Examining the Nutrition of Cardiological Patients in Hospitals: Evaluating the Discrepancy between Received Diets and Reference Diet Based on ESC 2021 Guidelines—Hospital Diet Medical Investigation) (HDMI) Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design and Setting
2.2. Sample
2.3. Bioethical Consideration
2.4. Instrument and Data Collection
2.5. Statistical Analysis
3. Results
3.1. The Outcomes from the Survey
3.2. Differences in the Content of Nutrients and product Groups
3.3. Fulfilling the ESC Guidelines
3.4. Estimated Number of Patients
4. Discussion
4.1. A Summary of Main Results
4.2. Strengths and Limitations
4.3. Agreement and Disagreement with Other Studies
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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The Predominance of Plant-Based Food Patterns and the Reduction in Animal-Based Ones |
Limitation of saturated fatty acids to <10% of energy intake and their replacement by PUFAs, MUFAs and carbohydrates from whole grains |
Minimalization of the amount of unsaturated trans fatty acids in the diet and exclusion of highly processed products |
<5g total salt intake per day |
30–45 g of fiber per day, optimally from whole grains |
≥200 g of fruit per day (≥2–3 servings) ≥200 g of vegetables per day (≥2–3 servings) |
Reduction in the consumption of red meat to the maximum 350–500 g per week, especially processed meat |
Eating fish 1–2 times a week, especially fatty fish |
Consuming 30 g of unsalted nuts per day |
Limitation of alcohol consumption to a maximum of 100 g/week |
Avoidance of sweetened beverages, including fruit juices and sweet carbonated and non-carbonated drinks |
Variables | Hospital | ||||||
---|---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | 6 | 7 | |
Type of the hospital (degree of reference) | 3rd | 2nd | 3rd | 3rd | 3rd | 1st | 3rd |
Total number of beds | 1035 | 452 | 683 | 677 | 363 | 176 | 321 |
Number of beds in internal medicine unit | 386 | 96 | 21 | 87 | 45 | 52 | 50 |
Number of beds in cardiology unit | 63 | 32 | 20 | 250 | 76 | 0 | 171 |
Presence of dietician | No | No | No | Yes | Yes | Yes | Yes |
Nutrition education | Yes | Yes | No | Yes | Yes | Yes | Yes |
The person responsible for nutrition education | Specialists outside the hospital (occasionally) | Doctor | - | Dietician, doctor, nurse | Dietician, doctor, nurse | Dietician, doctor, nurse | Dietician, doctor, nurse |
Place of meal preparation | Catering | Catering | Kitchen in the hospital | Kitchen in the hospital | Catering | Kitchen in the hospital | Kitchen in the hospital |
Hospital | M | SD | Mini | Max | p-Value ** |
