Association of diet quality and weight increase in adult heart transplant recipients

Background Understanding the quality of the diet of heart transplant recipients (HTRs) is essential to developing effective dietary interventions for weight control, but relevant evidence is scarce. We investigated diet quality and its association with post‐transplant increase in weight adjusted for height (body mass index [BMI]) in Australian HTRs. Methods We recruited adult HTRs from Queensland's thoracic transplant clinic, 2020–2021. Study participants completed a 3‐day food diary using a smart‐phone app. Socio‐demographic information was collected by self‐administered questionnaire, and height, serial weight and clinical information were obtained from medical records. We calculated the Dietary Approaches to Stop Hypertension (DASH) index based on nine food groups and nutrients (index of 90 indicates highest possible quality), and any changes in BMI (≤ 0 kg m–2 or >0 kg m–2) post‐transplantation. Median DASH index values were assessed in relation to sex and BMI change using Mann–Whitney U test. Results Among 49 consented HTRs, 25 (51%) completed the food diary (median age 48 years, 52% females). Median BMI at enrolment was 27.2 kg m–2; median BMI change since transplant was +3.7 kg m–2. Fruit, vegetable, and whole grain intakes were generally lower than recommended, giving a low overall median DASH index of 30 with no sex differences. HTRs for which the BMI increased post‐transplant had significantly lower median DASH indices than those whose BMI did not increase (30 vs. 45, p = 0.013). Conclusions The diet quality of HTRs appears suboptimal overall, with fruit and vegetable intakes especially low. HTRs whose BMI increased post‐transplant had substantially lower quality diets than HTRs whose BMI did not increase. Overall, the diet quality of heart transplant recipients (HTR) appears suboptimal. Effective interventions to improve the diets of HTRs are urgently needed to help prevent unhealthy weight gain and improve their cardiometabolic conditions. Highlights Overall, consumption of wholegrains, vegetables, fruit and saturated fat was suboptimal in study heart transplant recipients Diet quality was significantly lower in study heart transplant recipients whose body mass index (BMI) increased after transplantation compared to those whose BMI did not increase