A Controlled Evaluation of Staging Dietary Patterns to Reduce the Risk of Diabetes in African-American Women

Wendy Auslander, PHD, Debra Haire-Joshu, PHD, Cheryl Houston, PHD, RD, Chaie-Won Rhee, MSW, James Herbert Williams, PHD

Diabetes Care. 2002;25(5)

Results

Overall, participants in the treatment group reported a greater readiness to change their dietary patterns than those in the control group at the posttest assessment. Table 2 shows the percent of participants who reported being in the action stages (versus the pre-action stages) to perform each low-fat dietary pattern. X ² tests of the treatment effect, controlling for pretest scores via logistic regression, were significant for all dietary patterns. These significant differences were maintained at follow-up assessment.

As shown in Table 3 , between-group comparisons of the knowledge of fat in diet at the posttest assessment revealed that there was a significant difference between the treatment and control groups (F[2,289] = 58.38, P < 0.0001). The treatment group had significantly higher scores than the control group, after adjusting for the baseline scores. This difference remained significant at the 3-month follow-up assessment (F[2,290] = 76.26, P < 0.0001). Skill-based knowledge as measured by the Knowledge of Label Reading Questionnaire also showed significant differences between groups at the posttest assessment (F[2,290] = 141.71, P < 0.0001) and remained significant at the follow-up assessment (F[2,291] = 133.49, P < 0.0001). Comparisons of the participants attitudes about diet and health revealed that there were no significant differences between the treatment and control groups at the postintervention or 3-month follow-up assessments.

The impact of the intervention indicated significant differences in the participants actual dietary behaviors ( Table 3 ). Assessment of the participants dietary behaviors showed that the treatment group reported significantly more low-fat dietary patterns (total score) compared with the control group at the posttest (F[2,286] = 97.71, P < 0.0001) and follow-up assessments (F[2,290] = 57.38, P < 0.0001). Analyses of the separate dietary patterns were consistent with the results of the total scale, except for one pattern: there was no significant difference between the treatment and control groups in "replacement" at the posttreatment and follow-up assessments.

As shown in Table 3 , dietary fat intake measured by the FFQ at the posttest assessment revealed a significant difference between the treatment and control groups. At posttest, the intervention was effective in reducing fat intake, as measured by the percent of calories from total fat (F[2,290] = 33.96, P < 0.0001). The post hoc t tests indicated that the treatment group reported significantly less fat intake than the control group, and that the differences were maintained at the follow-up assessment (F[2,291] = 29.52, P < 0.0001). The actual percent of calories from fat for the treatment group was reduced from 35.9% at pretest to 32.1% at posttest and 32.3% at follow-up, versus the same values for the control group (36, 35.6, and 34.5%, respectively).

Fat intake, as measured by the percent of calories from saturated fat, was also significantly reduced in the treatment group from pre- to posttest assessment (F[2,290] = 30.85, P < 0.0001). The post hoc t tests showed that the treatment group reported significantly less fat intake than the control group and that these differences were maintained at follow-up (F[2,291] = 25.59, P < 0.0001). The total daily energy intake of the treatment group was significantly lower than that of the control group from the pre- to posttest assessment (F[2,290] = 46.96, P < 0.0001) and at follow-up (F[2,291] = 30.75, P < 0.0001). Despite significant reductions in fat intake, results indicated that no significant group differences were detected in the weight and BMI of the participants.

1 2 3 4

Next Section

Cite this: A Controlled Evaluation of Staging Dietary Patterns to Reduce the Risk of Diabetes in African-American Women - Medscape - May 01, 2002.

Table 1. Baseline participants characteristics by randomization group
Characteristics	Treatment	Control
n	138	156
Age	41.2 ± 7.8	40.2 ± 8.2
Weight (lbs)	211.0 ± 39.0	206.1 ± 37.4
BMI	35.7 ± 6.2	35.3 ± 6.0
Relatives have diabetes	77 (55.8)	81 (51.9)
Marital status
Married/living together	33 (23.9)	37 (23.7)
Single	54 (39.1)	70 (44.9)
Divorced/separated/widowed	51 (37.0)	49 (31.4)
Educational status
High school or less	46 (33.3)	68 (43.6)
More than high school	92 (66.7)	88 (56.4)
At least one child in home (age <18 years)	86 (62.3)	102 (66.2)
Monthly family income ($)	1,367.8 ± 1,047.0	1,619.1 ± 1,206.7
Below poverty line	60 (47.2)	70 (48.0)

Data are n (%) or means ± SD. There were no significant group differences in any of the characteristics.