---|---|---|---|---|---|
Energy (kcal) (F = 12307.61; p < 0.001 *) | |||||
Hospital 1 | 2102.07 | 225.04 | 1816.34 | 2558.38 | 0.764 |
Hospital 2 | 2358.78 | 69.31 | 2226.81 | 2448.24 | 0.001 |
Hospital 3 | 1966.56 | 96.46 | 1811.74 | 2087.37 | 0.997 |
Hospital 4 | 1783.75 | 57.43 | 1701.71 | 1881.67 | 0.078 |
Hospital 5 | 1930.80 | 94.88 | 1812.60 | 2155.87 | 0.914 |
Hospital 6 | 2214.67 | 200.95 | 1936.56 | 2610.27 | 0.073 |
Hospital 7 | 2147.87 | 193.29 | 1810.47 | 2448.25 | 0.376 |
Reference (standardized menu) | 2005.36 | 20.64 | 1984.31 | 2039.82 | - |
Total amount of carbohydrates (F = 14789.56; p < 0.001 *) | |||||
Hospital 1 | 305.31 | 23.42 | 266.56 | 335.13 | 0.152 |
Hospital 2 | 313.61 | 17.84 | 297.40 | 342.39 | 0.041 |
Hospital 3 | 296.36 | 19.22 | 262.96 | 320.93 | 0.606 |
Hospital 4 | 256.89 | 11.35 | 236.96 | 273.61 | 0.204 |
Hospital 5 | 295.79 | 15.72 | 267.12 | 319.26 | 0.644 |
Hospital 6 | 330.95 | 23.53 | 308.43 | 378.07 | <0.001 |
Hospital 7 | 323.93 | 24.75 | 295.07 | 378.07 | 0.001 |
Reference (standardized menu) | 281.09 | 11.37 | 266.26 | 298.17 | - |
Percentage of energy from carbohydrates (F = 16905.28; p < 0.001 *) | |||||
Hospital 1 | 53.72 | 4.20 | 47.39 | 61.55 | 0.012 |
Hospital 2 | 48.44 | 2.18 | 45.86 | 51.66 | 1.000 |
Hospital 3 | 54.29 | 2.20 | 52.08 | 58.99 | 0.005 |
Hospital 4 | 51.73 | 2.24 | 47.29 | 53.92 | 0.243 |
Hospital 5 | 55.11 | 2.41 | 52.06 | 58.66 | 0.001 |
Hospital 6 | 56.08 | 4.86 | 46.41 | 63.33 | <0.001 |
Hospital 7 | 56.55 | 3.61 | 52.18 | 62.12 | <0.001 |
Reference (standardized menu) | 47.91 | 1.89 | 45.21 | 50.17 | - |
Digestible carbohydrates (F = 13424.08; p < 0.001 *) | |||||
Hospital 1 | 279.68 | 21.63 | 243.90 | 302.89 | 0.001 |
Hospital 2 | 284.35 | 17.34 | 268.19 | 314.86 | 0.001 |
Hospital 3 | 265.74 | 17.78 | 236.36 | 283.61 | 0.058 |
Hospital 4 | 229.35 | 10.92 | 210.00 | 240.88 | 0.946 |
Hospital 5 | 264.23 | 14.21 | 237.12 | 283.48 | 0.083 |
Hospital 6 | 307.76 | 23.65 | 286.53 | 355.29 | <0.001 |
Hospital 7 | 301.46 | 23.18 | 280.08 | 355.29 | <0.001 |
Reference | 238.42 | 10.78 | 224.78 | 253.90 | - |
Fiber (F = 5870.27; p < 0.001 *) | |||||
Hospital 1 | 25.64 | 3.49 | 19.60 | 32.23 | <0.001 |
Hospital 2 | 29.26 | 3.11 | 25.78 | 34.70 | <0.001 |
Hospital 3 | 30.61 | 3.73 | 26.59 | 38.50 | <0.001 |
Hospital 4 | 27.54 | 3.08 | 24.04 | 32.72 | <0.001 |
Hospital 5 | 31.56 | 2.75 | 25.95 | 35.78 | <0.001 |
Hospital 6 | 23.20 | 2.15 | 19.40 | 27.16 | <0.001 |
Hospital 7 | 22.47 | 3.11 | 14.99 | 27.16 | <0.001 |
Reference (standardized menu) | 42.68 | 2.55 | 39.39 | 45.99 | - |
