Teachable moment for lifestyle and dietary changes after a myocardial infarction: Identifying the window of opportunity

IF 7.9 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition Pub Date : 2026-03-01 Epub Date: 2026-01-31 DOI:10.1016/j.clnu.2026.106589

Bahram Yosofi , Manon Reesink , Susan van Maren , Manon G. van den Berg , Jessica C. Kiefte-de Jong , Robin Nijveldt , Saloua El Messaoudi

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引用次数: 0

Abstract

Background and aims: While lifestyle changes, including dietary modifications, are crucial for reducing cardiovascular risk, adherence to these changes remains low. A ‘teachable moment’ (TM) can improve adherence, and a myocardial infarction (MI) can serve as a TM for initiating lifestyle and dietary changes. However, the timing and duration of receptiveness remain unclear. This study aimed to investigate whether an MI serves as a TM for lifestyle and dietary change intentions, to explore when this TM is most pronounced and to identify predictors of this TM.

Methods

In this cross-sectional survey study, patients who experienced an MI reported their intentions to change lifestyle and diet, along with the validated CardiacTM scale. Patients were categorised based on the time since MI: within 2 weeks, 6 months, 1 year, and 3 years ago. Intentions to change lifestyle and diet were compared between groups. Logistic regression analyses were performed to examine the association between the CardiacTM factors, time elapsed post–MI and intentions to change lifestyle and diet.

Results

241 patients were included in the analyses. Event-related lifestyle change intentions differed significantly between the 6-month and 1-year post–MI groups (30.6 % vs. 55.4 %, p = 0.003), as well as between the 2-weeks and 6-month post–MI groups (54.3 % and 30.6%p = 0.010). The intention to change dietary behaviour and general lifestyle were comparable across groups. Multivariate logistic regression revealed that time post–MI (p = 0.018), changed self-concept (B = 0.748; p < 0.001) and cardiovascular disease (CVD) group identity (B = 0.550; p = 0.021) were significantly associated with event-related lifestyle change intentions. Affective impact (B = −0.496; p < 0.001), changed self-concept (B = 0.506; p < 0.001), perceived risk of non-communicable diseases (NCD) (B = −0.450; p = 0.003) and anticipated regret (B = 0.345; p = 0.008) were significantly associated with general lifestyle change intentions. Significant predictors of dietary change intentions were affective impact (B = 0.298; p = 0.025) and changed self-concept (B = 0.518; p < 0.001).

Conclusions

A significant association was found between time post–MI and event-related lifestyle change intentions. Changed self-concept was the strongest predictor of TM for dietary, event-related and general lifestyle change intentions. These results suggest lifestyle interventions should be provided shortly after the event and personalised based on patients' perceptions of their MI to maximise effectiveness.

查看原文本刊更多论文

心肌梗死后生活方式和饮食改变的教育时刻：确定机会之窗。

背景和目的：虽然生活方式的改变，包括饮食的调整，对降低心血管风险至关重要，但坚持这些改变的程度仍然很低。“可教时刻”（TM）可以提高依从性，心肌梗死（MI）可以作为开始生活方式和饮食改变的TM。然而，接受的时间和持续时间仍不清楚。本研究旨在调查MI是否可以作为生活方式和饮食改变意图的TM，探索何时这种TM最明显，并确定这种TM的预测因子。方法：在这项横断面调查研究中，经历心肌梗死的患者报告了他们改变生活方式和饮食的意图，并使用了经过验证的CardiacTM量表。根据心肌梗死发生时间对患者进行分类：2周内、6个月内、1年内和3年前。对两组之间改变生活方式和饮食习惯的意愿进行比较。采用Logistic回归分析来检验CardiacTM因素、心肌梗死后的时间和改变生活方式和饮食的意愿之间的关系。结果：241例患者纳入分析。事件相关的生活方式改变意愿在心肌梗死后6个月和1年组之间差异显著（30.6%对55.4%,p = 0.003），以及心肌梗死后2周和6个月组之间（54.3%和30.6%p = 0.010）。改变饮食行为和一般生活方式的意图在各组之间具有可比性。多因素logistic回归显示，心肌梗死后时间（p = 0.018）、自我概念改变（B = 0.748, p < 0.001）和心血管疾病（CVD）群体认同（B = 0.550, p = 0.021）与事件相关的生活方式改变意图显著相关。情感影响（B = -0.496; p < 0.001）、自我概念改变（B = 0.506; p < 0.001）、感知非传染性疾病（NCD）风险（B = -0.450; p = 0.003）和预期后悔（B = 0.345; p = 0.008）与一般生活方式改变意图显著相关。饮食改变意向的显著预测因子为情感影响（B = 0.298; p = 0.025）和自我概念改变（B = 0.518; p < 0.001）。结论：心肌梗死后时间与事件相关的生活方式改变意图之间存在显著关联。改变自我概念是TM对饮食、事件相关和一般生活方式改变意图的最强预测因子。这些结果表明，生活方式干预应在事件发生后不久提供，并根据患者对其心肌梗死的看法进行个性化治疗，以最大限度地提高疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition 医学-营养学

CiteScore

14.10

自引率

6.30%

发文量

356

审稿时长

28 days

期刊介绍： Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.