- Click here for explanation of classification scheme.

• DART: To determine if dietary advice reduces morbidity and mortality among men aged 70 years and younger recovering from a myocardial infarction (MI)
• DART-2: To determine if dietary advice reduces morbidity and mortality among men with stable angina.

• DART: Men aged less than 70 years recovering from a MI
• DART-2: Men with stable angina.

None specified.

Recruitment

DART and DART-2: Not specified. 

Design

DART and DART-2: Randomized controlled trial.

Intervention 

• DART: Advice was given by an RD verbally and from an information sheet to subjects and their partners
  • Advice to eat at least two portions (200g to 400g) of oily fish (mackerel, herring, kipper, pilchard, sardine, salmon, trout) weekly. Men who considered this unpalatable were given instructions to consume fish oil capsules daily (up to three "Maxepa" capsules containing 170mg EPA and 115mg DHA; Seven Seas Limited, Hull, Humberside, UK).
  • Advice to reduce fat intake to 30% of total calories and increase polyunsaturated fat ratio to saturated fat to one
  • Advice to increase intake of cereal fiber to 18g per day
• DART-2:
  • Subrandomized at level of fish consumption:
    • One subgroup initially offered fish oil capsules (advised to eat oily fish only if they disliked capsules; dose not specified)
    • One subgroup preferentially advised to eat fish (capsules provided if subjects disliked fish, as in DART; dose not specified)
  • Advised to eat more fruit and vegetables (four to five portions per day, excluding potatoes), to drink at least one glass of orange juice daily and to increase intake of oats.

Statistical Analysis

• DART: Risk of death from all causes, IHD deaths and non-fatal MIs were compared among those who received fish advice vs. those who did not, those who received fat advice vs. those who did not and those who received fiber advice vs. those who did not. P-values were reported for each comparison.
• DART-2: Risk of death from all causes, cardiac deaths and sudden deaths were compared among those who received fish advice vs. those who did not and those who received fruit advice vs. those who did not. Risk of all deaths, cardiac deaths and sudden deaths were compared for those who consumed dietary fish or fish oil vs. those who were given no fish advice.

Timing of Measurements

 

Dependent Variables

• Variable 1: brief description (how measured?)
• Variable 2: brief description (how measured?)
• etc

Independent Variables

 

Control Variables

 

Initial N

• DART: 2,033 men
• DART-2: 3,114 men.

Age

• DART: Mean age, 56.5 years
• DART-2: Mean age, 61.1 years.

Location

United Kingdom.

 

 DART (N=2,033)

	All Deaths % (N)	IHD Deaths % (N)	Non-fatal MI % (N)
Fish advice (N=1,015)	9.3 (94)	7.7 (78)	4.8 (49)
No fish advice (N=1,018)	12.8 (130)	11.4 (116)	3.2 (33)
Significance of difference, P	P<0 .05	P< 0.01	NS

Data on fat and fiber advice groups not shown (beyond scope of question).

Mean daily intake of fish (g): Fish advice group, 32g; no fish advice group, 9g. Mean percentage of EPA in relation to all plasma fatty acids (FAs): Fish advice group, 0.59; no fish advice group, 0.46.

Fish advice was associated with 29% reduction in overall mortality. Survival curves diverged after two months, but by 12 months they were parallel and remained so (data not shown in this manuscript).

Mortality Among Men Similar Among Those Consuming Fish Oil Capsules vs. Those Advised to Eat Fish

DART-2 (N=3,114)

	All Deaths % (N)	Cardiac Deaths % (N)	Sudden Deaths % (N)
Fish advice (N=1,571)	18.0 (283)	11.5 (180)	4.6 (73)
No fish advice (N=1,543)	15.7 (242)	9.0 (139)	3.0 (47)
Significance of difference, P	P=0.08	P=0.02	P=0.02

 Data on fruit advice groups not shown (beyond scope of question).