Hospital | M | SD | Mini | Max | p-Value ** |
---|---|---|---|---|---|
Total amount of protein (F = 7647.82; p < 0.001 *) | |||||
Hospital 1 | 73.95 | 9.93 | 59.16 | 92.37 | <0.001 |
Hospital 2 | 99.05 | 7.06 | 88.81 | 110.67 | 0.737 |
Hospital 3 | 76.19 | 8.58 | 60.14 | 89.47 | <0.001 |
Hospital 4 | 79.58 | 9.24 | 65.39 | 94.59 | <0.001 |
Hospital 5 | 80.93 | 6.33 | 72.44 | 89.17 | <0.001 |
Hospital 6 | 83.14 | 5.97 | 74.43 | 92.17 | <0.001 |
Hospital 7 | 82.07 | 8.00 | 64.63 | 92.17 | <0.001 |
Reference (standardized menu) | 104.63 | 5.42 | 99.66 | 110.50 | - |
Percentage of energy from protein (F = 6927.64; p < 0.001 *) | |||||
Hospital 1 | 14.14 | 1.65 | 11.04 | 16.39 | <0.001 |
Hospital 2 | 16.74 | 0.84 | 15.02 | 17.72 | <0.001 |
Hospital 3 | 15.64 | 1.69 | 12.88 | 18.35 | <0.001 |
Hospital 4 | 17.62 | 1.55 | 15.21 | 19.44 | 0.003 |
Hospital 5 | 16.95 | 1.21 | 15.51 | 18.90 | <0.001 |
Hospital 6 | 15.20 | 2.10 | 11.83 | 19.19 | <0.001 |
Hospital 7 | 15.40 | 1.86 | 12.34 | 19.19 | <0.001 |
Reference (standardized menu) | 21.06 | 1.05 | 20.04 | 22.46 | - |
Plant-based protein (F = 5740.80; p < 0.001 *) | |||||
Hospital 1 | 31.69 | 5.06 | 25.88 | 40.58 | <0.001 |
Hospital 2 | 34.04 | 4.38 | 29.80 | 42.46 | <0.001 |
Hospital 3 | 32.83 | 5.31 | 25.94 | 42.07 | <0.001 |
Hospital 4 | 35.50 | 3.95 | 31.85 | 43.69 | <0.001 |
Hospital 5 | 36.46 | 1.96 | 33.84 | 40.67 | <0.001 |
Hospital 6 | 34.04 | 2.51 | 30.74 | 40.06 | <0.001 |
Hospital 7 | 33.86 | 2.58 | 30.74 | 40.06 | <0.001 |
Reference (standardized menu) | 55.79 | 4.69 | 48.32 | 60.81 | - |
Animal-based protein (F = 2150.84; p < 0.001 *) | |||||
Hospital 1 | 42.00 | 10.52 | 30.00 | 59.57 | 0.659 |
Hospital 2 | 64.75 | 8.67 | 52.26 | 79.11 | 0.007 |
Hospital 3 | 43.16 | 8.19 | 28.66 | 54.04 | 0.831 |
Hospital 4 | 43.84 | 10.18 | 31.72 | 61.10 | 0.932 |
Hospital 5 | 44.22 | 6.43 | 35.25 | 50.96 | 0.941 |
Hospital 6 | 48.93 | 5.71 | 41.53 | 58.15 | 1.000 |
Hospital 7 | 48.03 | 7.39 | 32.78 | 58.15 | 1.000 |
Reference (standardized menu) | 48.04 | 9.86 | 38.28 | 62.00 | - |
Hospital | M | SD | Mini | Max | p-Value ** |
---|---|---|---|---|---|
Total amount of fat (F = 1697.67; p < 0.001 *) | |||||
Hospital 1 | 70.61 | 17.99 | 52.48 | 113.35 | 0.601 |
Hospital 2 | 85.13 | 6.03 | 76.65 | 91.61 | 0.011 |
Hospital 3 | 59.77 | 5.40 | 53.47 | 70.09 | 1.000 |
Hospital 4 | 55.01 | 4.66 | 47.42 | 60.16 | 0.953 |
Hospital 5 | 53.97 | 5.69 | 47.26 | 65.92 | 0.869 |
Hospital 6 | 67.20 | 20.62 | 39.60 | 114.07 | 0.913 |
Hospital 7 | 63.20 | 14.57 | 39.60 | 81.07 | 1.000 |
Reference (standardized menu) | 60.90 | 6.08 | 54.62 | 69.48 | - |
