Effects of a low-intensity worksite-based nutrition intervention

Male employees from four local worksites were recruited to participate in a short-term and low-intensity nutrition intervention which focused on promoting low-fat dietary habits. The sites were randomized to control conditions or to the intervention programme that consisted of an individualized health risk appraisal, group sessions, mass media activities and environmental changes. Participants were seen before and three months after intervention to measure blood lipids, nutrition knowledge and dietary changes. Eighty-three per cent of all eligible subjects were screened (n = 770) and follow-up measures were obtained for 82%. The score for nutrition knowledge improved significantly in the intervention group. There was also a net reduction in the intake of total calories and in the percentage of energy from total fat. Reported intake of carbohydrates and proteins increased. For all employees assessed, there were no changes in mean total cholesterol level or fatty acid composition. Only among participants with hypercholesterolemia was a significant reduction in blood cholesterol observed. This low-intensity intervention programme achieved some self-reported dietary changes and was successful (at least in part because statistical regression needs to be considered) in obtaining a more short-term beneficial cholesterol level in employees at higher cardiovascular risk.     

Dietary quality-adherence to the dietary guidelines in Tehranian adolescents: Tehran Lipid and Glucose Study

The aim of this study was to determine the Healthy Eating Index (HEI) score and its relation take of nutrients and the number of servings from each food group consumed by adolescents residing in district 13 of Tehran. This study, conducted within the framework of Tehran Lipid and Glucose Study (TLGS), was a part of a dietary intake assessment carried out in 443 families, including 465 adolescents, aged 10-18 years, according to the Food Guide Pyramid and dietary guidelines on individuals residing in district 13 of Tehran. In this study, dietary intake was assessed with two-day 24-hour recalls. HEI was calculated based on nine components. The score range of each component was 0 to 10, the sum score of this index therefore being 90. The HEI score was categorized into three groups: less than 45 (poor diet), between 45-72 (needs improvement) and more than 72 (good diet). The mean score of HEI was 64.9 +/- 9.6 in boys and 64.8 +/- 9.4 in girls. The results showed that the number of servings of food groups in those with good diet was significantly higher than the two other groups (p < 0.05). In contrast the percent of saturated fat intake and cholesterol consumption in those with HEI > or = 72 was lower than the other groups (p < 0.05). The approximate number of food items consumed and the total nutrient intake by adolescents with HEI score > or = 72 was significantly higher than the others (p < 0.05). There was a significant positive correlation between the number of servings of grains group (r = 0.1), vegetables (r = 0.4), fruits (r = 0.4), dairy (r = 0.3), meat (r = 0.1), and HEI (p < 0.001). There was a significant negative correlation between fat intake (r = -0.2, p < 0.001), percent of saturated fatty acids (r = -0.2, p < 0.05), cholesterol consumption (r = -0.4, p < 0.05), and the ratio of polyunsaturated fatty acids/saturated fatty acids (P/S) in diet (r = 0.2, p < 0.05), and HEI score. Seventy-four, 23, and 3% of diets were categorized into "needs improvement", "good", and "poor", respectively. In conclusion, the diets of most Tehranian adolescents need improvement, demonstrating the need for nutrition education in this age group.     

Health and nutrition education in primary schools of Crete: changes in chronic disease risk factors following a 6-year intervention programme

The effectiveness of a health and nutrition education programme, in changing certain chronic disease risk factors, was assessed after the 6 years intervention period was completed. The school-based intervention programme was applied to all children registered in the first grade (age 5.5-6.5 years) in 1992 in two counties of Crete, while the children from a third county served as a control group. In order to assess the effectiveness of the intervention, a variety of biological and behavioural parameters were measured before and following completion of the intervention in a randomly selected school-based sample of 602 intervention group (IG) and 444 control group (CG) pupils. At the end of the 6-year period, it was found that biochemical indices generally improved significantly more in the IG compared with the CG (mean change for IG v. CG was -0.27 v. -0.12 mmol/l for total cholesterol (TC); -0.07 v. +0.24 for TC:HDL and -0.13 v. +0.14 for LDL:HDL). Similarly, the changes observed in the anthropometric variables in the two groups were in favour of the IG (+3.68 v. +4.28 kg/m2 for BMI; +2.97 v. +4.47 mm for biceps skinfold). Total energy intake and consumption of total fat and saturated fat increased significantly less in the IG compared with the CG (+747.7 v. 1534.7 kJ (+178.7 v. +366.8 kcal); +5.9 v. +18.8 g and +0.8 v. +5.1 g respectively), while time devoted to leisure time physical activity and cardiovascular run test performance increased significantly more in the IG (+281 v. +174 min/week and +2.5 v. +1.2 stages respectively). The findings of the present study underline the importance of such programmes in health promotion and disease prevention. Although the long-term effects of these programmes can only be assessed by tracking this population through to adolescence and adulthood, these programmes seem to have the potential to lead to a healthier lifestyle and thus a reduction in risk factor levels.     

