The effects of physical and emotional status on adherence to a low-fat dietary pattern in the Women's Health Initiative

Lesley F. Tinker, Michael G. Perri, Ruth E. Patterson, Deborah J. Bowen, Martin McIntosh, Linda Miller Parker, Mary Ann Sevick, Lois Ann Wodarski

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Objective: To examine whether the effects of physical and emotional status on adherance to a low-fat (20% energy) dietary pattern are mediated by participation in an intervention program (attending sessions and self-monitoring). Design: The Baron and Kenny mediator model, a series of 4 regression analyses, was used to evaluate whether: a) physical and emotional status predicted program participation, b) program participation predicted dietary adherence, c) physical and emotional status factors predicted dietary adherence, and, ultimately d) the effects of physical and emotional status on dietary adherence were mediated by program participation. Subjects/setting: Data from 13,277 postmenopausal women randomily assigned to the low-fat intervention arm of the Women's Health Initiative Dietary Modification Trial. Intervention: The nutrition goals for women randomly assigned to the low-fat intervention were to reduce total fat intake to 20% or less of energy from fat and to consume 5 or more fruit/vegetable servings daily and 6 or more grain servings daily. Main outcome measures: Year 1 program participation (degree of attending group sessions and submitting fat scores) and adherence to the low-fat dietary pattern (percent energy from fat) as predicted by baseline physical and emotional status (eight SF-36 Health Survey subscales). Results: Participating in the dietary intervention program reduced (mediated) the negative effect of poorer mental health on dietary adherence by 15%. Additional findings included that a 10% increase in physical functioning increased session attendance by 0.4% (P<.001) and a 10% increase in mental health predicted a decrease in percent energy from fat of 0.3% (P<.001). Program participation had a marked effect on dietary adherence: a 10% increase in session attendance predicted a 1.2% decrease in percent energy from fat (P<.001). Applications/conclusions: Understanding and using instruments to assess the physical and emotional status of a target population will help dietetic professionals promote healthful dietary change and maintenance.

Original languageEnglish
JournalJournal of the American Dietetic Association
Volume102
Issue number6
DOIs
StatePublished - Dec 1 2002

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women's health
Dietary Fats
Women's Health
eating habits
Fats
lipids
energy
mental health
Mental Health
Diet Therapy
Dietetics
Health Services Needs and Demand
dietetics
fat intake
Health Surveys
Vegetables
Fruit
vegetables
Regression Analysis
Maintenance

ASJC Scopus subject areas

  • Food Science
  • Medicine(all)

Cite this

The effects of physical and emotional status on adherence to a low-fat dietary pattern in the Women's Health Initiative. / Tinker, Lesley F.; Perri, Michael G.; Patterson, Ruth E.; Bowen, Deborah J.; McIntosh, Martin; Parker, Linda Miller; Sevick, Mary Ann; Wodarski, Lois Ann.

In: Journal of the American Dietetic Association, Vol. 102, No. 6, 01.12.2002.

Research output: Contribution to journalArticle

Tinker, Lesley F. ; Perri, Michael G. ; Patterson, Ruth E. ; Bowen, Deborah J. ; McIntosh, Martin ; Parker, Linda Miller ; Sevick, Mary Ann ; Wodarski, Lois Ann. / The effects of physical and emotional status on adherence to a low-fat dietary pattern in the Women's Health Initiative. In: Journal of the American Dietetic Association. 2002 ; Vol. 102, No. 6.
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abstract = "Objective: To examine whether the effects of physical and emotional status on adherance to a low-fat (20{\%} energy) dietary pattern are mediated by participation in an intervention program (attending sessions and self-monitoring). Design: The Baron and Kenny mediator model, a series of 4 regression analyses, was used to evaluate whether: a) physical and emotional status predicted program participation, b) program participation predicted dietary adherence, c) physical and emotional status factors predicted dietary adherence, and, ultimately d) the effects of physical and emotional status on dietary adherence were mediated by program participation. Subjects/setting: Data from 13,277 postmenopausal women randomily assigned to the low-fat intervention arm of the Women's Health Initiative Dietary Modification Trial. Intervention: The nutrition goals for women randomly assigned to the low-fat intervention were to reduce total fat intake to 20{\%} or less of energy from fat and to consume 5 or more fruit/vegetable servings daily and 6 or more grain servings daily. Main outcome measures: Year 1 program participation (degree of attending group sessions and submitting fat scores) and adherence to the low-fat dietary pattern (percent energy from fat) as predicted by baseline physical and emotional status (eight SF-36 Health Survey subscales). Results: Participating in the dietary intervention program reduced (mediated) the negative effect of poorer mental health on dietary adherence by 15{\%}. Additional findings included that a 10{\%} increase in physical functioning increased session attendance by 0.4{\%} (P<.001) and a 10{\%} increase in mental health predicted a decrease in percent energy from fat of 0.3{\%} (P<.001). Program participation had a marked effect on dietary adherence: a 10{\%} increase in session attendance predicted a 1.2{\%} decrease in percent energy from fat (P<.001). Applications/conclusions: Understanding and using instruments to assess the physical and emotional status of a target population will help dietetic professionals promote healthful dietary change and maintenance.",
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