Percentage of energy from fat (F = 3635.99; p < 0.001 *) | |||||
Hospital 1 | 29.80 | 4.30 | 24.03 | 39.67 | 0.608 |
Hospital 2 | 32.47 | 1.94 | 29.53 | 34.83 | 0.076 |
Hospital 3 | 27.12 | 2.21 | 24.44 | 31.17 | 1.000 |
Hospital 4 | 27.73 | 2.39 | 24.70 | 31.26 | 1.000 |
Hospital 5 | 24.83 | 1.76 | 22.49 | 27.19 | 0.840 |
Hospital 6 | 26.74 | 6.09 | 18.16 | 40.03 | 1.000 |
Hospital 7 | 26.07 | 4.44 | 18.16 | 32.37 | 0.998 |
Reference (standardized menu) | 26.97 | 2.77 | 23.81 | 30.82 | - |
Saturated fatty acids (F = 2027.01; p < 0.001 *) | |||||
Hospital 1 | 29.24 | 4.21 | 23.59 | 38.38 | <0.001 |
Hospital 2 | 32.83 | 3.76 | 27.55 | 36.96 | <0.001 |
Hospital 3 | 27.85 | 2.92 | 23.41 | 33.35 | <0.001 |
Hospital 4 | 18.66 | 2.09 | 15.44 | 20.88 | 0.542 |
Hospital 5 | 24.20 | 2.63 | 20.98 | 29.12 | 0.003 |
Hospital 6 | 32.84 | 7.66 | 21.16 | 46.71 | <0.001 |
Hospital 7 | 30.26 | 6.51 | 21.16 | 42.16 | <0.001 |
Reference (standardized menu) | 14.56 | 2.86 | 11.51 | 18.65 | - |
Polyunsaturated fatty acids (F = 1000.07; p < 0.001 *) | |||||
Hospital 1 | 9.91 | 4.27 | 4.09 | 20.09 | <0.001 |
Hospital 2 | 12.10 | 2.04 | 9.97 | 15.94 | <0.001 |
Hospital 3 | 7.87 | 2.06 | 4.79 | 10.77 | <0.001 |
Hospital 4 | 12.71 | 1.27 | 10.51 | 14.32 | <0.001 |
Hospital 5 | 7.47 | 1.67 | 5.41 | 10.15 | <0.001 |
Hospital 6 | 7.34 | 3.12 | 4.34 | 14.81 | <0.001 |
Hospital 7 | 7.25 | 3.02 | 4.08 | 14.35 | <0.001 |
Reference (standardized menu) | 20.92 | 2.33 | 18.22 | 24.56 | - |
n-3 acids (F = 328.40; p < 0.001 *) | |||||
Hospital 1 | 2.31 | 1.39 | 0.65 | 5.64 | 0.979 |
Hospital 2 | 2.95 | 0.84 | 2.25 | 4.61 | 0.987 |
Hospital 3 | 1.60 | 0.75 | 0.59 | 2.74 | 0.169 |
Hospital 4 | 1.90 | 0.41 | 1.26 | 2.37 | 0.575 |
Hospital 5 | 1.20 | 0.48 | 0.67 | 1.87 | 0.022 |
Hospital 6 | 1.51 | 0.95 | 0.65 | 3.83 | 0.111 |
Hospital 7 | 1.48 | 0.94 | 0.53 | 3.71 | 0.098 |
Reference (standardized menu) | 2.63 | 0.22 | 2.42 | 2.94 | - |
n-6 acids (F = 1251.11; p < 0.001 *) | |||||
Hospital 1 | 7.59 | 3.02 | 3.45 | 14.41 | <0.001 |
Hospital 2 | 9.14 | 1.35 | 7.56 | 11.31 | <0.001 |
Hospital 3 | 6.26 | 1.68 | 3.85 | 8.41 | <0.001 |
Hospital 4 | 10.81 | 0.90 | 9.24 | 11.94 | <0.001 |
Hospital 5 | 6.27 | 1.26 | 4.65 | 8.27 | <0.001 |
Hospital 6 | 5.82 | 2.18 | 3.68 | 10.96 | <0.001 |
Hospital 7 | 5.76 | 2.10 | 3.55 | 10.61 | <0.001 |
Reference (standardized menu) | 18.28 | 2.35 | 15.28 | 21.77 | - |
Hospital | M | SD | Mini | Max | p-Value ** |
---|---|---|---|---|---|
Sodium (F = 3411.58; p < 0.001 *) | |||||
Hospital 1 | 4775.18 | 959.62 | 2915.91 | 5998.96 | 0.768 |
Hospital 2 | 4607.82 | 637.18 | 3644.99 | 5297.30 | 0.984 |
