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Title:Impact of lifestyle intervention for free-living adults on bone-related knowledge and behavioral indicators
Author(s):Plawecki, Karen L.
Director of Research:Chapman-Novakofski, Karen M.
Doctoral Committee Chair(s):Evans, Ellen M.
Doctoral Committee Member(s):Chapman-Novakofski, Karen M.; Harvey, Idethia S.; Gundersen, Craig
Department / Program:Nutritional Sciences
Discipline:Nutritional Sciences
Degree Granting Institution:University of Illinois at Urbana-Champaign
bone health
behavior change
food frequency
Abstract:The purpose of this research was to measure and evaluate lifestyle changes affecting bone health. Osteoporosis is a public health concern. Improving bone health, thereby preventing osteoporosis and fractures, can lead to a reduction in health care costs. Calcium is a key player in bone health. With an increase in calcium-fortified foods an objective was to develop a food frequency questionnaire that assesses both natural and fortified sources of calcium. A validation study in which the Calcium-Focused Food Frequency Questionnaire (CFFFQ) was tested against a 24-hour recall in adult females (pilot study, n=15) and college-aged females (primary study, n=300). In the pilot study, no significant differences in calcium intake for total calcium or food group category was found except for calcium from “foods with dairy” (t=2.23, p=.043) and “vegetable” (t=-3.106, p=.008). In the primary study and after removal of outliers (n= 187), significant correlations (r=.155 to.74, p<.04) were found between calcium (mg) in CFFFQ and 24-hour recall for “dairy”, “foods with dairy”, “fruit”, “vegetables”, “grains” groups and total calcium. In the reliability study, all groups were significantly correlated (r=.155 to .96, p<.034) except for the dairy. In using the CFFFQ with post-menopausal women [46 black and 139 white post-menopausal women (age 69.4 +5.8 years)], as daily calcium intake increased, the 24-hour recall increasingly underreported calcium (r = .41, p<.001). Per cross-tabulation and Chi-square analyses, the CFFFQ had greater specificity for lower calcium intakes. For calcium classified by food groups, there was moderate correlation for dairy (r = .56, p<.001) and fruit groups (r = .434, p<.001). Dairy was the primary calcium source for both groups (55% and 57% of intake for black, white women, respectively). The CFFFQ can be used to identify those with inadequate calcium intakes (<800 mg/day) and to identify key sources of dietary calcium. The CFFFQ was used in part of the larger bone-health community program (8 weeks) addressing disease risk and lifestyle changes within the framework of behavior constructs (n=69). There was significant increases in calcium intake (p<.027) and vitamin D intake (p<.015), with calcium from the fruit group (p<.005, 24-hour recall) and grain group (p<.042, CFFFQ). There was a significant change (p<.01) in 3 of 5 items related to susceptibility; 3 of 3 items related to perceived severity (p<.03); in 5 of 5 items related to benefits of nutrition changes (p<.001); in 1 of 7 items related to nutrition barriers (p<.05); in 4 of 4 nutrition self-efficacy items (p<.01); in 4 of 6 items related to subjective norm (p<.05); in 4 of 5 nutrition attitudes (p<.05) and 3 of 4 intentions (p<.01) [Wilcoxon Signed Rank]. This theory-based program was successful in improving calcium intake, vitamin D intake and Health Belief Model (HBM) and Theory of Reasoned Action (TRA) constructs related to bone-healthy diets, implying effective program applications to clinic and community-based practice.
Issue Date:2010-01-06
Rights Information:Copyright 2009 Karen L. Plawecki
Date Available in IDEALS:2010-01-06
Date Deposited:December 2

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