Table 2. Between-group comparisons of readiness to change dietary patterns
Readiness to change dietary patterns	Pretest			Posttest			Follow-up
Readiness to change dietary patterns	Treatment	Control	X ²	Treatment	Control	X ²	Treatment	Control	X ²
Substitution	53.3	51.9	0.05	89.1	54.5	37.7^§	78.8	60.9	11.0
Avoid fat as seasoning	44.5	46.2	0.08	88.3	59.0	29.8^§	86.1	60.3	24.3^§
Avoid fried foods	40.9	39.1	0.10	80.3	53.2	23.9^§	73.0	57.1	8.0
Modify meat	43.8	57.1	5.13^*	84.7	56.4	31.7^§	82.5	58.3	28.6^§
Replacement	40.9	46.8	1.04	75.9	57.1	13.8	72.3	59.6	6.4^*

Data are %. Treatment group, n = 138; control group, n = 156. Presented in percent of subjects in action (versus pre-action) stage within each eating pattern. Baseline values were used as covariates in the ANCOVA via logistic regression procedures for between-group comparisons for posttest and follow-up outcomes.

* P < 0.05;

P < 0.01;

P < 0.001;

§ P < 0.0001.

Table 3. Results of ANCOVA: pretest, posttest, and follow-up means in treatment and control conditions
Variables	Baseline			Posttest (3 months after baseline)			Follow-up (6 months after baseline)
Variables	Treatment	Control	t	Treatment	Control	t	Treatment	Control	t
Dietary fat knowledge	5.5	5.4	-0.53	6.1	5.6	2.87	6.3	5.7	4.21^§
Label reading knowledge	6.4	6.6	0.70	7.2	6.7	3.39	7.1	6.8	2.12^*
Attitudes about diet and health	2.7	2.7	1.23	2.7	2.7	1.64	2.8	2.7	1.79
Dietary patterns (Total)	2.2	2.2	0.89	2.6	2.2	8.62	2.5	2.2	5.98^§
Substitution	2.0	2.0	0.02	2.7	2.1	7.04	2.7	2.1	5.89^§
Avoid fat as seasoning	2.4	2.4	-0.42	2.7	2.4	5.78	2.7	2.4	4.97^§
Avoid fried foods	2.5	2.5	0.37	3.0	2.5	6.17	2.8	2.5	3.63
Modify meat	2.2	2.3	1.57	2.9	2.3	6.81	2.7	2.3	4.23^§
Replacement	1.9	2.0	2.05^*	1.9	1.9	1.70	1.9	1.8	1.96
Daily energy (kcal)	1099.9	1291.0	-1.13	1122	1272	-2.92	1089.5	1315.7	-3.50
Calories from fat (%)	35.9	36.0	0.03	32.1	35.6	-4.01	32.3	34.5	-2.50^*
Calories from saturated fat (%)	12.4	12.4	0.00	10.8	12.3	-4.39	10.9	12.0	-3.00
Weight (lbs)	211.0	206.1	-1.09	212	206	.96	209.4	207.6	1.30
BMI	35.7	35.3	-0.63	35.9	35.2	1.32	35.7	35.4	1.31

* P < 0.05;

P < 0.01;

P < 0.001;

§ P < 0.0001. Data are means and represent results of ANCOVA for treatment (n = 138) and control (n = 156) groups. Baseline values were used as covariates in the ANCOVA procedures. The t statistics were based on post hoc comparisons. All significance tests were two-tailed.

