British perspective on the U.S. Preventive Services Task Force guidelines

Effects of a multilevel dietary intervention in religious organizations

PURPOSE

This study examined how to improve dietary habits of individuals from the general public.

DESIGN

The Eating for a Healthy Life project was a randomized trial.

SETTING

The study was conducted among members of religious organizations (ROs).

SUBJECTS

Participants were a sample of RO members.

INTERVENTION

The intervention was a multilevel package, based on our previous experience, designed to lower fat and increase fruit and vegetable consumption.

MEASURES

The Eating Behaviors Questionnaire was administered preintervention and postintervention, together with 24-hour food recalls in a randomly selected subset. Analysis. Linear mixed models were used to evaluate the study's intervention, incorporating the design effects of blocking, intraclass correlation within RO, and correlation between the preintervention and postintervention points.

RESULTS

Participants (n = 2175) reported significantly healthier dietary behaviors in intervention ROs at the 12-month follow-up period, compared to participants in the comparison ROs, for a fat scale change of .08 summary scale points and an adjusted intervention effect of .06 overall.

CONCLUSION

Dietary intervention through ROs is a positive and successful method of changing dietary habits.

A comparative study of behavioural, physical and mental health status between term-limited and tenure-tracking employees in a population of Japanese male researchers

OBJECTIVES

Traditional lifelong employment systems have been changing rapidly in Japan. The aim of this study was to assess the health impacts of term-limited employment systems that have recently been introduced into Japanese academic institutes.

STUDY DESIGN

Cross-sectional.

METHODS

A total of 514 male researchers (275 term limited and 239 tenure track) were compared in terms of behavioural, physical and mental status at annual health examinations. At these examinations, working hours and health-related lifestyles were examined using a self-completed questionnaire. Clinical structured interviews of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) were used to detect major depression.

RESULTS

The term-limited researchers tended to work longer hours (P<0.001), drink alcohol more frequently (P<0.001) and eat breakfast less regularly (P<0.001) compared with the tenure-track researchers. Although the prevalence of DSM-IV major depression was comparable (P>0.05) between the two groups, fatigue was more prevalent (P=0.027) in the term-limited researchers than in the tenure-track researchers, adjusting for the effects of age. Compared with colleagues working in the same laboratories, the term-limited researchers worked longer hours, irrespective of fatigue, whereas only the fatigued tenure-track researchers worked longer hours. In the total sample, the fatigued researchers tended to belong to laboratories where their colleagues, on average, worked longer hours, compared with the non-fatigued researchers.

CONCLUSIONS

These results imply that the term-limited researchers suffered more from fatigue, due to longer working hours, than their colleagues, and that organized, rather than personal, interventions with respect to the working environment may be effective in reducing overload in such workplaces.

Baseline data and design for a randomized intervention study of dietary change in religious organizations

BACKGROUND

Reducing dietary fat has been identified as a potential means of preventing chronic disease. Several studies have identified methods of changing dietary fat consumption in small, intensive intervention settings. Fewer studies have examined how to improve dietary habits of individuals in the general public.

METHODS

The Eating for a Healthy Life (EHL) project was a randomized trial [n = 40 religious organizations (ROs) and 2175 individuals, 1099 in intervention]. The study tested an intervention package of self-help books, motivational messages, and social interactions designed to change dietary behaviors (lowering fat, increasing fruit and vegetable consumption) among members of religious organizations aged 18 and over. The primary outcomes are fat- and fruit- or vegetable-related behaviors measured using the Fat and Fiber Behavior (FFB) Questionnaire.

RESULTS

Religious organizations and their members participated fully in the initial study activities.

CONCLUSIONS

This study will support a rigorous test of the intervention package.

Efficacy of a minimal intervention to reduce fat intake

Effective dietary interventions must be developed to reduce fat intake in whole populations, rather than clinical subgroups. This study tested the effects of personalised feedback on fat intake in a general population. Hospital workers (n = 801) were randomised to receive personalised feedback or no personalised feedback. Personalised feedback consisted of one sentence expressing current fat intake as a percentage of total calorific intake. Changes in fat intake from baseline to five months post-intervention were evaluated. The personalised intervention produced significant decreases in total and saturated fat intake, compared with the control group. Total-fat decreased by 8.6% (versus 0.2% in the control group); saturated fat decreased by 9.3% (versus 1.7% in the control group). Fat intake as a proportion of total calorific intake did not decrease significantly in either condition. Findings also revealed differential effects of feedback on high- versus low-fat consumer groups. Personalised feedback significantly reduced fat intake in high-fat consumers, and prevented low-fat consumers from increasing their fat intake. Personalised fat feedback therefore represents an efficacious and low-intensity approach to the reduction of fat intake in the general population.

A dietary intervention in primary care practice: the Eating Patterns Study

OBJECTIVES

This study evaluated the effectiveness of a low-intensity dietary intervention in primary care practice in lowering dietary fat intake and raising dietary fiber intake.

METHODS

A randomized controlled trial of 28 physician practices in six primary care clinics enrolled, by telephone, adult patients who had appointments for nonurgent nonacute visits. Of 3490 eligible patients contacted, 2111 completed baseline interview; 86.1% also completed a 12-month follow-up. Physicians gave intervention participants a self-help booklet and a brief motivational message. Changes in fat and fiber from baseline to 12-month follow-up were evaluated.

RESULTS

Intervention and control groups both reported a decrease in fat intake and an increase in fiber intake. The differential change and 95% confidence interval (CI) for the percentage of energy obtained from fat was -1.2 (CI = -0.71, -1.7) (P = .0015), for grams fiber/1000 kcal 0.32 (CI = -0.066, 0.71) (P = .086), for fat score -0.044 (CI = -0.016, -0.072) (P = .010), and for fiber score 0.036 (CI = 0.011, 0.061) (P = .014), with greater reductions in fat and greater increase in fiber in the intervention group.

CONCLUSIONS

This low-intensity intervention was effective in dietary behavior change.