Predictors of Dietary Change and Maintenance in the Women’s Health Initiative Dietary Modification Trial

Tinker, Lesley F.; Rosal, Milagros C.; Young, Anne F.; Perri, Michael G.; Patterson, Ruth E.; Horn, Linda Van; Assaf, Annlouise R.; Bowen, Deborah J.; Ockene, Judith K.; Hays, J. Ray; Wu, LieLing

doi:10.1016/j.jada.2007.04.010

Cited by 89 publications

(93 citation statements)

References 56 publications

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“…Although other studies [24,29] found a positive association between educational level and adherence to a MeDiet, we did not. The main reason that may explain this finding is that in the PREDIMED study population the between-subject variability in educational levels is small, because the proportion of highly-educated subjects and, specifically, of those with a university degree was very small (7.6%), especially among women.…”

Section: Discussioncontrasting

confidence: 91%

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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: Discussioncontrasting

confidence: 91%

“…Several studies have addressed these predictors [14,28,29,35]. Up to now, the most important predictors of failure to achieve these changes are some sociodemographic characteristics, general health status [35], and lifestyle and psychological factors [28].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2009

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“…Optimism has also predicted changes in dietary behaviors, body fat, and aerobic capacity (Shepperd, Maroto, & Pbert, 1996;Tinker et al, 2007). Studies have also found that happiness is associated with physical activity/exercise (Carter, 1977;Courneya et al, 2003;Koopmans, Geleijnse, Zitman, & Giltay, 2008;Stevinson et al, 2009;Strauss, Rodzilsky, Burack, & Colin, 2001;Stubbe, de Moor, Boomsma, & de Geus, 2007).…”

Section: Introductionmentioning

confidence: 99%

Emotional Outlook on Life Predicts Increases in Physical Activity Among Initially Inactive Men

et al. 2011

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This study examined the relationship between emotional outlook on life and change in physical activity among inactive adults in the Aerobics Center Longitudinal Study. A total of 2,132 sedentary adults completed a baseline medical examination and returned for a follow-up examination at least 6 months later. Participants self-reported physical activity level and emotional outlook on life. Emotional outlook on life was significantly and positively related to physical activity participation at the follow-up visit in men but not women. Men who were usually very happy and optimistic at baseline had significantly greater increases in physical activity compared to men who were not happy. Men with a more positive outlook on life (e.g., happier) may be more likely to increase physical activity levels. Physical activity interventions targeting men may be more successful if they first increase happiness.

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“…Research has shown that high session attendance is associated with behaviour change (40,41) . The completion rate of maintenance-stage telephone sessions was not as high as the in-person class attendance rate.…”

Section: Discussionmentioning

confidence: 99%

Acceptability and feasibility of the ‘DASH for Asthma’ intervention in a randomized controlled trial pilot study

Blonstein

Camargo

et al. 2015

Public Health Nutr.

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Objective: 'DASH for Asthma' (n 90) was a 6-month randomized controlled trial that demonstrated potential benefits of a DASH (Dietary Approaches to Stop Hypertension) behavioural intervention for improving diet quality and asthma control by comparing intervention to usual care in adults with uncontrolled asthma. The present study examined acceptability and feasibility of the intervention from the perspective of intervention participants and lifestyle coaches. Design: Grounded in Social Cognitive Theory, the 3-month intensive stage, including three individual and eight group sessions, focused on diet modifications and behavioural self-regulation. The 3-month maintenance stage contained telephone consultations. Participants and lifestyle coaches completed surveys including 5-point Likert scales and open-ended questions. We analysed data using descriptive and inductive content analyses. Subjects: Forty-six intervention participants (survey response rate was 65-72 %) and two lifestyle coaches. Results: Participants and lifestyle coaches were highly satisfied (all mean ratings >4) with individual and group sessions. Participants identified mastery of knowledge and skills (awareness, goal setting, self-monitoring, problem solving), social learning (class members sharing experiences and ideas) and good coaching skills (reflective listening, empathy, motivational counselling) as important contributors to selfefficacy and programme satisfaction. Participants also valued personalized feedback received in individual sessions. Lifestyle coaches viewed participant engagement as a facilitator to effective sessions. Finally, participants and lifestyle coaches identified food tasting as beneficial for observational learning and facilitation of participant engagement. High class attendance and self-monitoring rate also reflected the high engagement among participants. Conclusions: The DASH behavioural intervention was feasible and highly acceptable to participants with uncontrolled asthma and lifestyle coaches.

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Predictors of Dietary Change and Maintenance in the Women’s Health Initiative Dietary Modification Trial

Cited by 89 publications

References 56 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

Emotional Outlook on Life Predicts Increases in Physical Activity Among Initially Inactive Men

Acceptability and feasibility of the ‘DASH for Asthma’ intervention in a randomized controlled trial pilot study

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