A Health Education Intervention to Increase Fiber Intake: A Randomized Clinical Trial

Abstract

The intake level of fiber, a nutrient with a vast number of health benefits, falls behind the recommendations nationwide. The impact of nutrition education on improving daily intake has thus been investigated and shown to be effective in enhancing the intake of specific fiber-rich foods. Not much has been done to probe the effect of education on enhancing fiber intake with emphasis on all sources of dietary fiber. Thus, we conducted a randomized controlled trial to determine if a multi-component intervention—the Full Plate Diet— that places emphasis on fiberrich foods, impacts the dietary fiber intake to a level that exceeds the recommendations of the Institute of Medicine. Thirty-five subjects (7 males and 28 females) were randomly assigned to either the intervention group (n=20), which received the nutrition/health education or to the control group (n=15) which did not receive the education. A collective analysis of the two groups’ dietary intake was divided into three time points; April, May, and June. The recalled intake of dietary fiber and food groups considered to be rich sources of dietary fiber as well as macronutrients were averaged for each of these time points for each treatment group. For the purpose of comparing changes in intake of dietary fiber across the 3 time points and between the intervention and control groups, a linear mixed-model was used. The delta changes between the various time points were computed by subtracting the final time point minus the initial time point. Results showed that fiber intake increased significantly by 9.3 grams from the first time-point (April) to the second time-point (May) (95% CI 2.2, 16.4). The intake of legumes significantly improved by 0.36 (95% CI: 0.01, 0.7) and by 0.65 (95% CI: 0.3, 1.0) servings in the intervention group between baseline and the second and third-time (June) points, respectively, but did not change in the control group. Short-term education with emphasis on fiber intake from various food sources could improve the daily fiber intake. Longer follow-up investigations should also be conducted to assess whether or not health education could significantly improve the level of fiber on a longterm basis.