Abstract

Objective To investigate the fat-reduction strategies used by a group of older adults who successfully made and maintained positive dietary changes for 5 years or longer. Design Participants completed 2 copies of a self-administered food frequency questionnaire: The first copy assessed diet before they began making changes and the second copy assessed diet after initiation of healthful dietary changes. Positive food changes were identified from the food frequency questionnaires. During in-person interviews, participants placed food changes onto a time line according to the nearest estimated date of initiation of the change. Subjects Participants were 65 free-living older adults (aged >50 years) who had maintained substantial changes to decrease fat intake in their diet for at least 5 years. Statistical analyses performed Quantitative and qualitative data were used to identify the fat-reduction strategies and to confirm and validate the fat-reduction strategy model. Confirmatory factor analysis was performed to confirm the new model. The Kuder-Richardson-20 reliability coefficient (kr) was used to determine internal consistency of the scales developed for the study. Results The majority of participants decreased their fat intake gradually, at different time points in their lives, and over a long period of time (5 to 43 years). Mean percent energy intake from fat decreased from 44.3±5.9% before dietary improvement to 25.9±7.1% at the time of the study. The final model consisted of 5 fat-reduction strategies with 63 food changes. The strategies were: increase summer fruits (4 items; kr=0.66), increase vegetables and grains (14 items; kr=0.79), decrease recreational foods (14 items; kr=0.76), decrease cooking fat (20 items; kr=0.86), and use fat-modified foods (11 items; kr=0.80). Applications/conclusions Dietetics professionals should base their advice on the dietary strategies used by consumers rather than hypothetical premises such as food or nutrient groupings. Nutrition education interventions will have better chances for success if they are based on a set of customized programs that guide appropriate consumer segments through a series of small, comfortable, and sustainable dietary changes over a prolonged period of time. J Am Diet Assoc. 2001; 101:1024–1030.

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