Date of Award
Doctor of Philosophy
Dr. Michele Burnette
Dr. Richard Spates
Dr. Maija Petersons
Coronary heart disease (CHD) is the leading cause of death in the United States, killing more than 500,000 people annually. Serum cholesterol is a principal risk factor for the development of atherosclerosis, a primary precipitant of CHD. Unfortunately, elevated serum cholesterol is a common but often undetected health risk for many Americans. Furthermore, the typical American diet contains high levels of fat and cholesterol which contribute to elevated serum cholesterol levels. The National Cholesterol Education Program (NCEP), created to improve awareness of serum cholesterol as a CHD risk factor, recommends that dietary changes constitute the initial step in the treatment of elevated serum cholesterol. Unfortunately, many Americans find it difficult to alter their diet to produce and maintain significant reductions in serum cholesterol. In spite of widespread cholesterol counseling services, relatively little research has investigated the development and experimental validation of efficient interventions to promote such dietary changes.
The current study examines a brief, behaviorally focused nutrition education program designed to promote the dietary changes recommended by the NCEP. Intervention components included techniques to reduce fat and cholesterol consumption, establish and operationalize dietary goals, manipulate environmental stimuli to promote dietary change, and remove barriers which prevent dietary change. A second experiment incorporated two additional meetings designed to improve adherence to dietary goals. Participants completed follow-up measures of serum cholesterol, dietary behavior, and stress to evaluate changes. A repeated measures analysis of variance including predicted scores for missing cell values revealed statistically significant improvements on a food frequency questionnaire for Experiment One (p<.005) and Experiment Two (p<.01), suggesting positive changes in low fat, low cholesterol food selection. Additionally, mean levels of serum cholesterol and saturated fat decreased in the first experiment In the second experiment mean levels of total and saturated fat decreased; however, a slight mean increase in serum cholesterol occurred. Although the results did not demonstrate unequivocal support for the intervention, the findings are encouraging, particularly because of the low intensity and cost effective nature of the intervention. Future research should consider the use of supplementary techniques to enhance the intervention outcome, including physical exercise and weight management strategies.
Carey, Peter F., "Reducing Dietary Fat and Cholesterol Consumption: An Evaluation of a Behaviorally Focused Nutrition Education Program" (1994). Dissertations. 1802.