title: The effect of medical nutrition therapy on changes in dietary knowledge and DASH diet adherence in older adults with cardiovascular disease.
abstract: OBJECTIVE
  To examine the effect of MNT on dietary knowledge of older adults at baseline, 6 months and 12 months and to assess the effect of dietary knowledge on change in DASH diet adherence from baseline to 12 months.
  
  
  METHODS
  Data for the analysis come from a controlled, randomized prospective design conducted from 2003-2005 with the outcome measures taken pre-, mid-, and post-intervention.
  
  
  METHODS
  Data were collected from participants in their homes in an urban community in North Carolina.
  
  
  METHODS
  Participants (N=147) were adults aged 60+ with a diagnosis of hypertension and/or hyperlipidemia.
  
  
  METHODS
  Intervention recipients received three sessions of MNT throughout the 1 year study period. The control group received nutrition information at enrollment.
  
  
  METHODS
  Participants completed a dietary knowledge questionnaire and a 24 dietary recall at baseline, 6 months, and 12 months. Instrumental variables models with participant fixed effects were used to determine the impact of MNT on dietary knowledge and dietary knowledge on DASH diet adherence.
  
  
  RESULTS
  Among those who received MNT, dietary knowledge increased from baseline to twelve months (p<.01). Changes in dietary knowledge were not associated with changes in DASH adherence from baseline to 12 months (p=0.44).
  
  
  CONCLUSIONS
  The MNT administered was effective at improving dietary knowledge, but not at improving DASH adherence. Three MNT sessions may be insufficient to change behavior. Integrating behavioral change theory and cultural sensitivity to MNT may improve diet adherence among diverse older adults.
authors.affiliation: Department of Public Health Sciences, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC 28223-0001, USA. efracine@uncc.edu
authors.forename: E
authors.initials: E
authors.lastname: Racine
authors.forename: J L
authors.initials: JL
authors.lastname: Troyer
authors.forename: J
authors.initials: J
authors.lastname: Warren-Findlow
authors.forename: W J
authors.initials: WJ
authors.lastname: McAuley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004032:Diet; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006949:Hyperlipidemias / Q000178:diet therapy*; D006973:Hypertension / Q000178:diet therapy*; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D044623:Nutrition Therapy; D010349:Patient Compliance; D014505:Urban Population