Feasibility of a randomized trial of a low-fat diet for the prevention of breast cancer: Dietary compliance in the women's health trial vanguard study

Henderson, Maureen; Kushi, Lawrence H.; Thompson, Donovan J.; Gorbach, Sherwood L.; Clifford, Carolyn K.; Insull, William; Moskowitz, Myron; Thompson, Robert S.

doi:10.1016/0091-7435(90)90014-b

Cited by 175 publications

(50 citation statements)

References 38 publications

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“…[7][8][9][10] In this respect, our results are consistent with previous studies. However, in all of the previous studies many beneficial dietary changes have been maintained for several years, opposite to observations in our study.…”

Section: Discussionsupporting

confidence: 83%

“…6 Several studies have demonstrated that subjects receiving dietary counselling can increase the use of vegetables, fruit, high-fibre grain products and low-fat alternatives, and simultaneously decrease the use of high-fat and energydense foods, energy-yielding beverages and alcohol. [7][8][9][10] However, previous studies have mainly focused on reducing intake of dietary risk factors, for example, saturated fat, for specific diseases. To our knowledge, no study has described food consumption during an intervention specifically focused on losing and maintaining weight in obese persons.…”

Section: Introductionmentioning

confidence: 99%

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Food selection and eating behaviour during weight maintenance intervention and 2-y follow-up in obese men

2004

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OBJECTIVE:The aim was to assess long-term changes in food consumption and eating behaviour during and 2 y after dietary counselling in weight-reduced obese men. DESIGN: Observational study from a randomised controlled trial. SETTING: Outpatient clinic of a research institute. SUBJECTS: A total of 36 subjects with complete data on food intake during the study. Subjects were obese (mean body mass index (BMI) 32.8 kg/m 2 ) men aged 35-50 y, recruited by media advertising. INTERVENTIONS: Dietary counselling was included in 2 months weight reduction with very-low-energy-diet and in 6 months weight maintenance programme, which also included physical activity counselling. This was followed by a 23 months unsupervised follow-up with yearly assessments. Food intake was assessed six times during the study by 4-day food records. Eating behaviour was assessed by Three-Factor Eating Questionnaire (TFEQ). RESULTS: Increased consumption of low-fat cheese, low-fat margarine, vegetables and high-fibre bread, and decreased consumption of sugar, sausage, high-fat cheese, high-fat margarine, fat products and sweets were observed during dietary counselling. Most of these changes returned later to prestudy consumption level. The relapse in dietary changes was partly associated with scoring low in restraint and high in disinhibition and hunger. CONCLUSION: In obese men, long-term maintenance of dietary changes was difficult. New ways to ease self-monitoring and increase self-efficacy might be necessary to improve maintenance of dietary changes.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Food selection and eating behaviour during weight maintenance intervention and 2-y follow-up in obese men

2004

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“…During screening, participants completed a standardized FFQ developed for the WHI to estimate average daily nutrient intake over the previous three-month period [32], which served as a baseline measure. The FFQ was based on instruments used in the WHI feasibility studies [34,35] and the original NCI/Block FFQ [36]. The WHI FFQ was self-administered and captured usual dietary intake for the previous three months.…”

Section: Anthropometric and Diet Measuresmentioning

confidence: 99%

Association between dietary fiber and markers of systemic inflammation in the Women's Health Initiative Observational Study

et al. 2008

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Objective-Systemic inflammation may play an important role in the development of atherosclerosis, type 2 diabetes, and some cancers. Few studies have comprehensively assessed the direct relationships between dietary fiber and inflammatory cytokines, especially in minority populations. Using baseline data from 1,958 postmenopausal women enrolled in the Women's Heath Initiative Observational Study, we examined cross-sectional associations between dietary fiber intake and markers of systemic inflammation (including serum C-reactive protein (hs-CRP), interleukin 6 (IL-6), and tumor necrosis factor α receptor 2 (TNF-α-R2)), as well as differences in these associations by ethnicity.Method-Multiple linear regression models were used to assess the relationship between fiber intake and makers of systemic inflammation.Results-After adjustment for covariates, intake of dietary fiber were inversely associated with both IL-6 (P values for trend were 0.01 for total fiber, 0.004 for soluble fiber, and 0.001 for insoluble fiber) and TNF-α-R2 (P values for trend were 0.002 for total, 0.02 for soluble, and <0.001 for insoluble fiber). Although the sample sizes were small in minority Americans, results were generally Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusions-These findings lend support to the hypothesis that a high-fiber diet is associated with lower plasma levels of IL-6 and TNF-α-R2. Contrary to previous reports, however, there was no association between fiber and hs-CRP among postmenopausal women. Future studies on the influence of diet on inflammation should include IL-6 and TNF-α-R2 and enroll participants from ethnic minorities. NIH Public Access

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“…The intervention was based on the programme developed in the Women's Health Trial Feasibility Study 5 , with extensive modifications that included: (i) revising written materials and exercises to be at a sixth grade reading level; (ii) expanding the range of foods and preparation methods, in particular to include those of US southern blacks and Cubans; and (iii) translating all materials, exercises and assessment instruments into Cuban Spanish. The nutrition intervention was delivered in group sessions led by centrally trained registered dietitians, which met weekly for 6 weeks, biweekly for 6 weeks, monthly for 9 months, and then quarterly.…”

Section: Methodsmentioning

confidence: 99%

Differences in fat-related dietary patterns between black, Hispanic and white women: results from the Women's Health Trial Feasibility Study in Minority Populations

Kristal

Shattuck

Patterson

1999

Public Health Nutr.

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Objective: This report examines how sources of fat and patterns of fat-related dietary habits differed between black, Hispanic and white women participating in a randomized trial of a low-fat diet intervention. Design: The intervention consisted of group sessions, which met weekly for 6 weeks, biweekly for 6 weeks and monthly for 9 months, and included didactic nutrition education and activities to provide motivation for sustained dietary change. Outcomes included total fat and fat from nine food groups from a food frequency questionnaire (FFQ), and a summary scale and five subscales that measure fat-related dietary habits. Setting/subjects: Data are from 1702 post-menopausal women, recruited from clinical centres in Atlanta, Birmingham and Miami, with dietary assessments at baseline and 6 months post-randomization. Results: Total fat intake was similar across race/ethnic groups at baseline, yet there were many differences in sources of fat and fat-related dietary habits. For example, blacks consumed less fat from dairy foods and more fat from meats than whites. Effects of the intervention on total fat intake or the summary fatrelated dietary habits scale did not differ across race/ethnicity groups. There were, however, many differences in how the intervention affected sources of fat and fatrelated dietary habits. For example, the intervention effect for added fats (e.g. butter and salad dressings) was −8.9 g for blacks and −12.0 g for whites (P Ͻ 0.05). The intervention effect for adopting low-fat meat purchasing and preparation methods was larger for blacks than whites, and the intervention effect for replacing high-fat foods with fruits and vegetables was larger for Hispanics than whites. Conclusions: This study demonstrates that, if properly designed, a single nutrition intervention programme can work well even in groups with culturally diverse dietary patterns.

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Feasibility of a randomized trial of a low-fat diet for the prevention of breast cancer: Dietary compliance in the women's health trial vanguard study

Cited by 175 publications

References 38 publications

Food selection and eating behaviour during weight maintenance intervention and 2-y follow-up in obese men

Food selection and eating behaviour during weight maintenance intervention and 2-y follow-up in obese men

Association between dietary fiber and markers of systemic inflammation in the Women's Health Initiative Observational Study

Differences in fat-related dietary patterns between black, Hispanic and white women: results from the Women's Health Trial Feasibility Study in Minority Populations

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