Promoting Long Term Dietary Change to Reduce CVD Risk

BACKGROUND:

Because long-term reductions in saturated fat are crucial for cardiovascular and overall health, national experts in the areas of cardiovascular disease, nutrition, and obesity have identified the development of new behavioral strategies that promote long-term dietary change as a research area of critical importance.

DESIGN NARRATIVE:

The study design was a randomized controlled experiment in which 186 men and women age 25-74 years who had an intake of saturated fat of more than 10 percent were randomized to one of three conditions: (1) a taste-based goal setting + standard low-fat dietary intervention, (2) a standard low-fat dietary intervention alone, or (3) an assessment-only control condition. Both active interventions followed the National Cholesterol Education Program (NCEP) Step I goals. Intake of saturated fat was measured using 3-day unannounced 24-hour telephone dietary recalls at baseline, post-intervention (eight weeks), and 12 months from baseline. Study participants were recruited from local communities and represented the level of ethnic diversity in the target population.

The primary aim of this study was to determine whether the addition of a taste-based goal setting strategy to a standard low-fat intervention resulted in better maintenance of reductions in saturated fat at 12 months than either a standard low-fat intervention alone or an assessment-only control condition. The secondary aims of this study were to examine the long-term effects of taste-based goal setting on four additional sets of outcomes of major interest. First, what were the long-term effects of taste-based goal setting on the hypothesized psychological mediators (i.e., attitudes toward perceived deprivation, the taste of low-fat foods, and eating high-fat foods in moderation)? Second, what were the long-term effects of taste-based goal setting on nutritional adequacy, such as sufficient intake of important food groups needed for overall health (e.g., fruits and vegetables) and dietary nutrients other than fats and cholesterol (e.g., intake of fiber, vitamins, and minerals)? Third, what were the long-term effects on physiological outcomes related to risk of cardiovascular disease (i.e., low density lipoprotein [LDL] plasma cholesterol, blood pressure, and body mass index)? Fourth, what were the long-term effects on psychological outcomes (i.e., food preoccupation, willingness to try new foods, and restrained eating)?