NUTRITIONAL ADEQUACY OF DIETS REPORTED AT BASE-LINE AND DURING TRIAL YEARS-1-6 BY THE SPECIAL INTERVENTION AND USUAL CARE GROUPS IN THE MULTIPLE RISK FACTOR INTERVENTION TRIAL

This chapter addresses whether a fat-modified diet as implemented by s pecial intervention participants in the Multiple Risk Factor Intervent ion Trial affected intake of vitamins and minerals, and whether nutrit ional adequacy was altered by this dietary intervention. Despite likel y underreporting of intake, for men in the special intervention group, most mean intakes of 15 micronutrients estimated from 24-h recalls we re above established recommended dietary allowances. A few means were slightly below; lowest was zinc at 77% (from 98% at baseline) followed by calcium at 79% (from 102% at baseline). Calculated as nutrient den sities (per 1000 kcal), nutrients that were below indexes of nutrition al quality (the corresponding standard based on nutrient density) duri ng follow-up, although not reduced below baseline by this measure, wer e vitamin D, calcium, iron (marginally), and zinc. Analyses by food gr oups indicated that intake of these nutrients might have been improved by greater replacement of high- and medium-fat dairy products with lo w-fat dairy products (for vitamin D and calcium) and of high-fat meats with low-fat meats, fish, or poultry (for iron and zinc), or (because iron was adequate) by increasing consumption of vegetables and whole- grain products. The safety of the eating pattern was further confirmed by more favorable micronutrient profiles in men who adhered best to t he intervention program, as measured by degree of serum cholesterol re duction and weight loss.