Effect of a Nutrient Rich Foods consumer education program: results from the nutrition advice study.
BACKGROUND
The Nutrient Rich Foods (NRF) approach to eating uses the NRF Index, a nutrient profiling metric to help consumers choose foods that contain more vitamins, minerals, and other nutrients per kilocalorie. Research is needed to test the efficacy of dietary guidance using nutrient profiling systems to rank foods.


OBJECTIVE
To examine whether nutrition education and supporting materials would increase understanding of the NRF approach and improve food shopping, meal planning, consumption of nutrient-rich foods, and diet quality.


METHODS
Unbalanced randomized controlled trial conducted in February to May 2009 with participants assigned to NRF education group (n=128) or control group receiving standard nutrition education (n=61).


METHODS
Adult primary food shoppers and preparers with at least one child in the household aged 3 to 17 years.


METHODS
Group education session and support tools (pocket guide, shopping list, refrigerator magnet, weekly e-mail messages, and biweekly mailings).


METHODS
Surveys of knowledge, attitudes, and behaviors and two 24-hour telephone dietary recalls at baseline and after an 8-week intervention period.


METHODS
Examined time-by-treatment interactions in outcome measures.


RESULTS
Compared to controls, NRF participants increased meal planning (+24.2% vs ?4.9%; P<0.01), ability to identify nutrient-rich foods (+60.2% vs +24.6%; P<0.001), and use of shopping lists (+14.1% vs +3.3%; nonsignificant trend), and consumed more vegetables and fruits (P<0.05). NRF participants improved overall diet quality as shown by their scores on the Healthy Eating Index (P=0.04) and NRF scale scores (nonsignificant trend). Significant improvements were observed in Healthy Eating Index component scores for total fruit; whole fruit; whole grains; saturated fat; and energy from solid fats, alcohol, and added sugars.


CONCLUSIONS
Findings of this study showed that a consumer education program increased participants' use of the NRF approach and improved diet quality. Larger and longer-term studies are needed to confirm the findings and better understand processes of change.
University of Pennsylvania School of Medicine, 801 Blockley Hall, 423 Guardian Dr, Philadelphia, PA 19104, USA. kglanz@upenn.edu
Karen
K
Glanz
James
J
Hersey
Sheryl
S
Cates
Mary
M
Muth
Darryl
D
Creel
Jill
J
Nicholls
Victor
V
Fulgoni
Susan
S
Zaripheh
D000328:Adult; D000465:Algorithms; D003132:Commerce / Q000706:statistics & numerical data; D003256:Community Participation; D054626:Consumer Health Information; D004032:Diet / Q000592:standards*; D005260:Female; D005502:Food / Q000145:classification*; D005523:Food Supply / Q000706:statistics & numerical data; D005638:Fruit; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D008297:Male; D011939:Mental Recall; D008612:Menu Planning; D008875:Middle Aged; D018673:Nutrition Policy; D052756:Nutritional Sciences / Q000193:education*; D009753:Nutritive Value; D014481:United States; D016885:United States Department of Agriculture; D014675:Vegetables