Dietary pattern and its relationship with health-related factors among patients with coronary artery disease in Iranian Hospital

The prevalence of coronary artery disease (CAD) has increased in recent times in developing countries like Iran. In Iran, about 50% of all deaths per year are caused by CAD and mostly due to behavioral factors such as unhealthy dietary pattern. The objective of this cross-sectional study was to determine dietary patterns and their relationship with socio-demographics, health-related factors, biochemical characteristics, blood pressure and body mass index (BMI) among coronary artery disease patients in Fatemeh-Zahra Hospital, Sari, Iran. Data on socio-demographics, smoking status and supplement intake of CAD patients were collected via a self-administered questionnaire. Dietary pattern was assessed by semi-quantitative food frequency questionnaire, while the physical activity level was assessed by using the International Physical Activity Questionnaire. Weight, height and blood pressure were measured using a weight scale, body meter and blood pressure scale (ABN-mercury sphygmomanometer) by trained nurses. The serum lipid profile was measured using Ebra- auto analyzer by trained technician. The data of socio-demographic, lipid profile, weight, height and blood pressure were collected from patients’ record. Data were analyzed by using Statistical Package for Social Sciences (SPSS) 18. A total of 250 subjects (52% males and 48% females) who fulfilled the selection criteria participated in this study. The mean age of the subjects was 59.68±10.26 years and 51.6% of the subjects had low physical activity (total Met-min/wk <600). Most of the subjects were non-smokers (72.8%) and did not take supplements (89.2%). Mean of BMI was 26.68 ± 4.42 kg/m² and 43.6% were overweight and 21.6% were obese. Mean of triglyceride, total cholesterol, LDL, and HDL were 183.7 ± 94.8 mg/dl, 179.7 ± 4 2.5 mg/dl, 100.8 ± 31.5 mg/dl, 36.6 ± 9.06 mg/dl respectively. The mean of systolic blood pressure was 123.5 ± 12.5 mmHg and diastolic blood pressure was 80.07 ± 8.1 mmHg. The dietary patterns were identified using factor analysis. The first factor that explained 12.15% of variances was the traditional pattern. The second pattern, with 12% of variances was the western pattern. The third pattern with 9.06% of variances was the healthy pattern. Educational level [uneducated (p = 0.007 and primary school (p = 0.004)], income (p = 0.028), physical activity (p = 0.016) and being a housewives (p = 0.005) were associated with the traditional pattern. Smoking (p = 0.040), farmers, housewives (p = 0.001) and age (p = 0.000) associated with the western pattern. Urban residence (p = 0.015), male (p = 0.049), farmers (p = 0.020) and income (p = 0.027) were associated with the healthy pattern. Based on the biochemical characteristics, blood pressure and BMI, the traditional pattern was significantly associated with increase in systolic and diastolic blood pressure (β = 0.133 and β = 0.148 respectively) and decrease in LDL (β = -0.127) and HDL (β = -0.182). The western pattern was significantly associated with increase in total cholesterol (β = 0.16), LDL (β = 0.13) and BMI (β = 0.12). The healthy pattern was significantly associated with decrease of TG (β = -0.123), BMI (β = - 0.170), systolic (β = -0.130) and diastolic blood pressure (β = -0.135). In conclusion, these findings indicated that the healthy pattern was practiced by less number of subjects with percentages of variance lower than other patterns. Also, this study provided insight into the socio-demographic and health-related factors that are related to dietary patterns of coronary artery disease and factors that are influenced by dietary patterns. This study can also be used to strengthen public health strategies that aim to improve dietary intake for primary and secondary prevention of CAD.

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