The relationship between self-rated health status and the overall quality of dietary intake of US adolescents

The objective of this study was to compare the quality of overall dietary intake of US adolescents by self-rated health status. Using 2 nonconsecutive days of dietary recall data and responses to a single question describing self-rated health status from the Continuing Survey of Food Intakes by Individuals 1994-1996, linear regression analysis was used to detect differences in Healthy Eating Index (HEI) scores by self-rated health status for 1,504 adolescents, ages 11 to 18 years. After adjusting for factors related to both overall dietary quality and self-rated health status, overall HEI scores did not differ by self-reported health status. However, two individual HEI component scores were found to be significantly related to adolescent self-rated health status: the vegetables score (P=0.01) was higher among those with positive self-rated health status, and the total fat score (P=0.01) was higher among those with negative self-rated health status. Self-perception of health status is not related to the overall quality of the adolescent diet; therefore, food and nutrition professionals should focus on understanding motivators other than health status when exploring adolescent dietary behaviors.     

Health and nutrition education program in primary schools of Crete: changes in blood pressure over 10 years

OBJECTIVE: To examine the long-term effects of the 'Cretan Health and Nutrition Education Program' on blood pressure. SUBJECTS: A representative population of 176 pupils (85 from the intervention schools and 91 from the control schools). DESIGN: Blood pressure, dietary, anthropometrical and physical activity data were obtained at baseline (academic year 1992-1993) and at follow-up examination (academic year 2001-2002). RESULTS: The findings of the current study revealed that the increase over the 10-year period in systolic (SBP) and diastolic blood pressure (DBP) was higher in the control group (CG) than in the intervention group (IG) (P=0.003 and P<0.001 respectively). Regarding dietary indices, the IG were found to have a significantly higher intake of potassium (P=0.018) and magnesium (P=0.011) compared to the CG. Furthermore, the decrease in body mass index (BMI) z-score observed in the IG was found to differentiate significantly from the increase observed in the CG (P=0.042). On the contrary, the increase in leisure time, moderate to vigorous physical activities (MVPA) observed in the IG, was found to differentiate significantly from the decrease observed in the CG (P=0.032). Intervention's effect on SBP was mediated by changes in MVPA (beta=-0.20, P=0.030) and BMI (beta=0.19, P=0.048). Similarly, intervention's effect on DBP was mediated by changes in MVPA (beta=-0.18, P=0.048), BMI (beta=0.26, P=0.007) and magnesium intake (beta=-0.20, P=0.048). CONCLUSION: The findings of the current study are encouraging, indicating favorable changes in blood pressure, micronutrients intake, BMI and physical activity over the 10 years of follow-up and 4 years after program's cessation, thus providing some support for the effectiveness of school-based health education programs in successfully tackling certain chronic disease risk factors early in life.     

