- The purpose of this study was to develop and evaluate a nutrition
education program for men on healthy eating when dining out. The
Health Belief Model provided the basic framework to identify factors that
would potentially motivate men over 40 to change their dietary behavior
to reduce heart disease risk.
Roundtable discussions were held to identify nutrition needs. A 10
minute "Dine Right with MENu Insight" slide program on low-fat eating
away from home was developed. Three educational messages were the
key concepts of the program: 1) relationship between diet and health, 2)
proportionality, variety and moderation as themes of the Food Guide
Pyramid and 3) low-fat food choices at home and away. A four page
handout was developed to supplement the slide show presentation.
Four programs were presented to a total of 148 people (136 males,
12 females) at Rotary and Kiwanis groups in Corvallis and Albany,
Oregon in January and February, 1994. Each program included a pretest,
the "Dine Right with MENu Insight" slide presentation and a group discussion. Of the 136 males, forty-eight volunteered (aged 40-60 years)
and completed the 10-15 minute follow-up phone post-test 3-4 weeks
after attending the program.
Pre-test responses showed limited knowledge of the Food Guide
Pyramid, with 65% of the men incorrectly selecting the vegetable group as
the base of the Pyramid. Knowledge of low-fat menu choices was high
with an average score of 4.7+1.1 (out of a possible 5 points) and a range
of 0-5 prior to the education program. An attitude score measuring
awareness of healthy dietary practices underlying the Pyramid (eg,
variety, proportionality and moderation) had a mean of 5.3+1.7 (out of a
possible 15) with a range of 3-8. These pre-test data suggested that
participants were aware of the relationship between diet and health.
In the post-test, 98% of the men correctly selected the bread group
as the Food Guide Pyramid food group that should be eaten in the largest
amount. This was a significant increase (p<.001) from pre-test scores.
Half of the men had heard of the Pyramid prior to the program. A
reassessment of healthy dietary practices awareness showed a significant
increase in positive attitudes (p [less than or equal to] .001) with a mean of 3.6+.93 (out of a
possible 15 points) and a range of 5-7. Seventy-three percent of the men
reported that their diet could be "somewhat healthier". In the past year,
69% reported increasing their consumption of foods (eg, vegetables,
grains) to reduce heart disease; 79% reported decreased consumption (eg,
red meat). Seventy-five percent reported that they "sometimes" try to
select lower fat foods when eating out. Personal preference (65%), menu
selection (80%) and the restaurant (27%) influenced lower fat food
Many participants indicated awareness of the relationship between
proper food selection and optimal health before the program. However,
awareness did increase as a result of the program. There was a
significant positive (p [less than or equal to] .005) change in attitudes toward the importance of
watching fat in the diet in order to stay healthy between pre and posttests.
In addition, a positive (r=.36, p [less than or equal to] .05) correlation was reported
between knowing that the amount of dietary fat affects the chance of
heart disease and watching fat in the diet in order to stay healthy. These
data suggest that the Dine Right program conveyed a tie between diet
and optimum health.
Significant changes in participants' knowledge about the Food
Guide Pyramid and underlying concepts also suggest that the program
had an impact on participants. These data suggest that knowledge of
nutritious food choices at home and away from home increased or was
reinforced by the program.
The majority (79%) of men learned "some new things" from the
program. As a result of the program, 65% planned on making changes in
their diets when eating out (eg, by increasing grains, fruits, vegetables).
Thirty-five percent planned to make changes at home. Eighty-three
percent reported showing the Dine Right handout to someone else and
85% talked about the program with their spouse, family member,
coworker or friend.
The results of this research indicate that men respond to nutrition
education programs. Therefore nutrition and health campaigns to reach
the American male are merited. Men's health and nutrition programs
such as "Dine Right with MENu Insight" could be followed by additional
education programs utilizing a theoretical framework.
Future research should test each of the components of the Health
Belief Model on men's dietary behavior. Also extensions to other samples
of men (such as those with lower educational levels) is warranted in order
to better understand how to target nutrition education programs to this