Document Type : Original Article
Authors
- . Fatemeh Zeynalzadeh Borjloo 1
- . Tahereh Dehdari 1
- . Jamileh Abolghasemi 2
- . Fatemehsadat Amiri 3
- . Ali Vasheghani‑Farahani 4
1 Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
2 Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
3 Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
4 Department of Electrophysiology, Tehran Heart Center and Cardiac Primary Prevention Research Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Abstract
BACKGROUND: Given that many Iranian were interested in the consumption of foods that are high
in fats, the present study was done to determine the effect of a nutrition education intervention on
knowledge, attitude, and intake of foods high in fat among a sample of women in Tehran.
MATERIALS AND METHODS: In this quasi‑experimental study, 92 female referrals to the health
houses affiliated to Tehran municipal were selected and assigned to either intervention (n = 46) or
control (n = 46) groups. Information (data) regarding women’s knowledge, attitude, and practice in
terms of foods rich in fat intake was collected by three questionnaires. Then, a nutrition education
intervention included four 40–60 min training sessions over 4 weeks was designed and conducted
to the study participants in the intervention group. Two groups were followed up 2 months after the
intervention. Finally, all data were analyzed by using the independent‑samples t‑tests, Student’s
paired‑samples t‑test, and Pearson correlation analysis on the R software (version 6.3.2).
RESULTS: The results showed that there were significant reductions in a positive attitude towards food
with high fat content and intake of these foods in the intervention group compared with the control
group after the intervention (P < 0.001). Furthermore, following the intervention, the intervention group
reported a significant increase in dietary fat nutrition knowledge than the control group (P < 0.001).
Conclusion: Developing nutrition education interventions is an effective strategy for reducing the
consumption of foods rich in fat in Iranian women.
Keywords
- Lunn J, Theobald HE. The health effects of dietary unsaturated
fatty acids. Br Nutr Found Nutr Bull 2006;31:178‑224.
2. Riordan F, McGann R, Kingston C, Perry IJ, Schulze MB, Frost
Andersen L, et al. A systematic review of methods to assess intake
of saturated fat (SF) among healthy European adults and children:
A DEDIPAC (Determinants of Diet and Physical Activity) study.
BMC Nutr 2018;4:21.
3. White B. Dietary fatty acids. Am Fam Physician 2009;80:345‑50.
4. Zock PL. Health problems associated with saturated and
trans fatty acids intake. Woodhead Publishing Series in Food
Science, Technology and Nutrition. Cambridge, UK: Woodhead
Publishing; 2006. p. 3‑24.
5. Denke MA. Dietary fats, fatty acids, and their effects on
lipoproteins. Curr Atheroscler Rep 2006;8:466‑71. - 6. Stender S. Trans fat in foods in Iran, South‑Eastern Europe,
Caucasia and Central Asia: A market basket investigation. Food
Policy 2020;96: 101877.
7. Roefs A, Jansen A. Implicit and explicit attitudes toward high‑fat
foods in obesity. J Abnorm Psychol 2002;111:517‑21.
8. AlizadehM, MohtadiniaJ, Pourghasem‑GargariB, EsmaillzadehA.
Major dietary patterns among female adolescent girls of talaat
intelligent guidance school, Tabriz, Iran. Iran Red Crescent Med
J 2012;14:436‑41.
9. Esmaillzadeh A, Azadbakht L. Food intake patterns may explain
the high prevalence of cardiovascular risk factors among Iranian
women. J Nutr 2008;138:1469‑75.
10. Hyseni L, Bromley H, Kypridemos C, O’Flaherty M,
Lloyd‑Williams F, Guzman‑Castillo M, et al. Systematic review
of dietary trans‑fat reduction interventions. Bull World Health
Organ 2017;95:821‑30G.
11. Kamran A, Sharifirad GH, Heydari H, Sharifian E. The effect of
theory based nutritional education on fat intake, weight and blood
lipids. Electron Physician 2016;8:3333‑42.
12. Curtis JP, Adamson JA, Mathers CJ. Effects on nutrient intake of
a family‑based intervention to promote increased consumption
of low‑fat starchy foods through education, cooking skills and
personalized goal setting the Family Food and Health Project.
Br J Nutr 2012;107:1833‑44.
13. Sallis FJ, McKenzie LT, Conway LJ, Elder PJ, Prochaska JJ,
Brown M, et al. Environmental interventions for eating and
physical activity: A randomized controlled trial in middle schools.
Am J Prev Med 2003;24:209‑17.
14. Risérus U, Willett WC, Hu FB. Dietary fats and prevention of
type 2 diabetes. Prog Lipid Res 2009;48:44‑51.
15. Kelly BR. Diet and exercise in the management of hyperlipidemia.
Am Fam Physician 2010;81:1097‑102.
16. Shahril MR, Wan Dali WP, Lua PL. A 10‑week multimodal
nutrition education intervention improves dietary intake among
university students: Cluster Randomised Controlled Trial. J Nutr
Metab 2013;2013:658642.
17. Mumena W, Abdulhakeem F, Jannadi N, Almutairi S, Aloufi S,
Bakhishwain A, et al. Nutrition education intervention to limit
added sugar intake among university female students. Prog Nutr
2020;22:e2020038.
18. Yahia N, Brown CA, Rapley M, Chung M. Level of nutrition
knowledge and its association with fat consumption among
college students. BMC Public Health 2016;16:1047.
19. Ranga L, VenterI. The association between dietary fat knowledge
and consumption of foods rich in fat among black first‑year
students in a south African university self‑ catering residences.
J Consum Sci 2017;2:95‑112.