A Pre and Post Survey to Determine Effectiveness of a Dietitian-Based Nutrition Education Strategy on Fruit and Vegetable Intake and Energy Intake among Adults

The purpose of the study was to evaluate the effectiveness of a multicomponent nutrition education program among adults. A pretest—posttest design was used assessing Nutritional Knowledge (NK), BMI, Energy Intake (EI), Physical Activity Level (PAL), Dietary Intake (DI) and attitudes. 353 adults aged 19–55 years (178 control group (CG) and 175 intervention group (IG)) were recruited. IG participants attended nutrition education sessions evaluated through a post-test given at the end of the 12-week program. Statistical tests performed revealed that compared to CG, participants in IG increased fruit intake and decreased intake of snacks high in sugar and fat significantly (p < 0.05). NK and attitudinal scores also increased significantly in the IG (p < 0.05). No intervention effect was found for vegetables intake, EI, BMI and PAL (p > 0.05). Factors influencing NK were age, gender and education level. “Taste” was the main barrier to the application of the nutrition education strategy. Findings are helpful to health practitioners in designing their intervention programs.     

Effects of a controlled family-based health education/counseling intervention

OBJECTIVE: To describe the effects of a controlled family-based health education/counseling intervention on health behaviors of children with a familial history of cardiovascular diseases (FH-CVDs). METHODS: The intervention group (IG, n=432) received 5 counseling sessions. The control groups 1 (CG1, n=200) and 2 (CG2, n=423) received no counseling. Outcome measures comprised changes in diet, exercise, and cigarette smoking. RESULTS: The changes in the use of fats and salt, and in exercise, were more favorable in IG than in CG1 and/or CG2. CONCLUSION: Health education/counseling produced positive effects on diet and nutrition in particular and in part in exercise.     

Seasonal variations of vitamin D status in Greek postmenopausal women receiving enriched dairy products for 30 months: the Postmenopausal Health Study

The effectiveness of a 30-month dietary intervention on vitamin D status of Greek postmenopausal women was examined. Sixty-six postmenopausal women (55-65 years old) were randomized into an intervention group (IG), receiving a daily dose of 7.5 μg of vitamin D? for 12 months that increased to 22.5 μg for the remaining 18 months of intervention through fortified dairy products and attending nutrition and lifestyle counselling sessions, and a control group (CG). After 30 months of intervention, during winter, serum 25-hydroxy vitamin D (25(OH)D) levels significantly decreased in the CG while remained in the same high levels as in the summer period in the IG. Similarly, at 30 months of intervention the prevalence of vitamin D insufficiency was significantly higher in the CG compared to the IG (60.0 vs 25.0%, P = 0.006). In conclusion, the current intervention scheme with a daily dose of 22.5 μg of Vitamin D could significantly decrease the prevalence of vitamin D insufficiency during winter time but not entirely prevent it.     

Effectiveness of Tailored Dietary Counseling in Treating Malnourished Outpatients with Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial

BackgroundMalnutrition in patients with chronic obstructive pulmonary disease (COPD) is common and associated with poor prognosis. Nutrition interventions are necessary, but there is a lack of evidence regarding the effectiveness of tailored nutrition advice.ObjectiveThis study investigated whether tailored nutrition counseling could improve dietary intake, nutritional status, functional outcomes, and health-related quality of life (QoL) of malnourished outpatients with COPD.DesignWe conducted a randomized controlled trial in which participants were randomly assigned to either the intervention group (IG) or the control group (CG).Participants/settingOne hundred and twenty malnourished outpatients with COPD participated in the study between May and November 2017 at the National Lung Hospital, Hanoi, Vietnam.InterventionThe IG received tailored nutrition counseling once per month for 3 months based on a specifically developed written nutrition resource for COPD. The CG received the same educational resource at baseline without any discussion.Main outcome measuresThe main outcome measures were energy and protein intakes, body weight change, nutritional status (Subjective Global Assessment score), muscle strength, and QoL.Statistical analysesDifferences between groups before and after the intervention were assessed using two-way repeated measures analysis of variance. Generalized estimating equation modeling was used to investigate the differences between groups over time.ResultsAt baseline, there were no significant differences in outcomes of interest between the two groups. After 3 months of intervention, time–intervention interactions for energy intake, protein intake, and body weight change were significant (945 kcal/day, 95% CI 792 to 1,099 kcal/day, P<0.001; 50.0 g protein/day, 95% CI 43.9 to 56.1 g protein/day, P<0.001; and 1.0 kg, 95% CI 0.5 to 1.5 kg, P<0.001, respectively). Subjective Global Assessment scores improved in the IG and worsened in the CG. Significant improvements were found in inspiratory muscle strength in the IG (5.4 cmH₂O, 95% CI 2.3 to 8.6 cmH₂O, P=0.001) and significant decreases in handgrip strength were found in the CG after 3 months of the intervention (1.4 kg, 95% CI 0.4 to 2.4 kg, P=0.007). There was a significant interaction effect for all QoL scores (analysis of variance two-way repeated, P≤0.003). The IG also significantly improved all QoL scores from baseline to 3 months (P<0.004).ConclusionsTailored nutritional counseling has the potential to improve dietary intakes, nutritional status, functional outcomes, and QoL in malnourished outpatients with COPD.     

