SYSTEMATIC REVIEW article
Front. Public Health
Sec. Public Health and Nutrition
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1692665
This article is part of the Research TopicLifestyle behaviors and chronic diseases: pathways, interventions, knowledge and public health challengesView all 6 articles
A scoping review of lifestyle adherence among coronary artery disease (CAD) patients and at-risk individuals in South Asian adults
Provisionally accepted
- 1University of Wollongong, Wollongong, Australia
- 2Rehman Medical Institute, Peshawar, Pakistan
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Coronary artery disease (CAD) represents a critical public health challenge in South Asia. It is the leading cause of morbidity and mortality in the region. CAD accounts for nearly one-third of all deaths in Pakistan. Lifestyle behaviors, dietary habits, and physical activity are crucial for the prevention and management of CAD. This review aimed to assess adherence to dietary and physical guidelines among CAD patients and at-risk individuals in South Asia, with emphasis on Pakistan. Methods: The systematic review was conducted using PRISMA guidelines and registered with PROSPERO (CRD420251017976). Six databases (PubMed, Scopus, Web of Science, CINAHL, MEDLINE, and Google Scholar) were searched for studies on adults (≥18 years) with CAD or at risk in South Asia. The review followed the PRISMA-ScR guidelines, and the inclusion criteria were structured using the PCC framework (Population: adults with coronary artery disease or at risk; Concept: lifestyle adherence, including diet and physical activity; Context: South Asia, with emphasis on Pakistan). Results: Seventeen studies were included. Findings reveal consistently poor adherence, with only 25% of patients reporting regular fruit and vegetable intake and over 56% exhibiting physical inactivity. A diet high in fats, refined carbohydrates, and red meat has increased the CAD risk, while a plant-based diet and exercise have mitigated CAD risk. Key barriers to guideline adherence were low health literacy, cultural norms, and gender restrictions. Culturally tailored intervention, on the other hand, showed modest improvement in diet and quality of life identified Conclusion: This review suggests that adherence to diet and physical activity guidelines in South Asia is poor, with most patients inactive and few meeting fruit and vegetable targets. Unhealthy diets increased CAD risk, while plant-based diets and exercise were protective. Limited but promising evidence supports culturally tailored interventions.
Keywords: Coronary Artery Disease, Lifestyle guidelines, Diet, physical activity, South Asia, Pakistan
Received: 26 Aug 2025; Accepted: 13 Oct 2025.
Copyright: © 2025 Gamaryani, Gopaldasani, Mubarak and Jones. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Asim Gamaryani, agg206@uowmail.edu.au
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.