Hospital 3 | 4431.87 | 730.49 | 3112.99 | 5729.69 | 1.000 |
Hospital 4 | 4938.30 | 542.37 | 3941.12 | 5492.84 | 0.508 |
Hospital 5 | 4479.40 | 698.99 | 3009.38 | 5470.33 | 1.000 |
Hospital 6 | 4619.53 | 377.62 | 3797.37 | 5069.05 | 0.971 |
Hospital 7 | 4601.40 | 404.12 | 3678.83 | 5065.45 | 0.981 |
Reference (standardized menu) | 4367.64 | 194.53 | 4218.51 | 4591.51 | - |
Salt (F = 3416.12; p < 0.001 *) | |||||
Hospital 1 | 11.94 | 2.40 | 7.30 | 15.00 | 0.768 |
Hospital 2 | 11.53 | 1.59 | 9.12 | 13.25 | 0.984 |
Hospital 3 | 11.09 | 1.83 | 7.79 | 14.33 | 1.000 |
Hospital 4 | 12.35 | 1.36 | 9.86 | 13.74 | 0.509 |
Hospital 5 | 11.20 | 1.75 | 7.53 | 13.68 | 1.000 |
Hospital 6 | 11.56 | 0.94 | 9.50 | 12.68 | 0.971 |
Hospital 7 | 11.51 | 1.01 | 9.20 | 12.67 | 0.981 |
Reference (standardized menu) | 10.93 | 0.49 | 10.55 | 11.49 | - |
Hospital | M | SD | Mini | Max | p-Value ** |
---|---|---|---|---|---|
Fruits (F = 723.54; p < 0.001 *) | |||||
Hospital 1 | 222.13 | 82.60 | 138.75 | 334.95 | 0.022 |
Hospital 2 | 302.08 | 38.68 | 228.75 | 341.25 | 0.998 |
Hospital 3 | 181.06 | 58.06 | 138.75 | 301.23 | <0.001 |
Hospital 4 | 123.16 | 68.55 | 36.43 | 178.10 | <0.001 |
Hospital 5 | 159.66 | 79.48 | 111.00 | 336.00 | <0.001 |
Hospital 6 | 159.40 | 39.92 | 138.75 | 261.25 | <0.001 |
Hospital 7 | 140.73 | 13.00 | 122.50 | 174.75 | <0.001 |
Reference (standardized menu) | 316.93 | 19.07 | 300.00 | 346.20 | - |
Vegetables (F = 976.51; p < 0.001 *) | |||||
Hospital 1 | 405.29 | 122.86 | 188.75 | 578.40 | <0.001 |
Hospital 2 | 618.17 | 103.37 | 492.24 | 767.15 | 0.198 |
Hospital 3 | 505.80 | 174.03 | 290.73 | 897.74 | 0.001 |
Hospital 4 | 390.16 | 95.71 | 265.26 | 490.29 | <0.001 |
Hospital 5 | 344.32 | 82.91 | 209.17 | 438.37 | <0.001 |
Hospital 6 | 288.80 | 92.30 | 73.18 | 393.36 | <0.001 |
Hospital 7 | 280.55 | 95.49 | 73.18 | 393.36 | <0.001 |
Reference (standardized menu) | 759.97 | 132.29 | 574.61 | 861.45 | - |
Whole-grain products (F = 65.67; p < 0.001 *) | |||||
Hospital 1 | 24.00 | 40.61 | 0.00 | 100.00 | 0.005 |
Hospital 2 | 42.00 | 45.50 | 0.00 | 110.00 | 0.095 |
Hospital 3 | 47.50 | 34.92 | 0.00 | 80.00 | 0.012 |
Hospital 4 | 101.00 | 48.64 | 0.00 | 130.00 | 0.804 |
Hospital 5 | 135.00 | 129.07 | 0.00 | 260.00 | 1.000 |
Hospital 6 | 15.00 | 24.15 | 0.00 | 50.00 | 0.002 |
Hospital 7 | 15.00 | 24.15 | 0.00 | 50.00 | 0.002 |
Reference (standardized menu) | 135.00 | 69.76 | 50.00 | 200.00 | - |
Legumes | |||||
Hospital 1 | 28.99 | 12.04 | 20.48 | 37.50 | |
Hospital 2 | 41.25 | - | 41.25 | 41.25 | |
Hospital 3 | 25.42 | 4.69 | 20.00 | 28.13 | |
Hospital 4 | 62.50 | - | 62.50 | 62.50 | |
