R

AU - Miura, Kyoko

AU - Keevil, Brian G

AU - Morris, Julie

AU - Yonan, Nizar

AU - Pohl, Matthew

AU - Green, Adele C

AU - Fildes, James E

N1 - Funding Information: The authors are grateful to Dr William Critchley and Philip Foden for their assistance with statistical analyses and to Dr Christina Nagle for very helpful comments on manuscript drafts. This study was funded through a research grant from the New Start Charity (registered charity number 1049067). The funding body played no role in the study's conduct. Extra-virgin olive oil was supplied by Odysea Foods Ltd. Publisher Copyright: © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

PY - 2021/2/25

Y1 - 2021/2/25

N2 - BACKGROUND: Cardiovascular disease (CVD) is common after cardiothoracic transplantation and causes substantial morbidity.AIMS: To assess feasibility and potential effectiveness of dietary interventions to reduce CVD risk.MATERIALS AND METHODS: In a pilot intervention, we recruited patients from a tertiary hospital and randomly allocated them to a Mediterranean or low-fat diet for 12 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.RESULTS: Of 56 heart and 60 lung transplant recipients, 52 (45%) consented, 41 were randomized, 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. 0.0 kg/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.DISCUSSION: Dietary interventions in cardiothoracic transplant patients are feasible and potentially beneficial.CONCLUSION: A definitive nutritional intervention study in these high-risk patients is warranted.

AB - BACKGROUND: Cardiovascular disease (CVD) is common after cardiothoracic transplantation and causes substantial morbidity.AIMS: To assess feasibility and potential effectiveness of dietary interventions to reduce CVD risk.MATERIALS AND METHODS: In a pilot intervention, we recruited patients from a tertiary hospital and randomly allocated them to a Mediterranean or low-fat diet for 12 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.RESULTS: Of 56 heart and 60 lung transplant recipients, 52 (45%) consented, 41 were randomized, 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. 0.0 kg/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.DISCUSSION: Dietary interventions in cardiothoracic transplant patients are feasible and potentially beneficial.CONCLUSION: A definitive nutritional intervention study in these high-risk patients is warranted.

KW - cardiothoracic transplantation

KW - cardiovascular risk

KW - feasibility

KW - low-fat diet

KW - mediterranean diet

U2 - 10.1111/ctr.14186

DO - 10.1111/ctr.14186

M3 - Article

C2 - 33314283

SN - 0902-0063

VL - 35

JO - Clinical Transplantation

JF - Clinical Transplantation

IS - 2

M1 - e14186

ER -

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

Abstract

Keywords

UN SDGs

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