Behavioral variables and education are predictors of dietary change in the Women's Health Trial: Feasibility Study in Minority Populations

Background. Reducing the intakes of fats and increasing consumption of fruits and vegetables are an important goal for improving population health. Analyzing the effects of nutrition education programs on subjects' dietary intakes incorporating factors such as habit persistence in diets, unhealthy eating habits, perceptions of health risks, participation motivation, and expectancies can yield useful insights. Methods. A Food Frequency Questionnaire (FFQ) was used to measure intakes at baseline, 6 and 12 months, by 318 and 548 postmenopausal women in, respectively, the Control and Intervention groups of the Women's Health Trial: Feasibility Study in Minority Populations (WHTFSMP). Information on background, behavioral, and anthropometric variables was collected. The Intervention group met in classes led by nutritionists. Dynamic random effects models were estimated for the two groups using the data at baseline, 6 and 12 months on the intakes of carbohydrate, saturated, monounsaturated, and polyunsaturated fats, fiber, β-carotene, ascorbic acid, and calcium. Results. The nutrition education program lowered the intakes of fats while increasing fiber, β-carotene, and ascorbic acid intakes especially in subjects scoring high on indices reflecting concerns ab0out health, desirability of change, and participation motivation. In addition, subjects' education was a predictor of dietary intakes in the Intervention group. Conclusions. Nutrition education can be an effective tool for improving diets, but behavioral characteristics deserve greater attention in helping to design the most effective approaches for various target groups.