Changes in food patterns during a low-fat dietary intervention in women.

The Women's Health Trial was initiated by the National Cancer Institute to study the effects of a low-fat diet on the incidence of breast cancer in women at elevated risk for the disease. The purpose of this article is to examine the specific dietary changes that 173 women made while participating in a feasibility intervention program to reduce their fat intake to approximately 20% of total calories over a 12-month period. The intervention program used group sessions to teach nutrition information and behavioral skills necessary to make a life-style dietary change. Four-day food records were collected from participants at the beginning of the study and again at 12 months. Women in the intervention group reduced their total fat intake from a mean of 76 gm (39% of total energy) to 31 gm (22% of total energy), mainly by decreasing their fat intake from milk products, red meats, and fats/oils. These women used cheddar cheese, American cheese, whole milk, butter, mayonnaise, salad dressing, bacon, and hamburgers less frequently, and used diet American cheese, low-fat cottage cheese, and skim milk more frequently. They consumed less fat in their vegetable dishes, and their total caloric intake from fruit increased slightly. In addition, the overall quality of the diets improved, since there was a 20% to 50% increase in the energy-adjusted intake of vitamins and minerals from food sources.