The Relationship of Body Size to Participation and Success in a Fruits and Vegetables Intervention among Low-income Women

We examined participation and dietary change among women participants in a community-based nutrition education program, to determine whether intervention results differed by participant body size. Four dietary indicators (daily servings of fruits and vegetables, total calories, calories from fat, and Healthy Eating Index score) were assessed from 24-h recalls taken before, immediately after, and 4 months after a seven-session nutritional education program, from 156 African-American women age 20–50, in Washington, D.C. public housing. Knowledge, attitudes and practices related to nutritional behavior change were collected at three timepoints as well. Random effect models were used to examine dietary patterns, and compare change by body size and class attendance. Results showed that obese women (BMI ≥ 30) had more psychosocial barriers to dietary change and poorer baseline diets, but stronger program attendance. Post-intervention, both groups consumed approximately 250 fewer calories and 2.5% fewer calories from fat. At follow-up, non-obese women consumed significantly fewer calories; obese women consumed significantly fewer calories from fat, and showed significant improvement in HEI. Given the prevalence of obesity in low resource communities, nutritional interventions should tailor strategies to participant body size and related psychosocial needs.     

Three-Year Follow-Up of the POIBA Intervention on Childhood Obesity: A Quasi-Experimental Study

Childhood obesity has increased worldwide over the past four decades. This quasi-experimental study aimed to assess the effectiveness of a multicomponent and multilevel school-based intervention (POIBA) at 3 years of follow-up. The nutrition intervention focused on food groups, food pyramid, nutrients, portions, and balanced menus. In total, 3624 children participated in the study. Anthropometric measurements and information on food frequency and behavior, physical activity, and daily screen use were collected in the intervention (IG) and comparison group (CG). Positive unadjusted changes toward adherence to recommendations were found for water, meat, sweets, and fried potato consumption, proper breakfast, not having dinner in front of the TV, out-of-school physical activity, and daily screen use. Three scores were used to calculate the proportion of children making more than one change to improve healthy habits regarding physical activity (global Activity score), nutrition (global Nutrition score), and both (global score). Students exposed to the intervention had a significantly better global Activity score (16.2% IG vs. 11.9% CG; p = 0.012) and Global score (63.9% IG vs. 58.5% CG; p = 0.025). Intervention effects on obesity incidence at 3-year follow-up lost significance but maintained the positive trend. In conclusion, school-based interventions including a family component could be useful to address the childhood obesity problem.     

Healthy Eating Index scores are associated with blood nutrient concentrations in the third National Health And Nutrition Examination Survey

OBJECTIVES: The Healthy Eating Index (HEI) is a summary measure of dietary quality, based on a 100-point scale. Our objectives were to assess the HEI as a measure of dietary status through its correlation with nutritional biomarkers and to identify those biomarkers most associated with diet quality and healthful food intake patterns. DESIGN: National Health and Nutrition Examination Survey (NHANES) III, 1988-94. SUBJECTS: Adults (> or =17 years) with calculated HEI scores and blood nutrient data (n=16,467). STATISTICAL ANALYSES PERFORMED: Weighted crude and partial Pearson correlation coefficients (r) between HEI scores and blood nutrients were calculated. Geometric mean blood nutrient concentrations were calculated for five HEI score categories (ranging from < or =50 to >80). RESULTS: HEI score was positively correlated with serum (r=0.25) and red blood cell (r=0.27) folate, serum vitamins C (r=0.30) and E (r=0.21), and all serum carotenoids except lycopene (r=0.17 to 0.27). These blood nutrient concentrations were 21% to 175% higher for participants in the highest HEI score group (>80) compared with those in the lowest group (< or =50). Mean HEI scores were significantly (P<.0001) greater among the 42% of participants who took dietary supplements. Most correlations were attenuated when adjusted for additional factors. CONCLUSIONS: HEI score is correlated with a wide range of blood nutrients; the strongest relationships are with biomarkers of fruit and vegetable intake. These results are an important step in the validation of the HEI, emphasizing its potential as a tool for nutrition and health studies.     

