Environmental and policy approaches to cardiovascular disease prevention through nutrition: opportunities for state and local action.

This article reviews environmental and policy intervention approaches to cardiovascular disease prevention through nutrition and recommends opportunities for state and local health departments to initiate and participate in environmental and nutrition policy initiatives. By addressing these complementary aims, the authors hope to stimulate further efforts to achieve progress in nutrition promotion among state and local health-related organizations. Key categories of opportunity to develop new or expanded nutrition policies and environmental strategies include economic incentives, food assistance and feeding programs, regulations for institutional food service operations, and nutrition services in health care. Environmental strategies to reduce barriers to following dietary guidelines, such as point-of-choice programs and school nutrition programs, should be tailored for local communities and widely disseminated. In addition, current federal policy efforts, notably nutrition labeling rules, will provide a valuable focal point for state and local advocacy, education, and monitoring.

Community intervention and trends in dietary fat consumption among black and white adults.

OBJECTIVE: This study assessed whether a state public health department could effectively implement an affordable nutrition intervention program at the community level. DESIGN: Cross-sectional data were collected via telephone surveys of 9,839 adults, aged 18 years or older, in 1987, 1989, and 1991 in two South Carolina communities. Nutrition education programs began in 1988 in one community. The other community served as a comparison site. We assessed and compared changes in community levels of dietary fat and weekly meat consumption, salt use, and nutrition promotion awareness with analysis of covariance regression techniques that included race, sex, and age as covariates. RESULTS: We observed favorable changes in most eating behaviors and levels of awareness in both communities. The intervention community experienced greater absolute changes that the comparison community in use of animal fats (-8.9% vs -4.0%; P = .02) and liquid or soft vegetable fats (+8.4% vs +3.6%; P = .04), and in awareness of restaurant nutrition information (+33.0% vs +19.4%; P = .0001). Although the primary type of dietary fat used differed between black and white respondents, we observed significant change among both groups. CONCLUSIONS: These results suggest that community-wide nutrition education programs may have augmented regional or national changes in dietary behavior among white and black adults in the intervention community.