Fat-gram counting and food-record rating are equally effective for evaluating food records in reduced-fat diets

Objective: To compare rates of adherence to low-fat diets using food- record rating and fat-gram counting, to evaluate dietary adherence using the fat-gram counting method, and to assess correlations between food-record rating and fat-gram counting. Design: A diet monitoring and observation study was conducted to compare the effectiveness of food-record rating and fat- gram counting to evaluate dietary adherence. Subjects were randomly assigned to the food-record rating group of the fat-gram counting group. Each participant was asked to complete four 3-day food records. Food records were evaluated by food-record rating for one group and by fat-gram counting for the other. Each record was then scored using the alternate system. For a subset, manually calculated fat-gram values were compared for accuracy with values from the Nutrient Data Systems database. Statistical analyses performed: Mantel-Haenszel χ², regression, and K analyses were used to evaluate adherence rates and within-subject agreement between fat-gram counting and food-record rating. Subjects/setting: Seventy-eight participants were recruited from a lipid-lowering research trial conducted in Houston Tex. Results: Strong correlations were found between fat-gram values calculated manually and those calculated using the Nutrient Data Systems. No significant differences in adherence rates were found between the food-record rating and fat-gram counting groups. Conclusions: Fat-gram counting is at least as effective as food-record rating in monitoring dietary fat content. Dietitians can use it as an alternative dietary fat-monitoring procedure for clinical practice and research.