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Lookup NU author(s): Dr Rajiv Das, rosiered Brownson-SmithORCiD, Estelle Rickelton, Dr Simon Nichols
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© The Author(s), 2026. Published by Cambridge University Press. Low protein intake is prevalent in people with coronary heart disease (CHD) and is inadequately addressed in UK-based cardiac rehabilitation (CR). This pilot feasibility study aimed to identify whether targeted education increases protein intake in patients with CHD and low protein intake, compared with standard CR dietary education. People referred to CR with CHD (≥50 years) underwent anthropometric assessment, and completed a food diary, sit-to-stand test and three questionnaires (physical activity, sarcopenia screening, and nutrition knowledge). Participants with low protein intake (≤1.2 g/kg/day) were randomised to receive either extra protein education (intervention; PG) or standard education (control; CG), embedded within their usual six-week CR programme. At 6- and 12-weeks, outcome measures were repeated; 34 participants provided baseline data. Protein intake was inversely associated with waist circumference (r = ˗0.348). Twenty-seven participants (79%) with low protein intake were randomised to PG (n = 15) or CG (n = 12). At Week 6, the median (interquartile range) change in protein intake was 0.0 (˗0.0, 0.3) and 0.4 (0.2, 0.5) g/kg/day in PG and CG, respectively (effect size 0.5). At Week 12, the change in protein intake was 0.0 (˗0.0, 0.1) and ˗0.0 (˗0.2, 0.2) g/kg/day in PG and CG, respectively (effect size 0.3). Effect sizes for all other variables were ≤0.4. The intervention appeared well-received by those who completed the study; however, changes to primary and secondary outcomes were minimal. Uptake to the study was low and attrition high, limiting the interpretation of efficacy and the implementation of a definitive trial.
Author(s): James E, Das R, Brownson-Smith R, Rickelton E, Goodall S, Nichols S, O'Doherty AF
Publication type: Article
Publication status: Published
Journal: British Journal of Nutrition
Year: 2026
Pages: Epub ahead of print
Online publication date: 27/04/2026
Acceptance date: 02/04/2018
Date deposited: 11/05/2026
ISSN (print): 0007-1145
ISSN (electronic): 1475-2662
Publisher: Cambridge University Press
URL: https://doi.org/10.1017/S0007114526107235
DOI: 10.1017/S0007114526107235
PubMed id: 42036628
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