You might think patients who've had a heart attack might cut back on fast food, but in fact, some sufferers who were junk food eaters, return to their bad habits.
The researchers who published these findings online in the American Journal of Cardiology say the reduction in visits to junk food restaurants is not enough and patients need better dietary education.
Dr John Spertus of the University of Missouri Kansas City and colleagues studied nearly 2,500 heart attack patients across the US who filled out surveys while still hospitalised. Overall, 884 patients, or 36%, reported eating junk food frequently in the month before their heart attack, i.e., once a week or more.
When the researchers checked back six months later, 503 were still eating junk food every week.
Die hard junk food eaters
Those die-hard junk food eaters were more likely to be white, male, employed and without a college degree, compared to patients who didn't go for fast food as often.
They were also more likely to have dyslipidaemia.
The study showed that older patients and those who had bypass surgery were more likely to be avoiding junk food six months later.
Junk food not just burgers and chips
The survey also did not ask what menu items people ordered. Sue Hensley, a spokesperson for the National Restaurant Association, points out that junk food is more than burgers and fries.
"We're seeing trends toward more fruits and vegetables and healthy offerings in restaurants," says Hensley. Those include salads, whole grains and low fat milk.
Dr Spertus and his colleagues note, though, that the people in their study who kept on eating fast food every week tended to have unhealthy lipid profiles, "consistent with selection of less healthy options."
Nine out of 10 patients in the current study had received dietary counselling before they left the hospital, but this didn't seem to affect the odds that frequent fast food eaters would improve their diets. Their behaviour shows they need more education after discharge, Dr Spertus says.
"The problem is that patients are absorbing so much information at the time of their heart attack, that I just don't think they can capture and retain all the information they're getting," says Spertus.
Fast food restaurants in the US will soon post kilojoule, fat, sodium and other nutritional information on their menus, as required by the major health care law that was passed last year. Already, cities like New York and Philadelphia mandate kJ counts on menus. It's still up for debate whether such numbers next to food offerings will affect what people order.
The survey is part of a national study called TRIUMPH, which is funded by the National Heart, Lung and Blood Institute.
Dr Spertus also receives research funds from the American Heart Association.
(Reuters Health, Kerry Grens, February 2011)