ABSTRACT
Dietary guidelines for the general population and for the management of obesity, diabetes and heart disease suggest a reduction in dietary fat, and in particular dietary saturated fatty acids (SFA). In order to achieve the recommended levels, changes in food choice patterns are required. Foods are consumed in combination with other foods, and these combinations are often recognizable as cuisine patterns. In this study we examined the food choice patterns of a group of 63 adults with existing type 2 diabetes mellitus who completed a 12 month dietary intervention trial aimed at changing dietary fat under 'free living' conditions. In both lower fat (LF, 27%) and modified fat (MF, 37%E) groups, a reduction in dietary SFA and an increase in polyunsaturated fat were required, with an additional requirement to increase dietary monounsaturated fat in the MF group. The usual diets of the study sample were on average low in total fat (27%E), but high in saturated fat (12%E). Those already consuming total fat at the level concordant with their allocation (LF or MF) achieved targets faster than those with a discordant allocation, but there was no significant effect of usual diet on time of target achievement at 12 months. At 6 months, those achieving dietary fat targets had changed to low fat dairy products and leaner meats, were having more spreads, oils, and nuts and were consuming takeaway meals less than twice a week. Contributions to dietary fat shifted from takeaway foods, meat, dairy products and cakes to spreads, oils and nuts. The modified fat and low fat groups chose more Mediterranean and South East Asian cuisines respectively. In this study sample, usual dietary patterns had an initial impact on change in the diet, but identifiable changes in food choice patterns and the adoption of certain cuisines that combined foods indicative of the dietary guidelines resulted in successful achievement of dietary fat targets.
Subject(s)
Diet , Dietary Fats, Unsaturated/administration & dosage , Dietary Fats/administration & dosage , Fatty Acids, Monounsaturated/administration & dosage , Nutrition Policy , Fatty Acids, Unsaturated/administration & dosage , Feeding Behavior , Female , Food Preferences , Health Promotion , Humans , Male , New South Wales , Patient ComplianceABSTRACT
BACKGROUND: This study assesses the relative validity of a diet history interview in 56 free-living individuals with Type II diabetes mellitus. METHODS: The diet history interview was compared to a 3-day food record in a 1-year dietary intervention trial. The plausibility of energy intake data was examined throughout the trial. Paired data were compared for differences and the presence of systematic error was determined by Bland Altman analysis. Changes in accuracy and responsiveness were assessed over time. RESULTS: The proportion of underreporters was larger in the diet history at baseline. Underrecording with the food record was more common in subjects with BMIs > 30 kg/m(2). There was no difference between paired dietary data from the two methods; however, data on fatty acids failed to correlate. These correlations improved when outliers were removed. There was no evidence of a relationship between bias and mean intake of dietary variables. Accuracy of diet history measurement did not change during the trial for energy or macronutrients, but data on protein and monounsaturated fat were both affected by BMI. The diet history was more responsive than the food record to changes in monounsaturated fatty acid intake after 3 months, but this changed at the end of the trial. CONCLUSION: The diet history provided good estimates of energy and macronutrient intakes in a sample group with Type II diabetes mellitus. However, energy intake data revealed a high prevalence of underreporting especially in people with higher BMIs.