Nutrition education for children—results and perspectives

Aim Recent scientific literature reveals a tremendous change in the health status of children and adolescents caused by malnutrition and changes in general lifestyle. Thus, the crucial value of a sustainable nutrition education has long been recognised as a major component of public health nutrition strategies. This paper describes a study that took several requirements for nutrition education programmes into account by developing and evaluating a new age-adapted version of an existing nutrition education programme.Methods The objective of the evaluation was to draw conclusions about the effects of the interventions success. A quasi-experimental field study design was utilised, arranging subjects into intervention, comparison and control groups. For each group, a pre- and post-test was assessed. Between the pre-test and post-test, a period of 4 months elapsed. In total, data from 616 children, 474 parents and 47 teachers were included in the evaluation.Results In general, all children in the intervention group (IG) across all ages showed a statistically significant improvement of general nutrition-related knowledge between the pre-test and post-test, which was measured in one section of the questionnaire. The comparison between intervention group (IG) and control group (CG) revealed significantly stronger improvement for the intervention group (IG). In comparison with the control group, the intervention group did not show any meaningful improvement in any of the five age groups. Parents, kindergarten-teachers and school teachers of all intervention groups reported serious changes for the health-conscious attitudes in children.Conclusion In summarising, the presented age-adapted nutrition education programme and its evaluation could show a clear improvement of nutrition-related knowledge and less clear improvements in nutrition-related attitudes and behavioural intentions. A sustainable prolongation of the programme could lead to even higher improvement.     

A Culturally Sensitive and Theory-Based Intervention on Prevention and Management of Diabetes: A Cluster Randomized Control Trial

Type 2 diabetes is an emerging concern in Kenya. This clustered-randomized trial of peri-urban communities included a theory-based and culturally sensitive intervention to improve diabetes knowledge, health beliefs, dietary intake, physical activity, and weight status among Kenyan adults. Those in the intervention group (IG) received a culturally sensitive diabetes education intervention which applied the Health Belief Model in changing knowledge, health beliefs and behavior. Participants attended daily education sessions for 5 days, each lasting 3 h and received mobile phone messages for an additional 4 weeks. The control group (CG) received standard education on COVID-19. Data was collected at baseline, post-intervention (1 week), and follow-up assessment (5 weeks). Linear mixed effect analysis was performed to assess within and across group differences. Compared to the control, IG significantly increased diabetes knowledge (p < 0.001), health beliefs including perceived susceptibility (p = 0.05), perceived benefits (p = 0.04) and self-efficacy (p = 0.02). IG decreased consumption of oils (p = 0.03), refined grains (p = 0.01), and increased intake of fruits (p = 0.01). Perceived barriers, physical activity, and weight status were not significantly different between both groups. The findings demonstrate the potential of diabetes education in improving diabetes knowledge, health beliefs, and in changing dietary intake of among adults in Kenya.     

Applying the Stages of Change Model in a Nutrition Education Programme for the Promotion of Fruit and Vegetable Consumption among People with Severe Mental Disorders (DIETMENT)

Despite growing evidence of the benefits of adequate intake of fruit and vegetables (F&V) and the recommendation to consume five servings daily, the adoption of these habits is poor among people with severe mental disorder (SMD). The main aim of the present study is to determine changes in the intake of F&V and motivation to do so among people with SMDs after participating in a food education programme. A community-based randomized controlled trial was conducted in Spain, with the intervention group (IG) participating in a food education programme based on the stages of change model to promote consumption of F&V and the control group (CG) receiving three informative sessions on basic healthy eating. The main outcomes were related to the intake of F&V and stages of change. Data collection was performed at baseline, post intervention, and 12-month follow-up. Seventy-four participants enrolled in the study and sixty completed the 12-month follow-up. An increase in motivation towards the intake of F&V was observed in the IG but not in the CG (McNemar’s test p = 0.016, p = 0.625). No significant difference was observed for the intake of fruit, vegetables, or F&V. Basing food education strategies on the stages of change model shows positive results, increasing the awareness and disposition of people with SMD towards the intake of F&V. More research is needed to identify the most appropriate eating intervention to increase the intake of F&V.     

