56 Journal of Pharmacy and Nutrition Sciences, 2020, 10, 56-67 ISSN: 2223-3806 / E-ISSN: 1927-5951/20 © 2020 SET Publisher Role of Dietary and Lifestyle Modifications in the Secondary Prevention of Biomarkers of Plaque recurrence in Omani Coronary Revascularized Patients Amanat Ali 1,2,* , Noura S.M. Al-Alawi 2 , Muhammad Athar Sadiq 3 and Mostafa I. Waly 2 1 School of Engineering, University of Guelph, Albert A. Thornbrough Building, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada 2 Department of Food Science and Nutrition, College of Agricultural and Marine Sciences, Sultan Qaboos University, P.O. Box 34, Al-Khoud 123, Muscat, Oman 3 Cardiology Unit, Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Al-Khoud 123, Muscat, Oman Abstract: Objective: To assess the role of various dietary and lifestyle modifications in the secondary prevention of biomarkers of plaque recurrence in Omani coronary revascularized patients. Methods: Seventy-two patients, from the outpatient cardiology clinic of Sultan Qaboos University Hospital, were included in the study after obtaining an informed consent. In a questionnaire-based study, we collected data about four lifestyle modifications; physical activity, weight reduction, dietary intake and healthy eating patterns and smoking or non-smoking status, in personal interviews. A modified previously validated study questionnaire, which comprised of a semi- quantitative food frequency questionnaire, was used to assess the demographic information, eating patterns, diet quality index score, and daily dietary intake of study participants. The data about patient’s baseline characteristics, revascularization information and biochemical laboratory tests was harvested from the SQUH’s electronic record system. The statistical analysis of data was made using R-studio v.7 and Microsoft excel v.7. Results: The males had higher educational level as compared to females and were more active than females. The data indicated that 16% males and females were diabetic, 10% males and 21% females were hypertensive, and 30% males and 42% females had both diabetes and hypertension. Forty eight percent males and 63% females had body mass index (BMI) >30. However, no significant (P < 0.05) differences were observed in the BMI, diabetes and hypertension status in males and females. Both genders had poor nutritional knowledge. Although the LDL-C and HDL-C values in males and females differed, they were within the normal therapeutic limits. The HbA1c and C-reactive protein values were above the normal ranges with no significant (P < 0.05) difference in both males and females. The average daily energy intake in males (2694 kcalories) was significantly higher compared to females (1603 kcalories). The proportionate contribution of energy from macronutrients was within the acceptable macronutrient distribution ranges. Omani diet score for males (75.5) and females (74.6) didn’t differ significantly (P < 0.05), indicating their adherence to healthy dietary patterns. Conclusions: The results suggest that dietary and lifestyle modifications play significant role in the secondary prevention of biomarkers of plaque recurrence in Omani coronary revascularized patients. Behavioral counseling to promote healthy modifications in dietary and lifestyle factors are therefore recommended in the secondary prevention of risk of plaque recurrence. Keywords: Dietary and lifestyle modifications, Secondary prevention, Plaque recurrence, Omani coronary revascularized patients. INTRODUCTION Cardiovascular diseases (CVDs) are the leading cause of global mortality and morbidity and represent 31% of all global death [1, 2]. In the Middle East countries, the CVDs-associated mortality rate is higher than the world [3]. The hospital deaths due to coronary heart diseases (CHD) in Oman have gone up in the past years, which has been associated with the poor knowledge about the risk factors of CHDs [4]. It has *Address correspondence to this author at the School of Engineering, University of Guelph, Albert A. Thornbrough Building, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada; Tel: +1-519-824-4120 Ext: 53499; Fax: +1-519-836-0227; E-mail: amanat@uoguelph.ca, amanata@gmail.com been shown that the Middle Eastern patients, with acute coronary syndrome (ACS) had heart attacks at relatively younger age as compared to patients in Western countries [5, 6]. There are numerous biomarkers for the diagnostic, prognostic and prediction of CVDs [7]. The main inflammatory biomarkers, which predict the severity and prognosis of heart failure are high-sensitive C-reactive protein (hs-CRP), cytokines, tumor necrosis factor alpha (TNFα), interleukins (IL-1, IL-6 etc.), adiponectin and N-terminal probrain natriuretic peptide [8]. It has been reported that overall aggregate incidence of CVDs in tye-2 diabetic Omani patients is 9.4% [9], whereas 54.1% had diabetes at the time of coronary artery bypass surgery [10].