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Reducing dietary fat,
saturated fat, and sodium and increasing intakes of dietary fiber and fruits and
vegetables are important for cardiopulmonary risk reduction. Behaviorally, these dietary
changes are very challenging, and in different ways. Fewer than half of U.S. adults have
diets meeting recommended intakes of these constituents, and many do not see a need to
align their diets with recommendations. Various nutrition education and behavioral
counseling approaches have been shown to facilitate changes in fat, fiber, sodium, and
fruits and vegetables, but primarily in research settings and among the highly motivated.
Practice-based and interdisciplinary studies are needed to refine strategies to effect
long-term dietary changes, to differentiate behavioral issues for changes involving
additions versus deletions from the diet, and to elucidate the roles of sensory,
psychosocial, and contextual factors in adoption and maintenance.