The diet quality of adult women participating in a behavioural weight‐loss programme

Background: Diet quality plays an important role in health and has been shown to impact the risk of heart disease and certain cancers. The present study aimed to examine baseline and 16‐week follow‐up levels of energy intake, energy density and diet quality, as measured by the Healthy Eating Index 2005 (HEI‐2005), in overweight and obese women participating in a behavioural weight‐loss programme. Methods: Sixty‐six women [mean (SD) age 48.6 (10.8) years; body mass index 31.8 (3.7) kg m^?2; 92% Caucasian] completed dietary measures at baseline and follow‐up. All participants received a 16‐week Internet Behavioural weight‐loss programme based on the core of the Diabetes Prevention Program. Dietary intake was measured using the 2005 Block food frequency questionnaire. Diet quality was calculated using the HEI‐2005. Paired t‐tests were used to determine changes over time. Results: There was a reduction in reported energy intake [7.867 (3.232) MJ versus 5.748 (1.775) MJ, P < 0.001] over the 16 weeks. Participants had an increase in diet quality [HEI score = 53.9 (9.9) versus 57.4 (10.6), P = 0.002] as well as a reduction in energy density [0.0088 (0.0021) MJ g^?1 to 0.0080 (0.0021) MJ g^?1 (P = 0.002)]. All micronutrient intakes decreased over the 16 weeks. Conclusions: Participation in a 16‐week behavioural weight‐loss programme significantly improved diet quality and reduced dietary energy density and energy intake in adult women. However, despite the overall increase in diet quality score, there were deficiencies in key micronutrients in the diets of most women at the conclusion of the 16‐week study.     

Modifying the Healthy Eating Index to assess diet quality in children and adolescents

OBJECTIVE: The Healthy Eating Index (HEI) is a scoring system used by the US government to assess adherence to the Dietary Guidelines for Americans. We examined the ability of the HEI to monitor diet quality among youth. DESIGN: We modified and simplified the HEI for use by older children and adolescents. The new Youth Healthy Eating Index (YHEI) focuses on food quality and assesses both healthful and unhealthful foods and eating behaviors. Both HEI and YHEI scores were calculated from a food frequency questionnaire that was mailed to participants in the Growing Up Today Study in 1996. SUBJECTS/SETTING: Girls (n=8,807) and boys (n=7,645) 9 to 14 years of age who are children of participants in the Nurses Health Study II cohort and who reside across the United States. STATISTICAL ANALYSIS: Mean HEI and YHEI scores were calculated by sex and age, and associations with age, body mass index, activity, inactivity, energy intake, and several nutrients were assessed with Pearson correlations. Linear regression was used to examine the contributions of the individual HEI and YHEI components toward the total scores. RESULTS: The HEI score was highly correlated with total energy intake ( r =0.67), indicating a strong association with quantity of food consumption. In contrast, the YHEI was not strongly correlated with energy intake ( r =0.12) but was inversely associated with time spent in inactive pursuits ( r =-0.27). The HEI component for variety in food selection accounted for 60% of the variation in the total score and several HEI components were highly correlated with each other, particularly those for total and saturated fat ( r =0.78). CONCLUSIONS: To successfully monitor diet in a population of children and adolescents, the HEI may benefit from modifications that focus on food quality and include assessments of unhealthful foods. Further research is needed to determine the dietary elements that are most related to health in diverse populations of youth.     

