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 .
Effect of age on excess mortality in obesity.
CONTEXT The effect of age on excess mortality from all causes associated with obesity is controversial . Few studies have investigated the association between body mass index ( BMI , calculated as weight in kilograms divided by the square of height in meters ) , age , and mortality , with sufficient numbers of subjects at all levels of obesity . OBJECTIVE To assess the effect of age on the excess mortality associated with all degrees of obesity . DESIGN Prospect i ve cohort study . SETTING AND PARTICIPANTS A total of 6193 obese patients with mean ( SD ) BMI of 36.6 ( 6.1 ) kg/m2 and mean ( SD ) age of 40.4 ( 12.9 ) years who had been referred to the obesity clinic of Heinrich-Heine University , Düsseldorf , Germany , between 1961 and 1994 . Median follow-up time was 14.8 years . MAIN OUTCOME MEASURE All-cause mortality through 1994 among 6053 patients for whom follow-up data were available ( 1028 deaths ) analyzed as st and ardized mortality ratios ( SMRs ) using the male-female population of the geographic region ( North Rhine Westphalia ) as reference . RESULTS The cohort was grouped into approximate quartiles according to age ( 18 - 29 , 30 - 39 , 40 - 49 , and 50 - 74 years ) and BMI ( 25 to < 32 , 32 to < 36 , 36 to < 40 , and > or = 40 kg/m2 ) at baseline . The SMRs showed a significant excess mortality with an SMR for men of 1.67 ( 95 % confidence interval , 1.51 - 1.85 ; P<.001 ) and an SMR for women of 1.45 ( 95 % confidence interval , 1.34 - 1.57 ; P<.001 ) . The excess mortality associated with obesity declined with age . For men , the SMRs of the 4 age groups were 2.46 , 2.30 , 1.99 , and 1.31 , respectively ; for women , they were 1.81 , 2.10 , 1.70 , and 1.26 , respectively ( Poisson trend test , P<.001 ) . The SMRs increased with BMI but , within each BMI group , the SMRs decreased with age . The lowest SMRs ( for men , 1.01 ; for women , 0.91 ) were obtained for patients older than 50 years with BMI s of 25 to less than 32 kg/m2 . Thus , older men and women at a BMI range of 25 to less than 32 kg/m2 had no excess mortality . The highest SMRs ( for men , 4.22 ; for women , 3.79 ) were calculated for the patients aged 18 to 29 years with a BMI of 40 kg/m2 or higher . CONCLUSIONS In this large cohort of obese persons , risk of death increased with body weight , but obesity-related excess mortality declined with age at all levels of obesity
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 .