School of Public Health, Faculty of Health Science, Curtin University of Technology, Perth, Western Australia, Australia.
Int J Behav Nutr Phys Act. 2011 May 20;8:43. doi: 10.1186/1479-5868-8-43.
Tailored nutrition interventions have been shown to be more effective than non-tailored materials in changing dietary behaviours, particularly fat intake and fruit and vegetable intake. But further research examining efficacy of tailored nutrition education in comparison to other nutrition education methods and across a wider range of dietary behaviours is needed. The Stages to Healthy Eating Patterns Study (STEPs) was an intervention study, in middle-aged adults with cardiovascular risk factors, to examine the effectiveness of printed, tailored, iterative dietary feedback delivered by mail in improving short-term dietary behaviour in the areas of saturated fat, fruit, vegetable and grain and cereal intake.
STEPs was a 3-month randomised controlled trial with a pre and post-test design. There were three experimental conditions: 1) tailored, iterative, printed dietary feedback (TF) with three instalments mail-delivered over a 3-month period that were re-tailored to most recent assessment of dietary intake, intention to change and assessment of self-adequacy of dietary intake. Tailoring for dietary intake was performed on data from a validated 63-item combination FFQ designed for the purpose 2) small group nutrition education sessions (GE): consisting of two 90-minute dietitian-led small group nutrition education sessions and 3) and a wait-listed control (C) group who completed the dietary measures and socio-demographic questionnaires at baseline and 3-months later. Dietary outcome measures in the areas of saturated fat intake (g), and the intake of fruit (serves), vegetables (serves), grain and cereals as total and wholegrain (serves) were collected using 7-day estimated dietary records. Descriptive statistics, paired t-tests and general linear models adjusted for baseline dietary intake, age and gender were used to examine the effectiveness of different nutrition interventions.
The TF group reported a significantly greater increase in fruit intake (0.3 serves/d P = 0.031) in comparison to GE and the C group. All three intervention groups showed a reduction in total saturated fat intake. GE also had a within-group increase in mean vegetable intake after 3 months, but this increase was not different from changes in the other groups.
In this study, printed, tailored, iterative dietary feedback was more effective than small group nutrition education in improving the short-term fruit intake behaviour, and as effective in improving saturated fat intake of middle-aged adults with cardiovascular risk factors. This showed that a low-level dietary intervention could achieve modest dietary behaviour changes that are of public health significance.
与非定制材料相比，定制营养干预在改变饮食行为方面更为有效，尤其是在脂肪摄入、水果和蔬菜摄入方面。但是，需要进一步研究比较定制营养教育与其他营养教育方法的效果，并在更广泛的饮食行为范围内进行研究。健康饮食模式研究（STEPs）是一项针对中年心血管危险因素患者的干预研究，旨在检验通过邮件提供的定制、迭代、印刷饮食反馈在改善短期饮食行为方面的有效性，涉及饱和脂肪、水果、蔬菜和谷物及谷物摄入等方面。
STEPs 是一项为期 3 个月的随机对照试验，采用前后测试设计。有三个实验组：1）定制、迭代、印刷饮食反馈（TF），在 3 个月内通过邮件分三期发送，根据最近的饮食摄入评估、改变意图和饮食摄入自我充足性评估进行重新定制。饮食摄入的定制是基于专为该目的而设计的验证过的 63 项组合 FFQ 数据进行的 2）小团体营养教育课程（GE）：由两位营养师主导的 90 分钟小团体营养教育课程组成，以及 3）等待名单对照（C）组，他们在基线和 3 个月后完成饮食测量和社会人口统计学问卷。采用 7 天估计饮食记录收集饱和脂肪摄入量（g）以及水果（份）、蔬菜（份）、谷物和谷物总摄入量和全谷物（份）摄入量等方面的饮食结果测量值。使用描述性统计、配对 t 检验和调整基线饮食摄入、年龄和性别的一般线性模型来检验不同营养干预的效果。
与 GE 和 C 组相比，TF 组报告的水果摄入量显著增加（0.3 份/天，P=0.031）。所有三组干预组的总饱和脂肪摄入量均有所减少。GE 组在 3 个月后还出现了平均蔬菜摄入量的组内增加，但与其他组的变化没有差异。
在这项研究中，与小团体营养教育相比，定制、迭代、印刷饮食反馈在改善中年心血管危险因素患者的短期水果摄入行为方面更有效，在改善总饱和脂肪摄入方面同样有效。这表明，低水平的饮食干预可以实现适度的饮食行为改变，这对公共健康具有重要意义。
