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Dietary adherence and change in weight status among low-income African American Alabamians

Linda Knol, PhD, RD, Amy D. Eades, MS, RD, LD, Melissa Shoup, MS, RD, LD, and Olivia Kendrick, DrPH, RD. Department of Human Nutrition & Hospitality Management, University of Alabama, Box 870158, Tuscaloosa, AL 35487, 205-348-8129, lknol@ua.edu

The purpose of this study was to assess clinical outcomes and examine the relationship between the dietitianís opinion of patientsí adherence after an initial intervention of nutrition education/counseling and change in body mass index (BMI). Study participants (n=75) were low-income African American adults referred to a dietitian from two rural Alabama primary health care clinics for various diet related chronic disease states including overweight and obesity. Counseling sessions took place within the clinics and included the use of a four-step goal setting process. After counseling sessions, anticipated adherence was measured by the dietitianís personal assessment and categorized as Excellent/Good or Poor. BMI was assessed at the initial and follow-up visits. Average change in BMI for the Excellent/Good Adherence group (n=46) was -0.89 +/- 4.8 BMI units while average change for the Poor Adherence group (n=29) was 0.09 +/- 1.23 BMI units. After controlling for factors that might influence adherence such as comorbid conditions, age, gender, Stage of Change, comprehension and receptivity, those who were classified initially as Excellent/Good Adherence by the dietitian lost significantly more weight than those who were rated Poor (p<0.03). Goal setting is a strategy frequently used to help patients change dietary behavior. However, the process may assist the dietitian in identifying those patients who are able to set realistic, obtainable goals. Thus, dietitians should be encouraged to use the goal setting process in nutrition education counseling to better predict adherence for weight loss.

Learning Objectives:

Keywords: Nutrition,

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Healthy Lifestyles for Cardiovascular Health and Smoking Prevention

The 132nd Annual Meeting (November 6-10, 2004) of APHA