Dietary and Lifestyle Changes Before and After Diagnosis of Cardiovascular Disease

BACKGROUND: Although the presence or absence of cardiovascular disease (CVD) recurrence is related to lifestyle habits, including diet, evidence for the maintenance of dietary improvement among participants with incident CVD after acute treatment is scarce. AIM: To determine changes in diet and other lifestyle factors in participants with incident CVD in the Japan Public Health Center-based Prospective Study (JPHC study) over a 5-year period before and after diagnosis by comparing changes with those in participants without a diagnosis of CVD. METHODS: Participants were 68733 subjects aged 45-76 years at the baseline survey. Intakes of seven nutrients and 16 food groups were estimated using Food Frequency Questionnaires at the baseline survey and 5-year follow-up survey, and the amount of change was determined. Those diagnosed with CVD during the 5-year follow-up period were defined as participants with incident CVD (800 cases) and those not diagnosed were considered the non-CVD controls. Differences in the change between the two groups over the 5-year period were examined using the Mann-Whitney U test and multivariate linear regression analysis. Changes in smoking status, body mass index (BMI), and physical activity were compared by logistic regression analysis. RESULTS: CVD participants appeared to restrict sodium intake after diagnosis, and even after energy adjustment were more likely to avoid eating sodium, miso soup and pickles. In addition, they were less likely to eat beef and pork than controls. Significantly more CVD participants than controls stopped smoking and had decreased BMI. CONCLUSION: Participants with incident CVD showed modification in selective lifestyle factors, characterised by reduced sodium intake and smoking cessation.