Hospital 5 | - | - | - | - | |
Hospital 6 | 43.75 | - | 43.75 | 43.75 | |
Hospital 7 | 43.75 | - | 43.75 | 43.75 | |
Reference (standardized menu) | 43.25 | 11.17 | 26.25 | 52.50 | |
Nuts and beans | |||||
Hospital 1 | 10.27 | - | 10.27 | 10.27 | |
Hospital 2 | - | - | - | - | |
Hospital 3 | 7.50 | 3.54 | 5.00 | 10.00 | |
Hospital 4 | 11.90 | - | 11.90 | 11.90 | |
Hospital 5 | - | - | - | - | |
Hospital 6 | - | - | - | - | |
Hospital 7 | - | - | - | - | |
Reference (standardized menu) | 30.00 | 0.00 | 30.00 | 30.00 | |
Fish | |||||
Hospital 1 | 61.08 | 23.81 | 40.00 | 83.33 | - |
Hospital 2 | 233.33 | - | - | - | - |
Hospital 3 | 58.81 | 42.48 | 9.76 | 83.33 | - |
Hospital 4 | 153.33 | - | - | - | - |
Hospital 5 | 120.00 | - | - | - | - |
Hospital 6 | 88.24 | - | - | - | - |
Hospital 7 | 88.24 | - | - | - | - |
Reference (standardized menu) | 216.00 | - | - | - | - |
Red meat | |||||
Hospital 1 | 53.68 | 31.03 | 25.67 | 102.27 | |
Hospital 2 | 89.11 | 49.25 | 50.53 | 159.90 | |
Hospital 3 | 84.34 | 41.99 | 32.08 | 131.20 | |
Hospital 4 | 175.36 | 23.20 | 158.95 | 191.76 | |
Hospital 5 | 72.78 | 40.32 | 32.08 | 127.92 | |
Hospital 6 | 79.90 | 23.40 | 36.90 | 98.18 | |
Hospital 7 | 79.90 | 23.40 | 36.90 | 98.18 | |
Reference (standardized menu) | - | - | - | - | |
Processed meat (F = 717.13; p < 0.001 *) | |||||
Hospital 1 | 36.63 | 11.43 | 17.70 | 46.08 | 0.001 |
Hospital 2 | 47.23 | 12.14 | 29.50 | 57.82 | 0.053 |
Hospital 3 | 39.39 | 5.78 | 33.98 | 46.08 | 0.002 |
Hospital 4 | 37.29 | 10.24 | 22.66 | 46.26 | 0.003 |
Hospital 5 | 44.63 | 17.39 | 28.32 | 76.80 | 0.015 |
Hospital 6 | 33.48 | 10.45 | 22.66 | 47.20 | <0.001 |
Hospital 7 | 33.48 | 10.45 | 22.66 | 47.20 | <0.001 |
Reference (standardized menu) | 67.20 | 19.20 | 38.40 | 76.80 | - |
Sugar (F = 1327.33; p < 0.001 *) | |||||
Hospital 1 | 54.46 | 12.79 | 41.25 | 83.95 | <0.001 |
Hospital 2 | 52.46 | 3.61 | 48.13 | 56.57 | <0.001 |
Hospital 3 | 49.02 | 5.66 | 44.89 | 60.09 | <0.001 |
Hospital 4 | 2.07 | 1.45 | 0.40 | 3.75 | 1.000 |
Hospital 5 | 42.98 | 6.12 | 35.20 | 56.10 | <0.001 |
Hospital 6 | 49.43 | 3.41 | 46.25 | 56.25 | <0.001 |
Hospital 7 | 45.80 | 9.38 | 20.00 | 54.25 | <0.001 |
Reference (standardized menu) | 3.09 | 1.28 | 1.88 | 4.43 | - |
Recommendation | Hospital | ||||||
---|---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | 6 | 7 | |
The predominance of plant-based and reduction in animal-based food pattern | − | − | − | − | − | − | − |
Saturated fatty acids should account for <10% of energy intake | − | − | − | + | − | − | − |
<5 g total salt intake per day | − | − | − | − | − | − | − |
