A dietary intervention in primary care practice: the Eating Patterns Study.

Beresford, Shirley A.A.; Curry, Susan J.; Kristal, Alan R.; Lazovich, DeAnn; Feng, Ziding; Wagner, Edward H.

doi:10.2105/ajph.87.4.610

Cited by 143 publications

(117 citation statements)

References 31 publications

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“…On the other hand, married men and non-married women were less likely to achieve the intended dietary goals, perhaps because married women have generally more responsibility for food purchasing and preparing meals [4] and thus they could more easily adopt the intended changes.…”

Section: Discussionmentioning

confidence: 99%

Predictors of adherence to a Mediterranean-type diet in the PREDIMED trial

et al. 2009

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Background: Determinants of dietary changes obtained with a nutritional intervention promoting the Mediterranean diet have been rarely evaluated.Aim of the study: To identify predictors of higher success of an intervention aimed to increase adherence to a Mediterranean diet (MeDiet) in individuals at high cardiovascular risk participating in a trial for primary prevention of cardiovascular disease: the PREDIMED (PREvención con DIeta MEDiterránea) trial. Candidate predictors included demographic and socioeconomic characteristics, cardiovascular risk-factors and baseline dietary habits.Methods: 1048 asymptomatic subjects aged 55-80 years allocated to the active intervention groups (subjects in the control group were excluded). Participants' characteristics were assessed at baseline among subjects. Dietary change were evaluated after 12 months. Main Outcome measures were: attained changes in 5 dietary goals: increases in 1) fruit consumption; 2) vegetable consumption, 3) monounsaturated fatty acid (MUFA)/ saturated fatty acid (SFA) ratio, and decreases in 4) sweets and pastries consumption, 5) and meat consumption. Univariate and multivariate logistic regression analyses were used to examine associations between the candidate predictors and likelihood of attaining optimum dietary change (improved adherence to a MeDiet).Results: Among men, positive changes toward better compliance with the MeDiet were more frequent among non-diabetics, and among those with worse dietary habits at baseline (higher consumption of meat, higher SFA intake, lower consumption of fruit and vegetables). Among women, marital status (married) and worse baseline dietary habits (high in meats, low in fruits and vegetables) were the strongest predictors of success in improving adherence to the MeDiet.Conclusions/ applications: Some participant characteristics (marital status, and baseline dietary habits) could contribute to predicting the likelihood of achieving dietary goals in interventions aimed to improve adherence to a MeDiet and may be useful for promoting individualized long-term dietary changes and improving the effectiveness of dietary counseling.

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Section: Discussionmentioning

confidence: 99%

Predictors of adherence to a Mediterranean-type diet in the PREDIMED trial

et al. 2009

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“…However, the use of the stage of change model as a foundation for lifestyle intervention programs in general practice has been limited. One study involving short interventions of 3 to 5 minutes coupled with written information targeted dietary fat consumption, 20 as did a nonrandomized study of physical activity counseling by physicians. 9 A more extensive trial of physical activity counseling by general practitioners in Australia did not demonstrate any advantage of stage-based programs over routine care, 8 while a recent study of tailored physical activity counseling also showed no differences between intervention subjects and controls in activity levels at 6 weeks or 8 months.…”

Section: Discussionmentioning

confidence: 99%

The impact of behavioral counseling on stage of change in fat intake, physical activity, and cigarette smoking in adults at increased risk of coronary heart disease

Steptoe

Kerry²,

Rink³

et al. 2001

Am J Public Health

155

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A B S T R A C TObjectives. This study assessed stages of change in fat intake, physical activity, and cigarette smoking during a randomized controlled trial of behavioral counseling.Methods. Twenty general practices (primary health care centers) were randomized to lifestyle counseling by behavioral methods or to usual health promotion. A total of 883 patients were selected for the presence of 1 or more of the following risk factors: cigarette smoking, high cholesterol, or a combination of a high body mass index and low physical activity. Stage of change (precontemplation, contemplation, preparation, and action/maintenance) was assessed at baseline and after 4 and 12 months.Results. Encouraging smoking cessation, dietary fat reduction, and regular physical activity is a central element of cardiovascular disease prevention through lifestyle change. 1 The stage of change model has become increasingly influential as a framework for understanding healthrelated behavior and directing efforts in health promotion.2,3 The model postulates that individuals can be allocated to different stages of readiness for change (from precontemplation through contemplation, preparation, and action to maintenance of successful change) and that baseline stage is a predictor of behavior change. 4-6The stage of change framework suggests that intervention programs might be tailored to the individual's stage of readiness. The Change of Heart Study is a randomized controlled trial that compares brief behavioral counseling with usual health promotion advice among patients at increased risk of coronary heart disease in a primary care setting, 7 where there is limited evidence regarding the effects of stage-oriented programs.8-10 The behavioral and biological risk factor results of this study, which have been described elsewhere, show greater reductions in fat intake and the number of cigarettes smoked and greater increases in physical activity in the behavioral intervention group than in the control group at 4 and 12 months.11 In this article, we present stage of change outcomes in the study and address (1) whether behavioral intervention was more effective than normal practice in achieving the target stage (action/maintenance), (2) whether the likelihood of achieving the target stage for each behavior varied with initial stage, and (3) whether any advantage of behavioral intervention was equally evident for patients at different stages of readiness at baseline. Methods Study DesignThis randomized trial involved 20 general practices (primary care centers), half allocated to behavioral intervention and half to control conditions. 7 Patients with 1 or more of the following modifiable risk factors were recruited: regular cigarette smoking (more than 1 cigarette per day), high cholesterol (6.5-9.0 mmol/L), or a combination of high body mass index (BMI; 25-35 kg/m 2 ) and low physical activity (fewer than 12 episodes in the past 4 weeks of vigorous or moderate exercise lasting 20 minutes). Patients were excluded if they were on active follow-up or ...

