The Role of Nutrition in Secondary Prevention of Coronary Artery Disease

Secondary prevention strategies are designed to target multiple risk factors through pharmacologic and lifestyle intervention. Therefore, diet therapy plays an important role in secondary prevention of CHD. Epidemiologic studies have identified several dietary patterns that are associated with reduced risk for CHD morbidity and mortality, such as the Mediterranean diet and a "Prudent" diet. These dietary patterns exhibit a number of similarities with current dietary recommendations for primary and secondary prevention; they are nutrient rich (from fruits, vegetables, whole grains, nuts, seeds, and plant oils, reduced-fat and fat-free milk products, seafood, and lean animal and plant proteins) and low in saturated and trans fatty acids, cholesterol, and sodium. There also is strong evidence from secondary prevention studies that long chain omega-3 fatty acids from marine sources are effective for cardiovascular disease risk reduction. In addition, there is some evidence of benefits of dietary patterns including a Mediterranean diet, a very low-fat diet, a diet high in omega-6 polyunsaturated fatty acids as well as a Mediterranean-style diet high in alpha-linolenic acid (all of which are low in saturated fatty acids). It is apparent that there are multiple dietary treatment strategies available to clinicians that enable individualized treatment plans and optimal therapeutic outcomes for patients with coronary disease.