Diet quality of patients with acute coronary syndrome receiving public and private health care

Abstract

Objective: The aim of this study was to investigate the quality of the diets consumed by patients with acute coronary syndrome (ACS) who received public and private health care.

Methods: This observational, prospective, longitudinal cohort study evaluated patients with ACS who attended three private and one public cardiology reference hospitals. Information about dietary parameters during the 6 mo before the acute ACS event was collected at admission and 180 d later using a semiquantitative food frequency questionnaire. Diet quality was assessed using the Alternative Healthy Eating Index (2010), and a multilinear regression model was developed to evaluate the associated variables.

Results: The 581 volunteers included in this study comprised 325 (55.9%) and 256 (44.1%) patients treated at private and public hospitals, respectively. Although the dietary index increased significantly after ACS (P < 0001), diet quality remained unsatisfactory, particularly in terms of reductions in the consumption of cardioprotective components (vegetables, fruits, and eicosapentaenoic and docosahexaenoic fatty acids). Compared with patients receiving private health care, those attending a public hospital reported lower dietary quality (P < 0.001). The best diet quality was found to correlate with female sex (P < 0.001), receipt of dietary guidance at hospital discharge (P < 0.001), private health care (P < 0.001), a stable relationship status (P, 0.016), and older age (P < 0.001).

Conclusion: The overall post-ACS diet quality remained unsatisfactory, especially in terms of cardioprotective components and among patients receiving public health care. Sociodemographic factors and the assistance model/quality were determinants of the observed differences in dietary quality.

Keywords: Acute coronary syndrome; Diet; Patients; Quality of health care; Secondary prevention.