The Heart Institute of Spokane Diet Study

NCT ID: NCT00269425

Last Updated: 2010-08-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

202 participants

Study Classification

INTERVENTIONAL

Study Start Date

2000-10-31

Study Completion Date

2008-01-31

Brief Summary

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The purpose of this study is to determine whether a Mediterranean style diet, enriched in monounsaturated and omega-3 fats, is superior to the American Heart Association Step 2 diet, a traditional low fat diet, for improving rates of survival and cardiovascular complications in persons who have had a first myocardial infarction (heart attack).

Detailed Description

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Cardiovascular diseases (heart attack, stroke, and other vascular diseases) are major causes of mortality in developed countries. Although medicines and revascularization procedures prolong lives, rates of death and disability remain high. Lifestyle factors greatly contribute to risk. Yet, scientific data regarding the role of lifestyle change in prevention and treatment are limited. In the nutrition area, limitations include observational or uncontrolled study design, and focus on surrogate markers rather than on clinical outcomes.

Excess dietary fat has long been associated with cardiovascular diseases. Increased risk is related both to types of fat and calories from fat. Saturated fat, cholesterol, and trans-fatty acids have all been associated with adverse outcomes. Because fat is calorie-laden, high fat diets are commonly associated with weight gain and obesity. Low-fat diets have traditionally been recommended to control lipids and weight. However, these diets are high in carbohydrate and may actually be associated with weight gain if calories are not limited. Such diets have also been associated with worsening of hyperinsulinemia and insulin resistance and an adverse lipid pattern (low HDL cholesterol and high triglyceride levels). In contrast, increased intake of monounsaturated and omega-3 fats is associated with favorable effects on cardiovascular risk factors and markers including: endothelial function, lipids, and levels of insulin and glucose. Results have been consistent across various groups of high-risk patients, including those with hypercholesterolemia, diabetes, and hypertension. Most importantly, a Mediterranean style diet enriched in monounsaturated and omega-3 fats reduced death and cardiovascular complications after myocardial infarction (MI) in the Lyon Heart study.

The American Heart Association (AHA) Step 2 is a low-fat diet traditionally recommended for people with cardiovascular disease. The Mediterranean and AHA Step 2 diets differ primarily in the amount of monounsaturated and omega-3 fats, both of which are higher in the Mediterranean diet. Both diets are low in saturated fat (less than 7%) and cholesterol (less than 200 mg/d). Although the Lyon Heart Study compared a Mediterranean diet to a "prudent Western diet," a low fat diet similar to the AHA diet, the latter group did not achieve recommended intake levels of saturated fat or cholesterol. Furthermore, there was no longitudinal nutritional intervention in the low fat diet group. Therefore, the effect of nutritional intervention per se was not addressed.

Comparison(s): In survivors of a first MI, two longitudinal nutritional interventions, a Mediterranean style diet and an AHA Step 2 diet, will be compared. Both intervention groups will be compared to an untreated control group from our clinical database.

Conditions

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Myocardial Infarction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Mediterranean diet,

Group Type EXPERIMENTAL

Mediterranean diet

Intervention Type BEHAVIORAL

Mediterranean style diet with patient education and diet analysis

American Heart Association Step 2 diet

Group Type EXPERIMENTAL

American Heart Association Step 2 diet

Intervention Type BEHAVIORAL

Low fat diet with patient education and diet analysis

Case controlled

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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American Heart Association Step 2 diet

Low fat diet with patient education and diet analysis

Intervention Type BEHAVIORAL

Mediterranean diet

Mediterranean style diet with patient education and diet analysis

Intervention Type BEHAVIORAL

Other Intervention Names

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Low fat diet

Eligibility Criteria

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Inclusion Criteria

* First myocardial infarction

Exclusion Criteria

* Prior myocardial infarction
* Uncontrolled or secondary hypertension
* New York Heart Association heart failure stage III or IV
* Ventricular arrythmias requiring medical or defibrillatory intervention
* Other diseases that may make study completion difficult or unlikely
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Heart Institute of Spokane

UNKNOWN

Sponsor Role collaborator

Providence Medical Research Center

OTHER

Sponsor Role collaborator

Washington State Attorney General's Office

OTHER

Sponsor Role collaborator

Deaconess Medical Center, Spokane, Washington

OTHER

Sponsor Role collaborator

Providence Health & Services

OTHER

Sponsor Role lead

Responsible Party

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Providence Medical Research Center

Principal Investigators

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Katherine R. Tuttle, MD,FASN,FACP

Role: PRINCIPAL_INVESTIGATOR

Providence Medical Research Center

Locations

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Providence Medical Research Center

Spokane, Washington, United States

Site Status

Countries

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United States

Other Identifiers

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THIS-A20010724157261

Identifier Type: -

Identifier Source: org_study_id

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