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Cardiac Rehabilitation
17 Cardiac Rehabilitation: The Nutrition
Counseling Component
William E. Kraus and Julie D. Pruitt
Key Points
Cardiac rehabilitation following a cardiac event is a comprehensive, multidisciplin-
ary program that includes lifestyle counseling in nutrition, physical activity, stress
management, and smoking cessation.
Special concerns that can affect implementation of cardiac rehabilitation in older
patients include complicated co-morbidities; functional limitations, alterations in
taste, smell, and appetite; difficulties with medication use/effectiveness; and limited
financial, social, and/or caregiver resources.
Recommendations for dietary modification in cardiac rehabilitation include advice
to increase the intake of fruits, vegetables, and whole grains, to substitute non-
hydrogenated unsaturated fats for saturated and trans-fats, and to increase intake
of omega-3 fatty acids.
Key Words: Cardiac event; hypertension; dyslipidemia; lipid-modified diet;
sodium
17.1 CORE COMPONENTS OF CARDIAC REHABILITATION
The era of cardiac rehabilitation in the United States dates back at least 30 years,
when visionaries Herman Hellerstein, Andy Wallace, and Ken Cooper, among
others, envisioned that a comprehensive lifestyle approach to the rehabilitation
and prevention of patients having had a cardiac event would potentially yield
great benefits for the individual patient and the health-care system. Until that
time, the thought of vigorous exercise in the cardiac patient soon after an event
was close to anathema. Since then the concept of cardiac rehabilitation has grown
into a comprehensive multidisciplinary program that includes lifestyle counseling,
particularly in nutrition, physical activity, stress management, and smoking cessa-
tion, as core concepts within the program (1). Despite the importance of providing
From: Nutrition and Health: Handbook of Clinical Nutrition and Aging, Second Edition
Edited by: C. W. Bales and C. S. Ritchie, DOI 10.1007/978-1-60327-385-5_17,
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