a Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill , Chapel Hill , NC , USA.
b Cecil G. Sheps Center for Health Services Research , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA.
Ethn Health. 2019 May;24(4):415-431. doi: 10.1080/13557858.2017.1346784. Epub 2017 Jul 1.
Evidence for the cardioprotective effects of a Mediterranean-style (Med-style) diet is strong, however few Med-style dietary interventions have been developed for and tested among Hispanic Americans (HAs), especially younger HAs of reproductive age whose dietary habits may strongly influence dietary intake for all family members.
We adapted a previously tested and evidence-informed lifestyle intervention to reduce CVD risk and evaluated its feasibility, acceptability, and effects on self-reported lifestyle behaviors in this study enrolling low-income HA women attending a Title X family planning clinic in eastern North Carolina. The 3-month long intervention, given to all participants, promoted a Med-style dietary pattern with a focus on increasing consumption of foods commonly consumed by HA that have high quality dietary fats (polyunsaturated and monounsaturated fats primarily from plant sources and fish) and carbohydrates (fruits, vegetables, and whole grains). The intervention also recommended increasing physical activity and was given during 2 face-to-face counseling sessions and 2 telephone counseling sessions. Major outcomes were engagement with study activities and intervention acceptability; lifestyle behavior change at 3-month follow-up is also reported.
Baseline characteristics (n = 36) were: mean age 33 years, 35 (97%) without health insurance, 32 (89%) born in Mexico, and mean BMI 30 kg/m. Engagement was high among the 36 participants with 33 (92%) completing the intervention and follow-up measures. At follow-up, most participants thought the intervention was helpful (range: 85-100%) and acceptable (100% agreed 'I would recommend the program to others'). The mean dietary fat quality score improved by 0.5 units (95% CI: 0.0-1.1) and the mean fruit-vegetable servings/day improved by 0.7/day (95% CI: 0.1-1.3).
Intervention engagement and acceptability were high and there was improvement in self-reported dietary behaviors. This type of Med-style dietary pattern intervention should be evaluated in randomized trials enrolling HAs at risk for CVD.
地中海式（Med 式）饮食对心脏的保护作用有充分的证据，然而，针对西班牙裔美国人（HAs）开发和测试的 Med 式饮食干预措施很少，尤其是处于生育年龄的年轻 HAs，他们的饮食习惯可能会强烈影响所有家庭成员的饮食摄入。
我们改编了一项以前经过测试和有证据支持的生活方式干预措施，以降低心血管疾病的风险，并在这项研究中评估其可行性、可接受性以及对招募于北卡罗来纳州东部一家计划生育诊所的低收入 HA 女性的自我报告生活方式行为的影响。这项为期 3 个月的干预措施面向所有参与者，提倡地中海式饮食模式，重点是增加 HA 常吃的食物的摄入量，这些食物的饮食脂肪质量较高（主要来自植物来源和鱼类的多不饱和脂肪和单不饱和脂肪），碳水化合物（水果、蔬菜和全谷物）。该干预措施还建议增加身体活动，并通过 2 次面对面咨询和 2 次电话咨询进行。主要结果是参与研究活动和干预措施的可接受性；还报告了 3 个月随访时的生活方式行为变化。
基线特征（n=36）为：平均年龄 33 岁，35 名（97%）没有健康保险，32 名（89%）出生于墨西哥，平均 BMI 为 30kg/m。36 名参与者中有 33 名（92%）完成了干预和随访措施，参与度很高。随访时，大多数参与者认为干预措施很有帮助（范围：85-100%），并且可以接受（100%的人同意“我会向其他人推荐该计划”）。膳食脂肪质量评分平均提高 0.5 分（95%置信区间：0.0-1.1），每日水果和蔬菜摄入量平均增加 0.7 份/天（95%置信区间：0.1-1.3）。
干预措施的参与度和可接受性都很高，自我报告的饮食行为也有所改善。这种类型的 Med 式饮食模式干预措施应在招募有 CVD 风险的 HAs 的随机试验中进行评估。
