ABSTRACT
This chapter aims to promoting dietary change presents a unique challenge to health professionals. It draws on the literature on adherence to dietary advice in the context of lipid lowering in relation to Coronary Heart Disease. Adherence is a complex concept encompassing both the behavioural goal and the processes and context of that change. The assessment of adherence therefore requires a clear specification of the desired behaviour change, and a valid method of detecting whether the change has taken place. A commonly used alternative to assessing behavioural adherence is to use the level of a clinically relevant outcome as an index of dietary change, for example changes in serum lipid profile or weight. The problems raised by defining or assessing adherence to dietary advice are augmented by the design of interventions. The chapter examines the adherence to community-wide dietary interventions, which are usually designed to prevent the development of diet-related disorders.
