People who are confident, comfortable and flexible with their eating habits may be at a significantly lower risk of cardiovascular disease than people who are not. Researchers at Penn State suggest that a curriculum that helps people understand their eating habits could prove to be an important medical nutrition therapy.

"We wanted to see if people were at higher risk of developing cardiovascular disease if they were not eating competent to begin with," said Barbara Lohse, associate professor of nutritional sciences.

Lohse and her colleagues Sheila G. West, associate professor of biobehavioral health, and Tricia L. Psota, graduate student, measured eating competence among 48 men and women aged 21 to 70, who were at risk for cardiovascular disease. Eating competence, as defined by registered dietitian and mental health professional Ellyn Satter, is a nutritional model -- termed ecSatter -- that incorporates processes such as awareness of hunger, appetite and eating enjoyment with the body's biological tendency to maintain a preferred and stable weight.

"This population was already at high risk due to high levels of LDL -- the bad cholesterol -- and elevated total cholesterol, but did not have any other type of chronic disease," said Lohse.

Based on their responses to a questionnaire on eating competence, and readings of various biological markers of cardiovascular disease, the researchers found that participants who were not eating competent were five times more likely to have a LDL greater than the cutoff prescribed by the American Heart Association, and seven times more likely to have levels greater than that for triglyceride.

Lohse says that rather than only providing people with dietary information to lower their LDL or triglyceride levels, it might be more prudent to train people in becoming eating competent. She, however, cautions that the results offer only a snapshot in time indicating that future longitudinal studies will be required to reach a more comprehensive conclusion.

"What we have shown with this research is that we now have an instrument to measure eating competence. We are developing a curriculum that we are going to test until we know it instills eating competence," said Lohse, whose findings appear in the current issue (September/October) in the Journal of Nutrition Education and Behavior. The journal has published a special section on the ecSatter eating competence model and studies evaluating its effectiveness.

Such a curriculum, the Penn State researcher said, might provide a viable successful option to encourage eating behaviors that we know are associated with lower risk of cardiovascular disease. The journal's special section is partially funded by Penn State's Department of Nutritional Sciences and College of Health and Human Development and the Sunflower Foundation.