Q: "Are there any diet, exercise, or other practices that can help reduce or slow down the onset of coronary artery disease in a transplanted heart?"
Yes! We do believe that what and how much you eat, how active you are and NOT SMOKING after heart transplantation will at least reduce, if not prevent, the progression of CAV. I will not get into the details about these lifestyle choices at this time except that the recommendations regarding “healthy” nutrition and exercise are not any different than those for all children. Importantly, the sicker you are, and the longer you are sick, pre-transplant you can anticipate the longer the physical rehabilitation will be. Ultimately, though participation in childhood activities including competitive sports is possible, annual evaluations for safety will be required later. In 2015, the American Heart Association recommended for adults recipients that “…an annual exercise stress test can be obtained that simulates the metabolic demands of the competitive event prior to participation”.
While CAV is unique to heart transplant recipients there are important similarities to the causes of coronary artery disease of aging (atherosclerosis or CAD) and CAV. Smoking is a risk factor for both CAD and CAV and should be strongly discouraged. Being overweight is a risk factor for both CAD and CAV and patients would benefit from maintaining a balanced diet. I know that most of us have been frustrated by trying to teach kids about healthy eating habits, so I want to reinforce two points of emphasis for you. The first is that whatever you do should be a family fact except for kids under 2. The second is to try the little trick of using the My Plate approach – see https://www.usda.gov/media/blog/2017/09/26/back-basics-all-about-myplate-food-groups – and use the plate for their meals.