Effect of a community-based intervention on nutritional behaviour in a developing country setting: the Isfahan Healthy Heart Programme

Objective: The present study was conducted to determine the impact of a community-based intervention on the nutritional behaviour of a representative sample of Iranian adults. Design: The Isfahan Healthy Heart Programme (IHHP), a six-year, action-oriented, integrated community-based study aimed at health promotion through the reduction of CVD risk factors, targeted the whole population living in two intervention cities, and compared outcomes with the population of a non-intervention city considered as reference. Dietary interventions were performed as educational, environmental and/or legislative strategies. A global dietary index (GDI) was calculated representing the general dietary behaviour. In addition, two consumption indices were calculated for specific food groups, i.e. meat products and major sources of fat. Univariate AVOVA was conducted to evaluate the impact of the intervention on dietary behaviours. Setting: Isfahan and Najaf-Abad (intervention cities) and Arak (reference city), central Iran. Subjects: The baseline survey was conducted among 12 514 randomly selected adults aged≥19 years in both intervention and reference areas. The survey was repeated annually among about 5000 persons (2002-2005) in the intervention and reference communities. Results: According to significant year × group interactions in mean fat consumption index (FCI) and meat consumption index (MCI) in the total population, a significant improvement in FCI and MCI was found in the intervention areas v. the reference area (P< 0-001). In addition, the GDI improved significantly in the intervention areas v. the reference area (P< 0·001). Conclusions The IHHP interventions were effective in improving dietary behaviours at the population level. The highest effectiveness was documented in the change in the type of fat consumed. Such simple and integrated interventions can be adopted in other developing countries with limited financial resources.