title: Alteration in unhealthy nutrition behaviors in adolescents through community intervention: Isfahan Healthy Heart Program.
abstract: BACKGROUND
  Primary prevention of chronic diseases has been suggested to initiate health promotion activities from childhoods. The impact of Isfahan Healthy Heart Program (IHHP), a comprehensive community trial, on unhealthy snacks and fast food intake changes was evaluated in Iranian adolescents between 2001 and 2007.
  
  
  METHODS
  Healthy Heart Promotion from Childhood (HHPC) as one of the IHHP interventional projects was conducted in adolescents aged 11-18 years, selected randomly by multistage random sampling. Isfahan and Najafabad districts were intervention areas (IA) and Arak district was reference area (RA). The baseline and post-intervention surveys were conducted on 1941 and 1997 adolescents, respectively. Healthy lifestyle interventions were performed during the 2nd phase of the study targeting about 410000 students in urban and rural areas of the IA via education, environmental and legislation activities. Dietary intake was assessed annually using a fifty-item food frequency questionnaire in both communities.
  
  
  RESULTS
  The interaction of year×area demonstrated that the consumption of unhealthy snacks decreased significantly in middle school boys of RA compared to IA (P for interaction=0.01). However, middle school girls (P for interaction = 0.002) and both sexes of high school students in IA showed a significant reduction in fast food consumption against RA (P for interaction < 0.001).
  
  
  CONCLUSIONS
  The HHPC interventions made some improvement in fast food consumption. It did not show significant decrease regarding unhealthy snacks in adolescents. Proper and higher dose of interventions may be effective in achieving this goal.
authors.affiliation: PhD Candidate, Department of Nutrition, Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan.
authors.forename: Noushin
authors.initials: N
authors.lastname: Mohammadifard
authors.forename: Nizal
authors.initials: N
authors.lastname: Sarrafzadegan
authors.forename: Gholam Reza
authors.initials: GR
authors.lastname: Ghassemi
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Nouri
authors.forename: Rezvan
authors.initials: R
authors.lastname: Pashmi
keywords: Adolescent; Community Trial; Dietary Behaviour; Lifestyle; Nutrition