The role of Dietitian in cardiac rehabilitation and secondary prevention

Abstract

Rehabilitation and secondary prevention programs are recognized as an essential part of the overall care of patients with cardiovascular disease. They consist of multidisciplinary strategies aiming at the reduction of modifiable risk factors for cardiovascular disease. There are some evidence of the efficacy of nutritional care in modifying eating habits and behavior in patients undergoing cardiac rehabilitation. In 2007, the Italian Association of Dietitians (ANDID) appointed a working group of dietitians, skilled in nutrition applied in cardiovascular disease, with the aim to make an overview of the available scientific literature and to develop a Professional Position Paper on the role of Dietitian in cardiac rehabilitation and secondary prevention. The first Position Paper, developed in 2008, covered the available evidence about the dietitian professional role and contribution in the management of the topic. The working group has recently updated the contents by introducing, in agreement with the work done by ANDID, the methodology of the Nutrition Care Process and Model (NCP), a systematic problem-solving method intended to stimulate critical thinking, decision-making and address issues related to food and nutritional assistance, in order to provide a safe, effective and high quality care.

Nutrition Intervention in Cardiac Rehabilitation

“…34 In particular, RDNs provide expertise in clinical complexity in the context of multiple comorbidities, frailty, and coordination of nutritional care. 35,36 Cardiac rehabilitation programs that utilize an RDN provide more nutrition services including one-on-one counseling and cooking demonstrations compared with programs without an RDN. 35 Furthermore, patients with a higher body mass index, large waist circumference, and unfavorable lipid profiles are most likely to benefit from intensive individual nutrition counseling by an RDN.…”

“…35 Furthermore, patients with a higher body mass index, large waist circumference, and unfavorable lipid profiles are most likely to benefit from intensive individual nutrition counseling by an RDN. 36,37 The role of an RDN in CR is therefore fundamental in providing the best individualized care for complex patients in CR.…”

“…Medical nutrition therapy includes performing a comprehensive nutritional assessment, determining the nutrition diagnosis, implementing a nutrition intervention using evidence-based nutrition guidelines, and monitoring and evaluating individual progress toward goals 34. In particular, RDNs provide expertise in clinical complexity in the context of multiple comorbidities, frailty, and coordination of nutritional care 35,36. Cardiac rehabilitation programs that utilize an RDN provide more nutrition services including one-on-one counseling and cooking demonstrations compared with programs without an RDN 35.…”

“…Cardiac rehabilitation programs that utilize an RDN provide more nutrition services including one-on-one counseling and cooking demonstrations compared with programs without an RDN 35. Furthermore, patients with a higher body mass index, large waist circumference, and unfavorable lipid profiles are most likely to benefit from intensive individual nutrition counseling by an RDN 36,37. The role of an RDN in CR is therefore fundamental in providing the best individualized care for complex patients in CR.…”