20. Valentin N, Andreea S, Monica T, Zoltan A. Maternal knowledge,
attitudes and practices regarding dietary fats. Acta Medica
Marisiensis 2016;62:346‑9.
21. Eckel RH, Kris‑Etherton P, Lichtenstein AH, Wylie‑Rosett J,
Groom A, Stitzel KF, et al. Americans’ awareness, knowledge,
and behaviors regarding fats: 2006‑2007. J Am Diet Assoc
2009;109:288‑96.
22. Tabatabaei‑Malazy O, Qorbani M, Samavat T, Sharifi F, Larijani B,
Fakhrzadeh H. Prevalence of dyslipidemia in Iran: A systematic
review and meta‑analysis study. Int J Prev Med 2014;5:373‑93.
23. Arai K, Maeda E, Iwata T, Tanaka O, Murata K, Sakamoto M.
Impact of dietary behaviors on dyslipidemia in Japanese male
workers. Ann Transl Med Epidemiol 2014;1:1003.
24. Venter I. Construction of a valid and reliable test to determine
knowledge on dietary fat of higher‑educated young adults. S Afr
J Clin Nutr 2008;21:133‑9.
25. Venter I, Winterbach A. Dietary fat knowledge and intake
of mid‑adolescents attending public school in the Bellville/
Durbanville area of the city of Cape Town. S Afr J Clin Nutr
2010;23:75‑83.
26. Lawshe CH. A Quantitative approach to content validity. Pers
Psychol 1975;28:563‑75.
27. Polit DF, Beck CT. Nursing Research: Principles and Practice.
7th ed. Philadelphia: Lippincott Williams & Wilkins; 2004.
28. Landis JR, Koch GG. The measurement of observer agreement
for categorical data. Biometrics 1977;33:159‑74.
29. Cronbach LJ. Coefficient alpha and the internal structure of tests.
Psychometrika 1951;16:297‑334.
30. Kroeze W, Oenema A, Campbell M, Brug J. The efficacy of
Web‑based and print‑delivered computer‑tailored interventions
to reduce fat intake: Results of a randomized, controlled trial.
J Nutr Educ Behav 2008;40:226‑36.
31. Manios Y, Moschonis G, Katsaroli I, Grammatikaki E, Tanagra S.
Changes in diet quality score, macro‑ and micronutrients intake
following a nutrition education intervention in postmenopausal
women. J Hum Nutr Diet 2007;20:126‑31.
32. Ahmad Z, Pirzadeh A, Hasanzadeh A, Mostafavi F. The effect
of a social cognitive theory‑based intervention on fast food
consumption among students. Iran J Psychiatry Behav Sci
2018;12:e10805.
33. Abood AD, Black RD, Feral D. Nutrition education worksite
intervention for university staff: Application of the health belief
model. J Nutr Educ Behav 2003;35:260‑7.
34. Pletzke V, Henry WB, Ozier DA, Umoren J. The effect of nutrition
education on knowledge, attitude, and behavior relating to trans
fatty acids in foods. Fam Consum Sci Res J 2010;39:173‑83.
35. Kamran A, Shekarchi A, Sharifirad G, Sharifian E, Shekarchi L.
Evaluating dietary perceptions education program among rural
hypertensive patients on commitment and adherence to healthy
diet. J Hum Health 2015;1:7‑12.
36. Geaney F, Kelly C, Scotto Di Marrazzo J, Harrington MJ,
Fitzgerald PA, Greiner AB, et al. The effect of complex workplace
dietary interventions on employees’ dietary intakes, nutrition
knowledge and health status: A cluster controlled trial. Prev
Med 2016;89:76‑83.
37. FrancisM, Nichols SSD, Dalrymple N. The effects of a school‑based
intervention programme on dietary intakes and physical activity
among primary‑school children in Trinidad and Tobago. Public
Health Nutr 2010;13:738‑47.
38. Park SH, Shin JW, Kim SH, Chang KJ. Positive changes in blood
lipid profiles, nutrition knowledge, and dietary taurine intake
after 8‑week nutrition education program in low‑income Korean
children. Adv Exp Med Biol 2019;1155:273‑82.
39. Diekman C, Malcolm K. Consumer perception and insights on
fats and fatty acids: Knowledge on the quality of diet fat. Ann
Nutr Metab 2009;54 Suppl 1:25‑32.
40. Packman J, Kirk SFL. The relationship between nutritional
knowledge, attitudes and dietary fat consumption in male
students. J Hum Nutr 2000;13:389‑95.17.
41. OliN, Vaidya A, Pahkala K, Eiben G, Krettek A. Knowledge,
attitude and practice on diet and physical activity among
mothers with young children in the Jhaukhel‑Duwakot
Health Demographic Surveillance Site, Nepal. PLoS One
2018;13:e0200329.
42. Hatefnia E, Alizadeh K, Ghorbani M. Applying the theory of
planned behavior to determine factors associated with physical
activity by women with hypertension in rural areas of Iran. Asian
Biomed (Res Rev News) 2018; 12:83–90.
43. Pirzadeh A, Hazavei MM, Entezari MH, Hasanzadeh A. The effect
of educational intervention on girl’s behavior regarding nutrition:
Applying the beliefs, attitudes, subjective norms, and enabling
factors. J Educ Health Promot 2014;3:79.
44. EngbersLH, van Poppel MNM, Chin A Paw M, van Mechelen W.
The effects of a controlled worksite environmental intervention on
determinants of dietary behavior and self‑reported fruit, vegetable
and fat intake. BMC Public Health 2006;6:253.