cardiac rehabilitation, diet, exercise, obesity



  1. Zullo, Melissa D. PhD, MPH, MA
  2. Dolansky, Mary A. PhD, RN
  3. Jackson, Leila W. PhD, MPH


PURPOSE: Cardiac rehabilitation (CR) is a multifactorial program that encourages healthy behaviors in persons with a recent cardiovascular event or procedure. Research on the association between CR and health-behavior maintenance has focused on physical activity. Therefore, the purpose of this research was to examine the association of health behaviors (fruit/vegetable consumption and physical activity) and body mass index (BMI) with CR attendance and time since participation in respondents reporting history of myocardial infarction (MI).


METHODS: This was a cross-sectional study using the 2003 Behavioral Risk Factor Surveillance System (n = 1,374). Eligible respondents were those with a history of MI. Outcomes were fruit/vegetable consumption, physical activity, and BMI. Time since CR was based on age at MI and age at survey. Logistic (polytomous) regression was used to identify predictors.


RESULTS: CR attendees were 69% more likely to meet fruit/vegetable guidelines than were nonattendees (P = .02). CR was not associated with meeting physical activity guidelines. CR had a protective, yet nonsignificant effect on BMI. Meeting fruit/vegetable guidelines was associated with CR attendance in the past year (odds ratio = 4.64, confidence interval, CI: 1.03-20.95). CR attendees were 75% less likely to be overweight 1 to 2 years post-CR (CI: 0.08-0.73) and 59% less likely to be obese 2 to 5 years post-CR than were nonattendees (CI: 0.20-0.85).


CONCLUSIONS: CR attendance was associated with healthy behaviors, though maintenance diminished over time. Understanding the factors associated with healthy behaviors, and the time when behavior performance decreases, will assist with program planning directed at behavior maintenance.