30–45 g of fiber per day | − | − | + | − | + | − | − |
≥200 g of fruit per day (≥2–3 servings) | − | + | − | − | − | − | − |
≥200 g of vegetables per day (≥2–3 servings) | + | + | + | + | + | + | + |
Reduction In the consumption of red meat to the maximum 350–500 g per week, especially processed meat | + | + | + | + | + | + | + |
Eat fish 1–2 times a week | + | + | + | + | + | + | + |
30 g of unsalted nuts per day | − | − | − | − | − | − | − |
Alcohol consumption should be limited to a maximum of 100 g/week | + | + | + | + | + | + | + |
Sweetened beverages, including fruit juices and sweet carbonated drinks and non-carbonated, should be avoided | − | − | − | + | − | − | − |
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Śliż, D.; Jodczyk, A.M.; Łakoma, K.; Kucharska, A.; Panczyk, M.; Rostkowska, O.M.; Turlej, K.; Młynarska, A.; Drożdż, J.; Jarzębska-Wódka, M.; et al. Examining the Nutrition of Cardiological Patients in Hospitals: Evaluating the Discrepancy between Received Diets and Reference Diet Based on ESC 2021 Guidelines—Hospital Diet Medical Investigation) (HDMI) Study. Nutrients 2023, 15, 4606. https://doi.org/10.3390/nu15214606
Śliż D, Jodczyk AM, Łakoma K, Kucharska A, Panczyk M, Rostkowska OM, Turlej K, Młynarska A, Drożdż J, Jarzębska-Wódka M, et al. Examining the Nutrition of Cardiological Patients in Hospitals: Evaluating the Discrepancy between Received Diets and Reference Diet Based on ESC 2021 Guidelines—Hospital Diet Medical Investigation) (HDMI) Study. Nutrients. 2023; 15(21):4606. https://doi.org/10.3390/nu15214606
Chicago/Turabian StyleŚliż, Daniel, Alicja Monika Jodczyk, Klaudia Łakoma, Alicja Kucharska, Mariusz Panczyk, Olga Maria Rostkowska, Karolina Turlej, Agnieszka Młynarska, Jarosław Drożdż, Milena Jarzębska-Wódka, and et al. 2023. "Examining the Nutrition of Cardiological Patients in Hospitals: Evaluating the Discrepancy between Received Diets and Reference Diet Based on ESC 2021 Guidelines—Hospital Diet Medical Investigation) (HDMI) Study" Nutrients 15, no. 21: 4606. https://doi.org/10.3390/nu15214606
APA StyleŚliż, D., Jodczyk, A. M., Łakoma, K., Kucharska, A., Panczyk, M., Rostkowska, O. M., Turlej, K., Młynarska, A., Drożdż, J., Jarzębska-Wódka, M., Wierzbiński, P., Grabowski, M., Ukleja, A., Adamczyk, N., Baska, A., Wiecha, S., Barylski, M., Poliwczak, A. R., & Mamcarz, A. (2023). Examining the Nutrition of Cardiological Patients in Hospitals: Evaluating the Discrepancy between Received Diets and Reference Diet Based on ESC 2021 Guidelines—Hospital Diet Medical Investigation) (HDMI) Study. Nutrients, 15(21), 4606. https://doi.org/10.3390/nu15214606