Energy intake, body mass index and functional capacity of patients in a cardiovascular rehabilitation program.

Abstract

Background and aims: Cardiovascular diseases (CVD) impact individuals' quality of life, mainly due to their effects on functional capacity. Nutritional interventions are crucial for enhancing functional capacity in patients undergoing cardiovascular rehabilitation (CR) program. The energy consumption of patients with CVD warrants careful attention, particularly with regard to the quality of this energy, to prevent worsening CVD or developing other metabolic complications. This study hypothesizes that energy intake could impact, positively or negatively, depending on the amount, the functional capacity of patients with CVD. This research aims evaluate the relationship between total energy intake, as primary goal, and macronutrient energy intake, as secondary goal, and functional capacity outcomes in patients starting in a CR program.

Methods and results: This is a cross-sectional study conducted with patients starting a CR program. Food consumption was assessed using food records and the Incremental Shuttle Walking Test (ISWT) was used to assess functional capacity. A total of 116 patients were eligible for this study and 49 (42.2 %) were female, and the mean age was 59.4 (±12.2) years. The average walking distance in the ISWT was 289.41 (±138.45) meters, and the median distance for each heart rate increment was 8.93 (6.56-13.54) meters. It was observed that patients who walked more than the average in the ISWT consumed more calories (29.31 ± 8.35 kcal/kg/day) with no difference in macronutrient consumption, compared to those who walked fewer meters (23.87 ± 11.83 kcal/kg/day). Linear regression confirmed the association of caloric intake with walking distance even after adjustment for confounding variables such as sex and age, but it lost significance when adjusted for the participants' body mass index. However, when calories per kg of ideal body weight was used in the analysis, the association was missed.

Conclusion: The results of this study demonstrate that caloric intake could be associated with the functional capacity of patients with CVD, however this association is body weight depending. Individuals with lower BMI performed better in the ISWT than those with higher BMI. Further clinical studies are needed to clarify the relationship between diet composition and the functional capacity of individuals.