1. Jackie Nelson
Assignment 4- Journal Article
March 1st, 2016
Signed Copy of the Honor Pledge
“I have not given, received, or used any unauthorized assistance”
-Jackie Nelson
Date of Published Report: Nov. 2015
Type of Article: Primary Research Article
AMA Citation for all articles and broadcasts used within assignment
o Full Citation:
Noites A, Pinto J, Freitas CP, et al. Effects of the Mediterranean diet and exercise in
subjects with coronary artery disease. Revista Portuguesa de Cardiologia (English
Edition) 2015; 34(11):655-664. Doi: 10.1016/j.repce.2015.09.005
URL links for each article
o http://www.elsevier.pt/en/revistas/revista-portuguesa-cardiologia-
334/artigo/effects-of-the-mediterranean-diet-and-exercise-in-90446038
Key Points
 To see how the Mediterranean Diet and an exercise program intervention
would affect eating behaviors in adults and body fat and composition.
 Experimental Study
 Study Participants – 20 individuals with coronary heart disease. These
participants were broken up into two different groups, one with 10
participants that was labeled the experimental and the other labeled the
control group.
 Types of data collected (methods) – surveys? Interventions? Etc. This type of
data collected was through intervention methods. One group alone just
received education about Mediterranean diet and the other group got
education about the diet and also followed an intervention exercise program
that lasted 8 weeks. A semiquantitative food questionnaire was a method
used as well to record the participant’s food intake. Bioimpedance was used
to measure participants.
 Results-after the intervention both groups had a decrease in their total fat
and fat mass. In the experimental group (participants who did the 8 week
exercise program), had a decrease in their waist-to-height ratio.
 Conclusions drawn by the researchers about their results- Conclusions
showed that the Mediterranean diet reduced sat fat intake and the carb
intake, which lead to reduction in fat mass.
Strengths/Weaknesses- Critical Appraisal
 Strengths-

2. o The study had sufficient scientific justification that would be worth
conducting further research. The study was based on intervention
purposes to see if the intervention of educational sessions and an
exercise routine would affect body composition and eating behaviors
in adults. Since there is evidence that the Mediterranean Diet and
exercise reduce the risk of cardiovascular disease, the study
conducted was justified to see how this specific intervention would
reduce the risk. This is a strength for the article/study because it
means that there is significant reasoning why the study was
conducted in the first place.
o Sample size for this study was small, but it is a strength since this
study is an intervention. All the participants could then be closely
watched to see the benefits of the intervention and if they are
working.
o The demographics focused on 20 people who all are known for having
coronary heart disease. This is a strength for the study since the
purpose of the study is to see if the intervention would affect the
participants who were all there for the purposes of seeing how
Mediterranean Diet education and exercise implementation would
reduce the cardiovascular disease risk.
o The data presentation is a strength in the study as it is logical, and all
present. None of the results were left out of the study. Even if some of
the results didn’t have any change in the two groups from where they
started, the data was still given in the article. For example, there were
no differences in either group for their BMI at the end of the study
compared to the beginning of the study. This data was still given to
those reading the study. So there were no gaps in data. This is a
strength, because it makes the study and information conveyed more
reliable and believable since there are no present gaps.
o Since all the data was published in the study this also means that the
authors did not have a bias in publishing the data, which makes this a
strength in the article and makes their study more reliable.
 Weaknesses-
o The only thing that I would find to be a weakness of the study was
that there were only 20 participants and it was very selective to who
they chose to do the study on. The only reason why I see this as being
a weakness is that there is no data supplied about the participants
other than the fact that they had known coronary heart disease for at
least a year. There is a lot that can affect the risk of CHD like age and
sex for example, or the patient’s smoke, are sedentary, etc. There are
a lot of risk factors for CHD, and I think that these could have been
presented in the study.
Implications
 Nutrition Professionals

3. o From the perspective of a registered RD, I don’t think this would change
their practice of their policy because they already know that exercise and
the possibility of a Mediterranean diet could reduce the risk of
cardiovascular diseases. Since this isn’t really any new information, only
supporting evidence, it wouldn’t make them change their practice in any
way. They might be able to provide background evidence for their
reasoning for recommending diet and exercise change with this study,
but these results isn’t anything new.
 Consumer audience
o There’s not really any implication for them. Unless the audience had
CHD themselves and wanted to decrease their risks, then maybe the
audience would consider exercising or following a Mediterranean
diet. However, I doubt that the consumer audience would make these
changes if there was not a RD or a doctor to tell them to do so.