Rate your plate: An eating pattern assessment and educational tool used at cholesterol screening and education programs

Elevated blood cholesterol has been established as an important risk factor for coronary heart disease (CHD) (1-3). Currently, approximately 57% of adult Americans have blood cholesterol levels of200 mg/dl or higher, with approximately 27% having high levels of 240 mg/dl and above (4). The development of portable desktop analyzers, which allow for simple, rapid and accurate measurement of cholesterol levels, has permitted widespread screening for blood cholesterol. Public blood cholesterol screenings offer an opportunity for detecting large numbers of individuals with high blood cholesterol levels as a supplement to those identified by traditional physician office testing (6). In October 1988, the National Heart Lung and Blood Institute (NHLBI) published recommendations regarding public screening for measuring blood cholesterol (7). This report stressed the need to educate participants concerning the relationship of diet to blood cholesterol, the importance of a balanced healthy eating pattern to lower blood cholesterol, and clear information on cholesterollowering dietary alternatives (7). In order for screening staff to provide participants with relevant cholesterol-lowering dietary recommendations, an assessment of their current eating pattern status is necessary. Most generally accepted dietary assessment methods, e.g., food diaries and lengthy food frequency questionnaires, are too expensive and time-consuming for a community screening setting, or do not give an indication of the usual eating pattern, i.e., 24 hour recall (8-16). Brief dietary assessment tools are becoming increasingly popular (17-19), but there is still a need