Telephone counseling is increasingly reported to be an effective behavior change strategy, but more studies in broader populations are needed. This uncontrolled pilot trial investigated whether a 3-month/eight-call telephone counseling intervention could promote dietary changes associated with reduced chronic disease risk in adults consuming <5.0 servings of vegetables and fruits daily. Between 2002 and 2004, 97 adults (mean age 46 years; range 21 to 84 years) completed the intervention and a follow-up assessment at 6 months. Approximately half were of nonwhite ethnicity (53%). The majority were women (95%) and had never had cancer (89%). The intervention promoted daily intakes of three to five vegetable servings, two to four fruit servings, and three whole-grain and/or beans/legumes servings. Average total daily intake of vegetables, fruits, whole grains, beans/legumes, fiber, and fat were assessed at baseline and at 6 months, each by a set of three 24-hour recalls. Plasma carotenoids were measured on a subsample (n=41) as an objective biomarker of vegetable and fruit intake. Change in mean self-reported dietary intake (ie, vegetables, fruit, whole grains, beans/legumes, fiber, and fat) and plasma carotenoids were compared by paired t tests. The intervention was associated with a significant (P<0.001) increase in vegetable servings per day (baseline 2.1 servings per day, 6 months 3.5 servings per day; 67% increase), fruit servings per day (baseline 1.4 servings per day, 6 months 2.4 servings per day; 71% increase), and whole-grain and/or bean servings per day (baseline 1.0 serving per day, 6 months 1.4 servings per day; 40% increase). These changes were corroborated by a significant (P<0.001) increase in total plasma carotenoids. This 3-month/eight-call telephone counseling intervention was associated with dietary change in healthy adults consuming fewer than five servings per day of vegetables and fruit at study entry.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of the Academy of Nutrition and Dietetics
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Nutrition and Your Health: Dietary Guidelines for Americans, 2005. US Departments of Agriculture, and Health and Human Services, Washington, DC2006 (Home and Garden Bulletin No. 232)
- Telephone-based counseling improves dietary fat, fruit, and vegetable consumption: A best-evidence synthesis.J Am Diet Assoc. 2006; 106: 1434-1444
- The high cost of not consuming fruits and vegetables.J Am Diet Assoc. 2006; 106: 1364-1368
- Whole-grain diets reduce blood pressure in mildly hypercholesterolemic men and women.J Am Diet Assoc. 2006; 106: 1445-1449
- Most Americans eat much less than recommended amounts of fruits and vegetables.J Am Diet Assoc. 2006; 106: 1371-1379
- More Americans are eating “5 a day” but intakes of dark green and cruciferous vegetables remain low.J Nutr. 2000; 130: 3063-3067
- Telephone intervention for physical activity and dietary behavior change: A systematic review.Am J Prev Med. 2007; 32: 419-434
- Using the telephone to improve health behavior and health service delivery.Patient Educ Couns. 1999; 37: 3-18
- The efficacy of behavioral interventions to modify dietary fat and fruit and vegetable intake: A review of the evidence.Prev Med. 2002; 35: 25-41
- Interventions designed to increase adult fruit and vegetable intake can be effective: A systematic review of the literature.J Nutr. 2005; 135: 2486-2495
- Feasibility of a randomized trial of a high-vegetable diet to prevent breast cancer recurrence.Nutr Cancer. 1997; 28: 282-288
- Telephone counseling intervention increases intakes of micronutrient- and phytochemical-rich vegetables, fruit and fiber in breast cancer survivors.J Nutr. 2004; 134: 452-458
- Achieving substantial changes in eating behavior among women previously treated for breast cancer—An overview of the intervention.J Am Diet Assoc. 2005; 105: 382-391
- Telephone counseling helps maintain long-term adherence to a high-vegetable dietary pattern.J Nutr. 2007; 137: 2291-2296
- Increases in plasma carotenoid concentrations in response to a major dietary change in the women's healthy eating and living study.Cancer Epidemiol Biomarkers Prev. 2006; 15: 1886-1892
- A randomized trial of the effect of a plant-based dietary pattern on additional breast cancer events and survival: The women's healthy eating and living (WHEL) study.Control Clin Trials. 2002; 23: 728-756
- Social Foundations of Thought and Action: A Social Cognitive Theory.Prentice Hall, Englewood Cliffs, NJ1986
- Motivational Interviewing: Preparing People for Change.The Guilford Press, New York, NY2002
- Responsiveness of carotenoids to a high vegetable diet intervention designed to prevent breast cancer recurrence.Cancer Epidemiol Biomarkers Prev. 1997; 6: 617-623
- Plasma carotenoids are biomarkers of long-term high vegetable intake in women with breast cancer.J Nutr. 1999; 129: 2258-2263
- Serum carotenoids and breast cancer.Am J Epidemiol. 2001; 153: 1142-1147
- Plasma carotenoids and recurrence-free survival in women with a history of breast cancer.J Clin Oncol. 2005; 23: 6631-6638
- Nutrition and Your Health: Dietary Guidelines for Americans. 5th ed. US Departments of Agriculture and Health and Human Services, Washington, DC2000 (Home and Garden Bulletin No. 232)
- Action Guide for Healthy Eating. National Cancer Institute, Bethesda, MD1996 (NIH Publication No. 96-3877)
- Rationale for a consistent “powerhouse” approach to vegetable and fruit messages.J Am Diet Assoc. 2004; 104: 352-356
V. A. Newman is an associate clinical professor and J. P. Pierce is a professor, Department of Family and Preventive Medicine, Cancer Prevention and Control Program; S. W. Flatt is a data management coordinator and senior statistician, Cancer Prevention and Control Program, University of California, San Diego, La Jolla.
Accepted: January 18, 2008
© 2008 American Dietetic Association. Published by Elsevier Inc. All rights reserved.