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Validation of a Brief Dietary Assessment to Guide Counseling for Cardiovascular Disease Risk Reduction in an Underserved Population

https://doi.org/10.1016/j.jada.2006.11.006Get rights and content

Abstract

Background

Brief dietary assessment tools are needed to guide counseling in underserved populations to reduce cardiovascular disease (CVD) risk. The Dietary Risk Assessment is one such tool modified over time to reflect emerging evidence concerning diet and CVD risk.

Objective

To examine the capacity of the modified Dietary Risk Assessment tool to measure aspects of diet quality in a sample of underserved, midlife (aged 40 to 64 years) women, by comparing Dietary Risk Assessment results to those of a longer food frequency questionnaire (FFQ) and with serum carotenoids.

Design

This study used baseline data from women enrolled in a CVD risk reduction intervention trial. The Dietary Risk Assessment was administered to 236 women and results were compared to those from a longer FFQ administered to 104 women, and to serum carotenoids results from all participants.

Results

Correlations between Dietary Risk Assessment indexes and corresponding measures from the FFQ were statistically significant: fruit and vegetable, r=−0.53 (P<0.0001, correlation is negative as a lower Dietary Risk Assessment score indicates greater fruit and vegetable intake); saturated fat, r=0.60 (P<0.0001). In linear regression models stratified by smoking and adjusted for body mass index, low-density lipoprotein cholesterol level, high-density lipoprotein cholesterol level, very-low-density lipoprotein cholesterol level, and age, the Dietary Risk Assessment fruit and vegetable index was significantly associated with serum carotenoids (parameter estimate for nonsmokers −0.22, P=0.01; smokers −0.45, P=0.003). Correlation coefficients between Dietary Risk Assessment total score and three diet quality index scores derived from FFQ variables were statistically significant, ranging in magnitude from 0.57 to 0.60.

Conclusions

The modified Dietary Risk Assessment provides a reasonable assessment of dietary factors associated with CVD risk; thus, it is appropriate for use to guide dietary counseling in CVD prevention programs for underserved, midlife, women.

Section snippets

Setting and Participants

The Well Integrated Screening and Evaluation for Women Across the Nation project is a federally funded CVD risk reduction program for underinsured, midlife women. In addition to serving as a screening program, the project also includes a lifestyle intervention to help women improve dietary habits, increase physical activity, and stop smoking (9). To assess an enhanced project intervention described in detail elsewhere (10), a randomized, controlled trial was conducted at one community health

Results

Table 1 shows differences between study participants who completed the FHCRC-FFQ (n=104) and those who did not (n=132). The groups were similar, with a combined average age of 53 years, BMI of 31, approximately 25% smokers, and 95% without health insurance. Those who completed the longer FFQ reported an average of 1,670 kcal and 3.5 servings of fruits and vegetables consumed per day, calculated using the 5-A-Day method (10).

Correlations between Dietary Risk Assessment indexes and FHCRC-FFQ

Discussion

In this study we compared dietary intake as assessed by the Dietary Risk Assessment to that measured using the FHCRC-FFQ, determined the associations between fruit and vegetable intake measured using the Dietary Risk Assessment and the FHCRC-FFQ with levels of serum carotenoids, and compared the Dietary Risk Assessment total score to diet quality index scores calculated from responses to the FHCRC-FFQ. Results indicate that Dietary Risk Assessment indexes and the Dietary Risk Assessment total

Conclusions

The brief, modified Dietary Risk Assessment provides a reasonable assessment of the major dietary factors associated with CVD risk, and is thus appropriate for use to guide dietary counseling in CVD prevention programs focusing on underserved, midlife, Southern women.

S. B. Jilcott is a visiting scholar and volunteer, World Harvest Mission, Bundibugyo, Uganda; at the time of the study, she was a research associate, Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill

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  • Cited by (0)

    S. B. Jilcott is a visiting scholar and volunteer, World Harvest Mission, Bundibugyo, Uganda; at the time of the study, she was a research associate, Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill

    T. C. Keyserling is an associate professor, Department of Medicine, Schools of Medicine and Public Health, and the Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill.

    C. D. Samuel-Hodge is a research assistant professor, Department of Nutrition, Schools of Medicine and Public Health, and the Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill.

    A. S. Ammerman is a professor, Department of Nutrition, Schools of Medicine and Public Health, and the Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill.

    L. F. Johnston is a research associate, Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill.

    M. D. Gross is an associate professor, Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis.

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