Effects of a nutritional intervention on body composition, clinical status, and quality of life in patients with heart failure

OBJECTIVES: We assessed the effects of a nutritional intervention on clinical and nutritional status and quality of life in patients with heart failure. METHODS: Sixty-five patients with heart failure were assigned to one of two groups: the intervention group (IG; n = 30) received a sodium-restricted diet (2000 to 2400 mg/d) with restriction of total fluids to 1.5 L/d, and the control group (CG; n = 35) received traditional medical treatment and general nutritional recommendations. Anthropometric, body composition, physical activity, dietary, metabolic, clinical, and quality of life assessments were performed in all patients at baseline and 6 mo later. RESULTS: At the end of the study, kilocalories, macronutrients, and fluid intakes were significant lower in the IG than in the CG. Urinary excretion of sodium decreased significantly in the IG and increased in the CG (-7.9% versus 29.4%, P < 0.05). IG patients had significantly less frequent edema (37% versus 7.4%, P = 0.008) and fatigue (59.3% versus 25.9%, P = 0.012) at 6 mo than at baseline; in addition, functional class improved significantly, and no changes were observed in the CG. Extracellular water decreased -1.1 +/- 3.7% in the IG and increased 1.4 +/- 4.5% in the CG (P = 0.03). Physical activity increased 2.5% +/- 7.4% in the IG and decreased -3.1 +/- 12.0 in the CG (P < 0.05). The IG had a greater increase in total quality of life compared with the CG (19.3% versus 3.2%, P = 0.02). CONCLUSIONS: In this study, the beneficial effect of a supervised nutritional intervention was proved as part of a non-pharmacologic treatment of patients with heart failure, with improvements in clinical status and quality of life.     

Nutrition education worksite intervention for university staff: application of the health belief model

OBJECTIVE: To evaluate the efficacy of an 8-week worksite nutrition education intervention for university staff using the Health Belief Model (HBM) to promote healthful dietary behaviors that reduce risks for cardiovascular disease and cancer. DESIGN: 2 3 2 repeated measures baseline/posttest ex post facto research design. PARTICIPANTS: Staff employees were randomly assigned to treatment (n = 28) and control groups (n = 25). INTERVENTION: The intervention focused on specific health beliefs, nutrition knowledge, and dietary practices to demonstrate treatment effect. MAIN OUTCOME MEASURES: Dependent variables were specific health beliefs, nutrition knowledge, and dietary behaviors. Independent variables were demographic characteristics and group assignment. ANALYSES: Tests of parametric assumptions, power analyses, analysis of variance, and Kuder-Richardson and Pearson product-moment coefficients were computed and specificity of treatment effects was assessed. RESULTS: Perceived benefits of healthy nutrition practices and nutrition knowledge related to cardiovascular disease and cancer significantly improved among the treatment participants, P <.001. Treatment group participants also significantly reduced total calories, fat, saturated fat, and cholesterol intake (each P <.001). CONCLUSIONS: The intervention appears to be related to treatment effects and significantly increased nutrition knowledge and decreased energy, fat, saturated fat, and cholesterol intake to levels consistent with national recommendations.     

Adherence to Dietary Recommendations after One Year of Intervention in Breast Cancer Women: The DIANA-5 Trial

The Diet and Androgen-5 (DIANA-5) trial aimed at testing whether a dietary change based on the Mediterranean diet and on macrobiotic principles can reduce the incidence of breast cancer (BC)-related events. We analyzed the adherence to the DIANA-5 dietary recommendations by randomization group after 1 year of intervention. We evaluated the association between dietary adherence and changes in body weight and metabolic syndrome (MS) parameters. BC women aged 35–70 years were eligible. After the baseline examinations, women were randomized into an intervention group (IG) or a control group (CG). A total of 1344 BC women (689 IG and 655 CG) concluded the first year of dietary intervention. IG showed greater anthropometric and metabolic improvements compared to CG. These changes were significantly associated with increased adherence to the dietary recommendations. Women who increased recommended foods consumption or reduced discouraged foods consumption showed an Odds Ratio (OR) of 1.37 (0.70–2.67) and 2.02 (1.03–3.98) to improve three or more MS parameters. Moreover, women in the higher category of dietary change showed a four times higher OR of reducing body weight compared to the lower category (p < 0.001). The DIANA-5 dietary intervention is effective in reducing body weight and MS parameters.