importance of motivation in the adherence to dietary advice: a one year follow up study of middle aged women with a supposed risk to develop diabetes

A 1-year follow-up study was undertaken in 53 women, 51-years old, selected from the population study of women in Gothenburg (1968-1969) on account of an impaired glucose tolerance or a subnormal early insulin response. A dietary interview was obtained initially as well as 1 year later. Initially, the women received dietary advice in order to improve their food habits in general, to exclude sucrose and decrease the consumption of fat in particular and, if overweight, to reduce. The women's opinion of how well they had followed the dietary advice was tested against the prognosis of the interviewer and against changes in body weight, in the consumption of sucrose, and in the consumption of some selected foods. 8 women had had rather good food habits and a normal body weight from the beginning of the study. Of the remaining 45 women, the adherence to the dietary advice was regarded as successful in 42 %, while 33 % made some good efforts. Most of the successful women were overweight initially and half of them had made several re-visits (3-31) during the year. The 11 unsuccessful women were not convinced as to the necessity of changing their food habits, or they received no support from their families. The results indicate that the primary task in the efforts to make a subject follow dietary advice is to explain him why changes are needed, and what makes the food proposed superior. Besides, continuous re-visits may be needed. A medical reason for the reduction of overweight seemed to be the best motivation.