Counseling to Promote a Healthy Diet in Adults: Summary of the Evidence

Table 3. Counseling To Increase Intake of Fiber: Study Descriptions

Author, Year	Sample Population	Level of Risk	Baseline Patient Numbers	Retention Rate	Setting	Intervention and Control Group Counseling Provider and Resources	Intensity
Baron et al., 1990³⁴	Adult men and women in a group general practice, Abingdon, UK	Unselected	Intv: 187 Cont: 181	91%	Primary care	Intv: RN delivered 30 min group or individual diet advice and 2 F/Us Cont: RN F/U visit at 1 and 3 months; no dietary advice	Medium
Beresford et al., 1992¹⁰	Adult men and women in primary care 35% black North Carolina, USA	Unselected	Intv: 120 Cont: 122	79%	Primary care	Intv: RN on site provides 5 min intro to self-help materials with phone F/U 10 d later Cont: baseline interview only	Low
Beresford et al., 1997¹¹	Adult men and women in family practice clinics, USA	Unselected	Intv: 1,010 Cont: 1,111	86%	Primary care	Intv: MD-delivered 3-min intro to self-help booklet + reminder letter from MD Cont: NR	Low
Delichatsios, Friedman et al., 2001¹⁴	Adult men and women in a large multisite, multi-specialty group practice—Harvard Vanguard Medical Associates in Massachusetts, USA; 72% women, 45% white, 45% black	Unselected	NR	NR	Mailings and computer-generated messages	Intv: weekly diet-related educational feedback, advice, and behavioral counseling for 5-7 minutes by a totally automated, telephone-linked computer-based voice communication system Cont: weekly physical activity-related educational feedback, advice, and behavioral counseling for 5-7 minutes by a totally automated, telephone-linked computer-based voice communication system	Medium
Delichatsios, Hunt et al., 2001¹⁵	Adult men and women patients from 6 group HMO practices in the primary care research network of Harvard Pilgrim HealthCare, Massachusetts, USA	Unselected	Intv: 230 Cont: 274	Intv: 85% Cont: 92%	Mailings and computer-generated messages	Intv: mailed personalized dietary recommendations and 2 educational booklets; endorsement by 1 hour-trained MD or NP; 2 motivational phone counseling sessions by trained MPH student telephone counselors. RD consultation if needed. Cont: NR	Medium
Lindholm et al., 1995²³	Adult men and women at increased risk for CHD in 32 county health centers Lund, Sweden	At risk	Intv: 339 Cont: 342	Intv: 92% Cont: 95%	Primary care	Intv: MD- or RD-delivered group health care advice sessions Cont: usual health care advice from MD to reduce dietary fat, reduce weight if necessary, to stop smoking; pamphlet to reinforce instructions	High
Roderick et al., 1997²⁸	Adult men and women with hypercholesterolemia in general practice from 4 regions, United Kingdom	Unselected	Intv: 473 Cont: 483	Intv: 86% Cont: 74%	Primary care	Intv: RNs on-site (trained for intv by RD) delivered dietary assessment, advice and F/U Cont: standard health education materials	Medium

Note: Cont indicates control; F/U, followup; Intv, intervention; NR, not reported; RD, registered dietician; RN, registered nurse.

Table 3. Interventions To Increase Intake of Fiber: Study Outcomes

Author, Year	Main Outcome	Baseline Values	Duration of Followup	Final Followup Values	Change from Baseline to Final Followup	Net Difference in Change^a or Difference at Final Followup	P-value	Relative Change^b	Effect Size
Baron et al., 1990³⁴	Grams of fiber per day	Intv: M: 20.4 g F: 18.9 g Cont: M: 19.3 g F: 16.4 g	12 mo	Intv: M: 22.8 g F: 21.4 g Cont: M: 20.1 g F: 15.4 g	NR	M: 2.7 g F: 6.0 g	NS	M: 14% F: 37%	Medium
Beresford et al., 1992¹⁰	Grams of fiber per day (adjusted)	Intv: 14 g Cont: 15 g	3 mo	NR	NR	0.6 g	NR	4%	Small
Beresford et al., 1997¹¹	Grams of fiber per 1,000 kcal	Intv: 10 g per 1,000 kcal Cont: 10 g per 1,000 kcal	12 mo	NR	Intv: +0.5 g per 1,000 kcal Cont: +0.2 g per 1,000 kcal	0.3 g	NS	3%	Small
Delichatsios, Friedman et al., 2001¹⁴	Grams of fiber per day	Intv: 21 g Cont: 20 g	6 mo	Intv: 22 g Cont: 18 g	Intv: +1 g Cont: -2 g	3 g	P < 0.05	15%	Medium
Delichatsios, Hunt et al., 2001¹⁵	Grams of fiber per day	Intv: 7.3 g Cont: 8.2 g	3 mo	Intv: 9.3 g Cont: 9.0 g	Intv: +2 g Cont: +0.8 g	1.2 g	NR	15%	Small
Lindholm et al., 1995²³	Grams of fiber per day	NR	18 mo	NR	NR	0.9 g	P < 0.001	NA	Small
Roderick et al., 1997²⁸	Grams of fiber per day	Intv: 23.3 g Cont: 23.2 g	12 mo	NR	Intv: +0.9 Cont: -0.2	1.1 g	CI (-0.2 - 2.23)^c	4%	Small

^aBaseline minus followup value for the intervention group minus baseline minus followup value for the control group.
^bAbsolute change in the intervention group from baseline to followup divided by the baseline value of the control group.
^cP-value not reported, confidence interval given instead.

Note: Cont indicates control; Intv, intervention; NA not available; NS, not significant; NR, not reported.

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