title: Stage-matched nutrition guidance: stages of change and fat consumption in Dutch patients at elevated cardiovascular risk.
abstract: OBJECTIVE
  To assess the effects of stage-matched nutrition counseling on stages of change and fat intake.
  
  
  METHODS
  Controlled clinical trial.
  
  
  METHODS
  9 family practices in a family medicine practice network.
  
  
  METHODS
  143 patients at elevated cardiovascular risk, aged 40 to 70 years.
  
  
  METHODS
  Intervention patients received stage-matched counseling from their family physician and a dietitian. Control patients received usual care.
  
  
  METHODS
  Stages of change and fat intake were measured at baseline and after 6 and 12 months.
  
  
  METHODS
  Chi-squared tests, t tests, and regression analyses (alpha = .05) were conducted.
  
  
  RESULTS
  More patients in the intervention group than in the control group were in the postpreparation stage after 6 months (70% vs 35%; P < .01) but not after 12 months (70% vs 55%; P = .10). Between 0 and 12 months, the reduction in total fat intake (-5.6% kcal vs -2.4% kcal) was largest in the intervention group.
  
  
  CONCLUSIONS
  Stage-matched nutrition counseling promotes movement through stages of change, resulting in a reduced fat intake. Our results partly support stages of change as a tool for behavior change. Movement across stages of change was not an intermediating factor in the intervention effects. Research should focus on feasible ways to keep patients in the postpreparation stage.
authors.affiliation: Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands. marieke.verheijden@wur.nl
authors.forename: Marieke W
authors.initials: MW
authors.lastname: Verheijden
authors.forename: Juul E
authors.initials: JE
authors.lastname: Van der Veen
authors.forename: J Carel
authors.initials: JC
authors.lastname: Bakx
authors.forename: Reinier P
authors.initials: RP
authors.lastname: Akkermans
authors.forename: Henk J M
authors.initials: HJ
authors.lastname: Van den Hoogen
authors.forename: Wya A
authors.initials: WA
authors.lastname: Van Staveren
authors.forename: Chris
authors.initials: C
authors.lastname: Van Weel
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003376:Counseling; D018752:Diet, Fat-Restricted / Q000523:psychology; D004041:Dietary Fats / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D012307:Risk Factors
chemical_list: D004041:Dietary Fats