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• W2022085501 abstract "Successfully changing dietary patterns among patients and research participants is a challenging goal. It requires knowledge and skill on the part of the dietitian as well as cooperation and willingness on the part of the patient. It also helps if the recommended diet is satisfying and nourishing and tastes good. As the proponents of high-protein diets and high-carbohydrate diets continue to search for evidence of benefit vs risk, the Journal is pleased to provide a commentary by Dr Dean Ornish that offers further insights on this subject (p 537). Dr Ornish has a great deal of experience in helping patients make dietary changes that are quite the opposite of those recommended by Dr Atkins. In his commentary, Dr Ornish provides a review of the rationale favoring one approach over the other and encourages dietitians to recognize the physiological as well as nutritional differences between these two diets. Because no long-term studies comparing these two approaches have been conducted, the totality of the existing evidence must be evaluated in light of nutritional requirements and therapeutic goals. This month, the Journal offers several manuscripts that address the topic of dietary adherence from several different angles. By comparing the different methods and the behavioral approaches used, dietitians can decide how best to proceed with their own attempts to help achieve dietary adherence. Achieving adherence to dietary recommendations often is a matter of taste. Ullrich and colleagues (p 543) compare differences between individuals who like the taste of bitter, hot, and pungent foods and their level of food adventurousness. The authors suggest that distinguishing individuals by their food adventurousness may provide valuable insights into eating preferences. Approaches to facilitating dietary adherence involving group interventions have been the focus of several clinical trials. Authors of two different landmark trials on breast cancer prevention address dietary adherence. Winters and colleagues (p 551) report findings from the Women’s Intervention Nutrition Study (WINS) regarding the types of dietary changes made by women at high risk for breast cancer who successfully achieved low fat intake of less than 20% calories from total fat compared with those who did not. The authors report on the specific strategies used to achieve adherence as well as the impact on subsequent adherence to the recommended food groups. Among healthy, postmenopausal women who were randomized to a similar diet as part of the Women’s Health Initiative, Patterson and colleagues (p 654) report the level of dietary adherence achieved during the first 5 years of the Dietary Modification (DM) component of the Trial. Like WINS, the DM intervention also aimed at lowering total fat, but besides the population differences, the assessment and intervention methodologies were different. The control vs intervention differences are discussed. Similarly, knowledge of specific food habits of people with diabetes was found to be an important contributor to achievement of adherence related to glycemic control. Savoca, Miller, and Ludwig (p 560) demonstrate the combined impact of 15 specific food habits as they affect the total variance in hemoglobin A1c levels. Measurement of dietary adherence poses interesting challenges both for clinicians and for researchers. The Healthy Eating Index scores were developed as a summary measure of dietary quality based on a 100-point scale. On the basis of NHANES III data, Weinstein, Vogt, and Gerrior (p 576) provide correlations of these scores with objective nutritional biomarkers. These results provide further evidence of the validity of the HEI. A review paper by Kant (p 615) provides further discussion on dietary patterns and health outcomes. Two different papers address the accuracy of dietary assessment. Godwin, Chambers, and Cleveland (p 585) describe the benefits of using different portion size estimation aids and discuss the differences in dietary assessment techniques. Conway, Ingwersen, and Moshfegh (p 595) present results from a validation study testing the accuracy of dietary recall in normal weight vs overweight vs obese men using the USDA 5-Step Multiple-Pass Method. These authors provide reassuring evidence that with careful attention to detail, similar levels of accuracy can be achieved using the recall method. The Research and Professional Briefs this month address additional topics ranging from Marett and Slavin’s article (p 636) on the impact of a type of fiber, arabinogalactan, on serum lipids and glucose, to Shields and colleagues’ (p 650) look at gourmet coffee consumption among college women. We trust this month will shower you with new information and provide useful results for your own application. Best regards." @default.
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• W2022085501 date "2004-04-01" @default.
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• W2022085501 title "Achieving dietary adherence" @default.
• W2022085501 doi "https://doi.org/10.1016/j.jada.2004.02.034" @default.
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