Abstract 6211: Low Social Support Predicts Non-Adherence to Diet at 1-Year in a Lifestyle Intervention Trial Among Family Members of Patients with CVD
Lack of social support has been linked to CVD, but the mechanism is not established. The relation between social support and diet has not been defined in well-controlled studies. The purpose of this study was to evaluate the prospective relation between low social support and adherence to the Adult Treatment Panel (ATP) III therapeutic lifestyle changes (TLC) and heart-healthy diets among family members of patients recently hospitalized with CVD. Participants in the randomized controlled NHLBI Family Intervention Trial for Heart Health (FIT Heart), who completed a 1-year follow-up (94%) were included in this analysis (n =458; 66% female, 35% non-white, mean age 50). Non-adherence to diet was assessed using the validated MEDFICTS tool (score ≥ 40 =non-adherent to TLC diet; ≥ 70 =non-adherent to heart-healthy diet). Social support was assessed using the validated ENRICHD Social Support Instrument (ESSI) (social support measured on a scale of 5–25; high =score ≥ 18). Demographics, depression, stage of change, and CVD risk factors were systematically evaluated as potential confounders of non-adherence to diet. Logistic regression models were adjusted for age, race/ethnicity, sex, and group assignment. Significant univariate predictors (p <.05) of non-adherence to a heart-healthy or TLC diet at 1-year were low social support at baseline, increased BMI and waist size at baseline and 1-year, low levels of physical activity at 1-year, depression at 1-year, stage of change at baseline and 1-year, assignment to the control group, and being male. In a multivariable adjusted model, those with low social support at baseline were 2.7 times more likely to be non-adherent to diet at 1-year vs. those with high social support (95% CI =1.1–6.4), and there was no interaction by group assignment. In this ethnically diverse population, low social support at baseline was independently associated with non-adherence to diet at 1-year in family members of patients with CVD. These data suggest that individuals with low social support may be at heightened CVD risk due to dietary factors, and targeted educational efforts may be beneficial in reducing their risk.