A Healthy Nordic Diet for secondary prevention of myocardial infarction: a randomized controlled trial (NORDHEART study)

Background:Myocardial infarction (MI) is the most common cause of death. Diet may play an important role in the progression of atherosclerosis, but few interventional data exist. Plaque volume and composition are underlying predictors of coronary events.

We have shown in primary prevention settings that a “healthy Nordic diet” markedly reduce cardiovascular risk factors but few dietary intervention studies have been conducted in patients with myocardial infarction.

Objectives:The aim of this randomized study is to investigate if a healthy Nordic diet can reduce the progression of plaque volume and coronary artery calcification (CAC), as well as other cardiovascular risk factors, in patients with myocardial infarction.Work plan:n=130 patients with a recent MI will be randomized to a healthy Nordic diet (largely plant-based, rich in polyunsaturated fat from rapeseed oil and nuts and dietary fiber and whole grain from rye and oats), or “usual care” lifestyle advice.

Primary outcome is change in plaque volume assessed by CT angiography before and after 18months of intervention.

Secondary outcome is CAC and other established and exploratory risk factors (e.g. blood lipids, blood pressure, inflammation, glycemia, ceramides).

Biomarkers in blood will be used to evaluate dietary adherence.Significance:If a Healthy Nordic diet can reduce plaque volume and decrease cardiovascular risk profile, this would be novel information of high clinical importance for secondary prevention of MI.