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“…A control group was phone screened and dietary intake was assessed, but no information was provided. A drop in fat intake from baseline was evident in the control and intervention groups post treatment, but greater changes occurred in the intervention group at 3 and 12-month post-treatment assessments (Beresford et al, 1997). Findings indicated that changes in fat intake could occur even in low intensity, public health-based interventions.…”

Section: Other Program Characteristics Impacting Dietary Adherencementioning

confidence: 83%

“…Recent dietary intervention studies have disseminated dietary information in a variety ways, ranging from group counseling (e.g., Schapira et al, 1991) to the distribution of self-help pamphlets (e.g., Beresford et al, 1997).…”

Section: Other Program Characteristics Impacting Dietary Adherencementioning

confidence: 99%

“…Many dietary interventions are intensive in that they require participants to attend weekly or monthly sessions, they provide individualized feedback, and they include either individual or group counseling. One exception is the Eating Patterns Study, a randomized controlled trial that evaluated the value of self-help materials distributed in a health-care setting on decreasing dietary fat intake (Beresford et al, 1997). After an initial telephone screen that assessed fat intake, the intervention group was given a self-help booklet detailing healthful eating and physician endorsement.…”

Section: Other Program Characteristics Impacting Dietary Adherencementioning

confidence: 99%

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"The Impact of a Low-Fat Diet and the Use of Fat Substitutes on Fat Preferences Among Overweight Women Seeking Weight Loss Treatment"

Kalupa¹

2003

PsycEXTRA Dataset

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Public reporting burden for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to a penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. , 1999). The current study evaluated the impact of dietary fat modification on fat preference in three weight loss groups. The impact of changes in fat preference on shortterm adherence to a 6-week weight loss program was assessed. Sixty-one otherwise, healthy overweight women (BMI 25-37 kg/m2) between the ages of 18-60 were randomly assigned to one of three brief, 6-week weight loss programs. All three groups were asked to reduce dietary intake to 1800 kilocalories per day, but one group was asked to maintain fat at 36%, and two additional groups were asked to consume 20-25% of kilocalories in fat. One low-fat group was instructed to use fat substitutes and the other was instructed to avoid substitutes. It was hypothesized that decreased fat intake and sensory exposure to fat would cause a decrease in preference for high fat foods. Excellent adherence was observed with over 91% of participants completing treatment. In addition, guidelines regarding kilocalories, respective fat intake, fat substitute use were followed. Taste changes that occurred were subtle and did not affect on short-term dietary adherence. More time on the prescribed fat levels might be required to induce a change in fat preference. Differential changes in fat preference following dietary fat modification were expected, but not observed in the current investigation. However, results suggest that a modified 6-week Behavior Choice program might be a viable treatment option for women in this age and weight category (BMI < 37 kg/m2). However, adherence to low-fat diets remains a challenge. Hedonic responses to food may be important to understand the adherence problem. When compared to bland-tasting foods, nutritionally-equivalent foods that are flavorful are more satiating (Rolls, 1995;Warwick et al., 1993). Two previous studies that examined the sensory impact of dietary fat modification reported conflicting results (Mattes, 1993;Guinard et al., 1999).The current study evaluated the impact of dietary fat modification on fat preference in three weight loss groups. The impact of changes in fat preference on shortterm adherence to a 6-week weight loss program was assessed. Sixty-one otherwise, healthy overweight women (BMI 25-37 kg/m 2 ) be...

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A dietary intervention in primary care practice: the Eating Patterns Study.

Cited by 143 publications

References 31 publications

Predictors of adherence to a Mediterranean-type diet in the PREDIMED trial

Predictors of adherence to a Mediterranean-type diet in the PREDIMED trial

The impact of behavioral counseling on stage of change in fat intake, physical activity, and cigarette smoking in adults at increased risk of coronary heart disease

"The Impact of a Low-Fat Diet and the Use of Fat Substitutes on Fat Preferences Among Overweight Women Seeking Weight Loss Treatment"

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