Survey of UK dietetic departments: Diet in secondary prevention of myocardial infarction

Aim: To collate information on current British dietetic practice in the area of diet in secondary prevention of myocardial infarction, and to compare this with best evidence.

Methods: A questionnaire was sent to all Chief Dietitians, to be completed by the whole department, asking about current dietary advice and practice, referrals and written dietary information for people following myocardial infarction.

Results: Fifty-seven per cent of questionnaires were returned. Dietary fat advice was prioritized by 84% of departments, fruit and vegetables by 49%, oily fish by 45% and fibre by 28%. Most dietitians (81%) felt that this advice would protect from further cardiovascular disease. Percentages of post-myocardial infarction patients given advice by a dietitian varied (median 60%), reasons for non-referral included patients having normal lipids or weight. More were given dietary advice by another health professional (median 90%); however, most dietitians were unsure about the quality of this advice. Diet sheets were felt to reflect advice priorities, but where sheets were sent they were much less likely than departments to prioritize oily fish or fruit and vegetable advice.

Conclusion: Dietetic practice for people following myocardial infarction is out of line with current best evidence. Almost half of departments correctly prioritize oily fish advice, but often only see patients with raised lipids or weight. This is not the most effective strategy for preventing deaths.