Stage-matched nutrition guidance: Stages of change and fat consumption in Dutch patients at elevated cardiovascular risk

Objective: To assess the effects of stage-matched nutrition counseling on stages of change and fat intake. Design: Controlled clinical trial. Setting: 9 family practices in a family medicine practice network. Participants: 143 patients at elevated cardiovascular risk, aged 40 to 70 years. Intervention: Intervention patients received stage-matched counseling from their family physician and a dietitian. Control patients received usual care. Main Outcome Measures: Stages of change and fat intake were measured at baseline and after 6 and 12 months. Analysis: Chi-squared tests, t tests, and regression analyses (α = .05) were conducted. Results: More patients in the intervention group than in the control group were in the postpreparation stage after 6 months (70% vs 35%; P < .01) but not after 12 months (70% vs 55%; P = .10). Between 0 and 12 months, the reduction in total fat intake (-5.6% kcal vs -2.4% kcal) was largest in the intervention group. Conclusions and Implications: Stage-matched nutrition counseling promotes movement through stages of change, resulting in a reduced fat intake. Our results partly support stages of change as a tool for behavior change. Movement across stages of change was not a mediating factor in the intervention effects. Research should focus on feasible ways to keep patients in the postpreparation stage.