Results of a two-year health education campaign on dietary behavior. The Stanford Three Community Study

A two-year, bilingual mass-media health education campaign was carried out in two communities with a third serving as control. In one of the two treated communities, personal couseling of high risk individuals ("intensive instruction") took place. Dietary behavior, before and after the campaigns, was assessed using a dietary questionnaire which estimated the average daily consumption by participants of cholesterol, saturated fat, and polyunsaturated fat. Both intensive instruction and the mass-media campaigns led to significant reductions (20-40%) in cholesterol and saturated fat consumption in both men and women, with intensively instructed men tending to outperform men exposed to mass-media alone. In general, the improvements in the treated communities were maintained over the two years of the study, whereas the initial small drops in the control community at the end of the first year were followed by recidivism during the second year. Polyunsaturated fat consumption fell slightly in all three communities so that increases in P/S ratios in the two treated communities were of only modest degree. Mean changes in plasma cholesterol concentration for the various cohorts under study were higly correlated with those which would have been predicted on the basis of the self-reported changes in dietary behavior. The results indicate that mass-media health education campaigns can lead to significant changes in dietary practices in the general population with potentially important public health implications.