Journal article
Correlates of maintenance of a low-fat diet among women in the Women's Health Trial
Preventive medicine, Vol.21(3), pp.279-291
1992
DOI: 10.1016/0091-7435(92)90027-F
PMID: 1614990
Abstract
Background. The Women's Health Trial (WHT) was a feasibility study for a randomized controlled trial designed to test the hypothesis that a reduction in dietary fat reduces breast cancer incidence among women age 45 to 69. Between 1984 and 1988, 2,064 women participated in its two phases.
Methods. A follow-up study of 525 women who were randomized to receive the WHT dietary intervention program was conducted to assess maintenance of the diet 1 year on average after the trial ended. Among 448 participants, the mean percentage of energy from fat as measured by a food frequency questionnaire was 40.0% at baseline, 26.3% at the end of the trial, and 27.7% at follow-up. Based on 408 women with complete data, a recursive model was estimated, describing the influence of baseline characteristics of the women on attendance at intervention program sessions, adherence to the diet during the trial, and long-term maintenance of the diet after the trial ended. The effects of women's experiences during the trial on adherence and long-term maintenance were investigated as well.
Results. Attendance at the educational sessions was strongly related to adherence to the diet during the trial (
P < 0.001), and adherence was the most important predictor of long-term maintenance (
P < 0.001). The percentage of energy from dietary fat at baseline was an important correlate of both adherence (
P < 0.001) and long-term maintenance (
P < 0.001). College-educated women were more likely to adhere to the diet during the trial (
P < 0.001). Feelings of deprivation adversely affected long-term maintenance (
P < 0.01), primarily through their effect on adherence during the trial (
P = 0.01). Costliness of the diet in time and money negatively influenced long-term maintenance (
P < 0.05). Development of a distaste for fat encouraged adherence (
P = 0.06).
Conclusions. The low-fat dietary pattern established during the WHT was maintained for as long as 20 months after the trial ended. A recursive model was useful in analyzing the process and correlates of long-term maintenance of dietary behavior change. Both predisposing variables and women's experiences while on a low-fat diet were associated with long-term maintenance. The results suggest that feelings of deprivation should be avoided, perhaps by use of low-fat substitutes, by those attempting to lower their dietary fat and that more research is needed on the development of a distaste for fat among individuals who adopt low-fat diets.
Details
- Title: Subtitle
- Correlates of maintenance of a low-fat diet among women in the Women's Health Trial
- Creators
- Nicole Urban - Fred Hutch Cancer CenterEmily White - Fred Hutch Cancer CenterGarnet L. Anderson - Fred Hutch Cancer CenterSusan Curry - Group Health CooperativeAlan R. Kristal - Fred Hutch Cancer Center
- Resource Type
- Journal article
- Publication Details
- Preventive medicine, Vol.21(3), pp.279-291
- Publisher
- Elsevier Inc
- DOI
- 10.1016/0091-7435(92)90027-F
- PMID
- 1614990
- ISSN
- 0091-7435
- eISSN
- 1096-0260
- Language
- English
- Date published
- 1992
- Academic Unit
- Health Management and Policy; Community and Behavioral Health
- Record Identifier
- 9984366379802771
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