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document
The effects of physical and emotional status on adherence to a low-fat dietary pattern in the Women 's Health Initiative . 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 randomly 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 .
9509
Intervention_Educational
physical and emotional status
9510
Intervention_Educational
low-fat dietary pattern
9511
Intervention_Educational
low-fat ( 20 % energy ) dietary pattern
9512
Intervention_Educational
intervention program ( attending sessions and self-monitoring )
9513
Intervention_Educational
dietary adherence
9514
Intervention_Physical
low-fat intervention
9515
Intervention_Physical
low-fat intervention
9516
Intervention_Physical
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
9517
Intervention_Educational
low-fat dietary pattern
9518
Intervention_Educational
dietary intervention program
9519
Outcome_Mental
Year 1 program participation ( degree of attending group sessions and submitting fat scores
9520
Outcome_Mental
adherence to the low-fat dietary pattern ( percent energy from fat )
9521
Outcome_Mental
effect of poorer mental health
9522
Outcome_Mental
dietary adherence
9523
Outcome_Mental
physical functioning
9524
Outcome_Mental
session attendance
9525
Outcome_Mental
mental health
9526
Outcome_Mental
dietary adherence
9527
Outcome_Mental
session attendance
9528
Outcome_Other
energy from fat
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Participant_Condition
low-fat ( 20 % energy ) dietary pattern
9530
Participant_Sample-size
13,277
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Participant_Condition
postmenopausal
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Participant_Sex
women
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Participant_Sex
Women