Table 3. Results of ANCOVA: pretest, posttest, and follow-up means in treatment and control conditions
Variables	Baseline			Posttest (3 months after baseline)			Follow-up (6 months after baseline)
Variables	Treatment	Control	t	Treatment	Control	t	Treatment	Control	t
Dietary fat knowledge	5.5	5.4	-0.53	6.1	5.6	2.87	6.3	5.7	4.21^§
Label reading knowledge	6.4	6.6	0.70	7.2	6.7	3.39	7.1	6.8	2.12^*
Attitudes about diet and health	2.7	2.7	1.23	2.7	2.7	1.64	2.8	2.7	1.79
Dietary patterns (Total)	2.2	2.2	0.89	2.6	2.2	8.62	2.5	2.2	5.98^§
Substitution	2.0	2.0	0.02	2.7	2.1	7.04	2.7	2.1	5.89^§
Avoid fat as seasoning	2.4	2.4	-0.42	2.7	2.4	5.78	2.7	2.4	4.97^§
Avoid fried foods	2.5	2.5	0.37	3.0	2.5	6.17	2.8	2.5	3.63
Modify meat	2.2	2.3	1.57	2.9	2.3	6.81	2.7	2.3	4.23^§
Replacement	1.9	2.0	2.05^*	1.9	1.9	1.70	1.9	1.8	1.96
Daily energy (kcal)	1099.9	1291.0	-1.13	1122	1272	-2.92	1089.5	1315.7	-3.50
Calories from fat (%)	35.9	36.0	0.03	32.1	35.6	-4.01	32.3	34.5	-2.50^*
Calories from saturated fat (%)	12.4	12.4	0.00	10.8	12.3	-4.39	10.9	12.0	-3.00
Weight (lbs)	211.0	206.1	-1.09	212	206	.96	209.4	207.6	1.30
BMI	35.7	35.3	-0.63	35.9	35.2	1.32	35.7	35.4	1.31

* P < 0.05;

P < 0.01;

P < 0.001;

Table 3. Results of ANCOVA: pretest, posttest, and follow-up means in treatment and control conditions
Variables	Baseline			Posttest (3 months after baseline)			Follow-up (6 months after baseline)
Variables	Treatment	Control	t	Treatment	Control	t	Treatment	Control	t
Dietary fat knowledge	5.5	5.4	-0.53	6.1	5.6	2.87	6.3	5.7	4.21^§
Label reading knowledge	6.4	6.6	0.70	7.2	6.7	3.39	7.1	6.8	2.12^*
Attitudes about diet and health	2.7	2.7	1.23	2.7	2.7	1.64	2.8	2.7	1.79
Dietary patterns (Total)	2.2	2.2	0.89	2.6	2.2	8.62	2.5	2.2	5.98^§
Substitution	2.0	2.0	0.02	2.7	2.1	7.04	2.7	2.1	5.89^§
Avoid fat as seasoning	2.4	2.4	-0.42	2.7	2.4	5.78	2.7	2.4	4.97^§
Avoid fried foods	2.5	2.5	0.37	3.0	2.5	6.17	2.8	2.5	3.63
Modify meat	2.2	2.3	1.57	2.9	2.3	6.81	2.7	2.3	4.23^§
Replacement	1.9	2.0	2.05^*	1.9	1.9	1.70	1.9	1.8	1.96
Daily energy (kcal)	1099.9	1291.0	-1.13	1122	1272	-2.92	1089.5	1315.7	-3.50
Calories from fat (%)	35.9	36.0	0.03	32.1	35.6	-4.01	32.3	34.5	-2.50^*
Calories from saturated fat (%)	12.4	12.4	0.00	10.8	12.3	-4.39	10.9	12.0	-3.00
Weight (lbs)	211.0	206.1	-1.09	212	206	.96	209.4	207.6	1.30
BMI	35.7	35.3	-0.63	35.9	35.2	1.32	35.7	35.4	1.31

* P < 0.05;

P < 0.01;

P < 0.001;

Comments

Commenting is limited to medical professionals. To comment please Log-in.

Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.

processing....

A Controlled Evaluation of Staging Dietary Patterns to Reduce the Risk of Diabetes in African-American Women

Results

Tables

Tables

Tables

Tables

Tables

References

Authors and Disclosures

Authors and Disclosures

Comments

Email This

Feedback