Rayane Abusabha

Review of Self-Efficacy and Locus of Control for Nutrition- and Health-Related Behavior

This article reviews several cognitive predictors of health- and diet-related behaviors commonly used in theories and models of nutrition and health behavior change. Constructs such as self-efficacy, self-esteem, outcome expectancies, health value, and locus of control are examined. Self-efficacy has repeatedly been a good predictor of health behavior, sometimes explaining more than 50% of variability. Research on locus of control and other predictive factors has been less conclusive. The take-home message is threefold: (a) task specificity of self-efficacy and domain specificity of locus of control are crucial for unraveling their effects on behavior; (b) careful segmentation of different population groups under study may explain the inconsistencies in previous research; and (c) especially when studying dietary behavior, these predictors of behavior change should not be used alone or in place of one another but should be used simultaneously to explain complex food and diet-related behaviors. We recommend that nutritionists systematically integrate available theories and models and explore new areas for studying human behavior, such as sociology and anthropology, to form a more powerful, comprehensive model for behavior change.

How to Make Nutrition Education More Meaningful Through Facilitated Group Discussions

Facilitated group discussions provide an alternative method to lecture and one-on-one approaches for conducting educational interventions at clinic sites. They are an interactive form of education wherein learners generate the specific topics to be addressed and share their knowledge and experience with other group members through discussion. In brief, the educator becomes a facilitator who, rather than lecturing, encourages clients to discuss freely among themselves their own approach to the nutrition problems posed during the session. As a facilitator, the nutritionist strives to create a comfortable atmosphere for discussion, encourages participation, and interjects only to correct misinformation and manage group dynamics. Facilitated group discussions allow nutrition practitioners to deliver meaningful nutrition education in a manner that helps empower their clients to improve their dietary habits; at the same time such discussions meet the increased public administrative demands for efficiency. Possible benefits to clients include more confidence, better communication skills, improved thinking skills, and increased motivation and commitment to improving nutrition behavior. We recommend that nutrition educators try facilitated group discussions in their clinics.

Factors Perceived to Influence Dietary Fat Reduction Behaviors

Abstract Dietary change is an inherently complex process. Although dietary fat reduction is an important issue in nutrition education, factors facilitating this type of change have not been fully examined. By accumulating information from individuals who have already been successful in initiating and maintaining dietary fat reduction, practical means of assisting others can be learned. This study collected information from 155 participants between the ages of 30 and 55. Participants were included if they reported the initiation of sustained dietary fat reduction strategies beginning at least 5 years prior to recruitment. Data used to examine individual patterns of dietary fat reduction were collected via in-depth, semistructured, retrospective interviews. Qualitative analyses identified 134 factors that played a role in facilitating the adoption of multiple fat reduction strategies. The factors identified were further classified into two categories: unplanned and planned. Unplanned factors were defined as life events or occurrences that are not nor should they be intentionally included in ones life as a means of dietary improvement (e.g., market influence, health issues, disease diagnosis). Planned factors were defined as occurrences often intentionally included in ones life to facilitate dietary change (e.g., going on a weight loss diet, acquiring an appliance, making a resolution).They frequently resulted from mediation by an unplanned factor.These factors can be used to help nutrition educators identify specific times conducive to initiating dietary change, as well as techniques for facilitating dietary fat reduction.

Dietary Fat Reduction Strategies Used by a Group of Adults Aged 50 years and Older

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 questionaire: 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.

Body weight, body composition, and energy intake changes in breastfeeding mothers.

Body weight, body composition, and energy intake changes are described for 13 breastfeeding mothers followed for 18-24 months after delivery. Body weight was assessed at 1-6, 9, 12, 18, 24 months postpartum and 1 month after infant weaning, and energy intake was assessed at 2-6, 9, 12, 18, 24 months postpartum and 1 month after infant weaning. Compared to prepregnancy weight, participants were an average of 4.0 ± 6.6 kg heavier 18 months postpartum (p<0.05). The mean rate of weight loss from 1 month postpartum until termination of lactation was 0.32 ± 0.27 kg/month. Eight of the 12 women gained weight after weaning their infant. Percent body fat assessed by underwater weighing declined from 34.6 ± 2.8% at 1 month postpartum to 31.4 ± 4.8% at 1 month after infant weaning (p<0.05). Further research is needed to study the factors which affect weight loss postpartum, and how weight gain after weaning can be prevented.

A Comparison of Two Methods for Estimating Food Groups According to the Food Guide Pyramid

Abstract LEARNING OUTCOME: To describe two methods used to estimate Food Guide Pyramid servings Nutrition researchers are increasingly using the Food Guide Pyramid (FGP) as a standard to evaluate dietary intake data. Various methods have been described for evaluating FGP servings but little information is available on the comparability of methods within the same group of individuals. Therefore, we estimated the FGP servings in a single group of women (n = 156) using both a food frequency questionnaire (FFQ) and three 24-hour dietary recalls. Women (age >60 years) were recruited from a medical center clinic in rural Pennsylvania. FFQ data were collected by telephone using Health History and Habits Questionnaire Diet Analysis System software (National Cancer Institute). Following the FFQ interviews, three 24-hour diet recalls were collected by telephone on randomly assigned days using the Nutrition Data System (Nutrition Coordinating Center, University of Minnesota). FFQ data were categorized into food groups by converting frequency of consumption to daily intakes using a medium serving as the standard for FGP servings. Recall data were categorized into FGP servings by editing nutrient and food summary data generated within NDS; foods listed as ingredients were aggregated into whole foods and assigned to FGP servings with the appropriate serving sizes. The mean number of FGP servings from each of six groups: breads, vegetables, fruits, dairy, meats, and fats, oils and sweets were calculated from both methods. Paired t-tests were used to assess differences between methods. The difference between methods were statistically significant for all food groups (p