Changes of body composition and dietary intakes after a nutritional intervention in a sample of heart-transplanted patients: primary longitudinal data.

Introduction: the long-life immunosuppressive therapy, which heart-transplanted (HTx) patients are exposed to, may increase the risk of many chronic diseases or complications. In particular, metabolic syndrome (MetS) represents a very frequent condition in HTx patients already before the transplantation, and steadily grows during their follow-up. Aim: to evaluate any beneficial effect of a nutritional intervention in HTx patients, in order to prevent or reduce metabolic diseases. Materials and methods: at baseline (T0), after 6 (T1), and 12 months (T2) patients were invited to compile a 4-day dietary record (4dDR) to bring at the scheduled visits. During the meetings, a nutritionist detected dietary habits and provided personalised nutritional advices based on the Mediterranean Diet, monitoring the improvement during the follow-ups. At each timepoint, anthropometric and body composition data were assessed. To estimate nutrient intakes from 4-dDR was used The Italian Food Composition Database (BDA). The study was approved by the Regional Ethics Committee. Results: at T0, 15 patients were enrolled, 11 have already returned at T1 and, 7 of them, also at T2. The mean age of the subjects was 57±14 years (males: 91%). Although any significant difference was found between T0 and T2 for body weight (kg) (T0=75.3±20.6; T2=75.7±20.4; p=0.71), a significant decrease of fat mass (%) (T0=23.2±6.3; T2=14.8±10.1; p=0.014) and a significant increase of fat free mass (%) (T0=76.8±6.3; T2=85.2±10.1; p=0.014) were obtained, with an increase of body cell mass between T1 and T2 (%) (T1=50.9±3.8; T2=53.4±3.4; p=0.031). Accordingly, dietary data between T0 and T2 showed a significant decrease of energy from saturated fatty acids (%) (T0=13.0±2.1; T2=9.6±1.5; p=0.001), sodium (mg) (T1=2138±359; T2=1822±417; p=0.045), and a decreasing trend for cholesterol (mg) (T0=219±82; T2=171±59; p=0.082). Moreover, macronutrient balance improved, with an increase of energy from carbohydrates and fiber intake, even if not already significant. Conclusions: fat mass of HTx patients significantly decreased after 12 months of intervention, perhaps as a consequence of the overall diet improvement, which showed a significant reduction of the major dietary risk factors for cardiovascular diseases.