Available studies show convincingly the health benefits of lifestyle changes in CAD patients .
Effect estimates of combined dietary changes look promising .
BACKGROUND Guidelines for lifestyle and dietary modification in patients with coronary artery disease ( CAD ) are mainly supported by evidence from general population studies .
CAD patients , however , differ from the general population in age ( older ) and treatment with preventive drugs .
This review seeks to provide evidence for a prognostic benefit of lifestyle and dietary recommendations from studies in CAD patients .
Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease
In a prospect i ve , r and omised single-blinded secondary prevention trial we compared the effect of a Mediterranean alpha-linolenic acid-rich diet to the usual post-infa rct prudent diet .  After a first myocardial infa rct ion , patients were r and omly assigned to the experimental ( n = 302 ) or control group ( n = 303 ) . Patients were seen again 8 weeks after r and omisation , and each year for 5 years . The experimental group consumed significantly less lipids , saturated fat , cholesterol  , and  linoleic acid  but more  oleic  and  alpha-linolenic acids  confirmed by measurements in plasma . Serum lipids , blood pressure , and body mass index remained similar in the 2 groups . In the experimental group , plasma levels of albumin , vitamin E , and vitamin C were increased , and granulocyte count decreased . After a mean follow up of 27 months , there were 16 cardiac deaths in the control and 3 in the experimental group ; 17 non-fatal myocardial infa rct ion in the control and 5 in the experimental groups : a risk ratio for these two main endpoints combined of 0.27 ( 95 % CI 0.12 - 0.59 , p = 0.001 ) after adjustment for prognostic variables . Overall mortality was 20 in the control , 8 in the experimental group , an adjusted risk ratio of 0.30 ( 95 % CI 0.11 - 0.82 , p = 0.02 ) . An alpha-linolenic acid-rich Mediterranean diet seems to be more efficient than presently used diets in the secondary prevention of coronary events and death
Available studies show convincingly the health benefits of lifestyle changes in CAD patients .
Effect estimates of combined dietary changes look promising .
BACKGROUND Guidelines for lifestyle and dietary modification in patients with coronary artery disease ( CAD ) are mainly supported by evidence from general population studies .
CAD patients , however , differ from the general population in age ( older ) and treatment with preventive drugs .
This review seeks to provide evidence for a prognostic benefit of lifestyle and dietary recommendations from studies in CAD patients .