title: Effect of Current Dietary Recommendations on Weight Loss and Cardiovascular Risk Factors.
abstract: BACKGROUND
  Dietary recommendations emphasize increased consumption of fruit, vegetables, and whole grain cereals for prevention of chronic disease.
  
  
  OBJECTIVE
  This study assessed the effect of dietary advice and/or food provision on body weight and cardiovascular disease risk factors.
  
  
  METHODS
  Healthy overweight men (n = 209) and women (n = 710), mean age 44.7 years, body mass index [BMI] 32.4 kg/m2, were randomized between November 2005 and August 2009 to receive Health Canada's food guide (control, n = 486) or 1 of 3 interventions: dietary advice consistent with both Dietary Approaches to Stop Hypertension (DASH) and dietary portfolio principles (n = 145); weekly food provision reflecting this advice (n = 148); or food delivery plus advice (n = 140). Interventions lasted 6 months with 12-month follow-up. Semiquantitative food frequency questionnaires and fasting blood, anthropometric and blood pressure measurements were obtained at baseline, 6 months, and 18 months.
  
  
  RESULTS
  Participant retention at 6 and 18 months was 91% and 81%, respectively, after food provision compared to 67% and 57% when no food was provided (p < 0.0001). Test and control treatments showed small reductions in body weight (-0.8 to -1.2 kg), waist circumference (-1.1 to -1.9 cm), and mean arterial pressure (0.0 to -1.1 mm Hg) at 6 months and Framingham coronary heart disease risk score at 18 months (-0.19 to -0.42%), which were significant overall. Outcomes did not differ among test and control groups.
  
  
  CONCLUSIONS
  Provision of foods increased retention but only modestly increased intake of recommended foods. Current dietary recommendations showed small overall benefits in coronary heart disease risk factors. Additional dietary strategies to maximize these benefits are required. (Fruits, Vegetables, and Whole Grains: A Community-based Intervention; NCT00516620).
authors.affiliation: Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada; Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, Ontario, Canada. Electronic address: nutritionproject@smh.ca.
authors.forename: David J A
authors.initials: DJA
authors.lastname: Jenkins
authors.affiliation: Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Prevention and Cancer Control, Cancer Care Ontario, Toronto, Ontario, Canada.
authors.forename: Beatrice A
authors.initials: BA
authors.lastname: Boucher
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of Preventive Oncology, University of Calgary, Calgary, Alberta, Canada; Department of Psychology, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia.
authors.forename: Fredrick D
authors.initials: FD
authors.lastname: Ashbury
authors.affiliation: Prevention and Cancer Control, Cancer Care Ontario, Toronto, Ontario, Canada.
authors.forename: Margaret
authors.initials: M
authors.lastname: Sloan
authors.affiliation: Prevention and Cancer Control, Cancer Care Ontario, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Patrick
authors.initials: P
authors.lastname: Brown
authors.affiliation: Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Ahmed
authors.initials: A
authors.lastname: El-Sohemy
authors.affiliation: Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Hanley
authors.affiliation: Nutrition Department, Harvard School of Public Health, Harvard University, Boston, Massachusetts.
authors.forename: Walter
authors.initials: W
authors.lastname: Willett
authors.affiliation: Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Melanie
authors.initials: M
authors.lastname: Paquette
authors.affiliation: Department of Health Research Methods, Evidence, and Impact, McMaster University, Ontario, Canada.
authors.forename: Russell J
authors.initials: RJ
authors.lastname: de Souza
authors.affiliation: Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Christopher
authors.initials: C
authors.lastname: Ireland
authors.affiliation: Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Natalie
authors.initials: N
authors.lastname: Kwan
authors.affiliation: Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Food Science, University of Guelph, Guelph, Ontario, Canada.
authors.forename: Amy
authors.initials: A
authors.lastname: Jenkins
authors.affiliation: Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Sathish C
authors.initials: SC
authors.lastname: Pichika
authors.affiliation: Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Prevention and Cancer Control, Cancer Care Ontario, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Nancy
authors.initials: N
authors.lastname: Kreiger
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002170:Canada; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D004032:Diet; D005260:Female; D005638:Fruit; D006801:Humans; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000150:complications / Q000178:diet therapy*; D010349:Patient Compliance; D012307:Risk Factors; D014675:Vegetables; D015431:Weight Loss; D000067348:Whole Grains
keywords: body weight; cardiovascular disease; diet; dietary recommendations; risk factors