Does dietary health education reach only the privileged? The Stanford Three Community Study

The relationship of selected social factors to diet, weight and plasma cholesterol was studied in one control and two treatment towns before and after a 3-year, bilingual, mass-media health education program. Spanish-speaking persons reported higher dietary cholesterol and saturated fat than English-speaking participants at baseline, and this remained true after adjusting for the confounding influence of socioeconomic status (SES). Obesity was also more prevalent in Spanish-language and low-SES groups, but plasma cholesterol was not related to these sociodemographic factors. Over the 3 years of the education program, all groups reported 20-40% decreases in dietary cholesterol and saturated fat. These decreases were as large in low-SES groups as in high-SES groups; Spanish-speaking participants reported significantly greater decreases in dietary saturated fat (p = 0.02). Weight change was not related to either SES or language group, but change in plasma cholesterol was marginally more favorable in Spanish-speaking subjects (p = 0.06).