Final results of the Maryland WIC Food for Life Program.
BACKGROUND
The few randomized community trials in middle-income populations that tried to modify multiple dietary risk factors for cancer only demonstrated small changes. This trial sought to decrease the percent of calories derived from fat and to increase fruit, vegetable, and fiber intake among low-income women served by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Maryland.


METHODS
We conducted six-month intervention programs for 1055 women at ten WIC sites; 1011 women served as controls. Intervention participants were invited to five interactive nutrition sessions and were sent written materials. Controls received usual care. Women were surveyed at baseline, two months post intervention, and one year later. All analyses conducted used an intention-to-treat paradigm.


RESULTS
Mean differences (intervention-control) in change from baseline were for percent calories from fat -1.62 +/- 0.33% (P < 0.0001), for consumption of fruits and vegetables 0.40 +/- 0.11 servings (P = 0.0003), and for fiber intake 1.01 +/- 0.31 grams (P = 0.001). These differences in change were related in a dose-response relationship to the number of sessions women attended and remained significant one year post-intervention for the first two outcomes.


CONCLUSIONS
Multiple dietary improvements can be achieved in a low-income population with an effective, multi-faceted intervention program. The changes in this trial exceeded those in previous community trials conducted in higher SES populations.
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, 660 W. Redwood Street, Baltimore, MD 21201, USA. shavas@epi.umaryland.edu
Stephen
S
Havas
Jean
J
Anliker
Deborah
D
Greenberg
Gladys
G
Block
Torin
T
Block
Cheryl
C
Blik
Patricia
P
Langenberg
Carlo
C
DiClemente
D000293:Adolescent; D000328:Adult; D018592:Cross-Over Studies; D004034:Diet Surveys; D004041:Dietary Fats; D004043:Dietary Fiber; D002149:Energy Intake; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D005522:Food Services / Q000458:organization & administration*; D005638:Fruit; D006266:Health Education / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008396:Maryland; D039382:Maternal Nutritional Physiological Phenomena; D009035:Mothers / Q000193:education* / Q000523:psychology; D009369:Neoplasms / Q000209:etiology / Q000517:prevention & control*; D052756:Nutritional Sciences / Q000193:education*; D011203:Poverty / Q000523:psychology; D015397:Program Evaluation; D012044:Regression Analysis; D014675:Vegetables
D004041:Dietary Fats; D004043:Dietary Fiber