The first nutritional counseling session was then conducted with the objective of
reducing dietary intake of total lipids, saturated fatty acids and trans-fatty acids. The group
received counseling by the nutritionist such as food groups and specific items, frequency, and
portion size of each food group to be consumed, and they were asked to follow a specific
daily food plan. The food plan included daily consumption of whole grains and products, 3
fruits, 2 portions of dark green vegetables, 2 portions of dark yellow vegetables and 2 units of
Brazil nuts (10 grams). The participants were also instructed to reduce intake of red meat,
replacing it by chicken or fish, to substitute margarine for halvarine or fruit jam or
ricotta/yogurt pâté, to use olive oil for salad dressing, to use soy oil for cooking, to
reduce/eliminate their intake of fried foods and sandwiched cookies, and increase the intake
of low-fat milk. The same investigator gave all the information about the food plan. After the
first nutritional counseling, another blood lipids tests were requested, to be carried out one
week prior to the next visit.
During this study, the participants had at least two sessions of nutrition counseling
and the 24-hour recall was completed using a photograph album of food portions (Zabotto,
1996) to help them to identify the size of portions. The quantity of food and/or preparations
not illustrated in the photo album was estimated in accordance with the report given by the
patient. The 24-hour recall was used to measure dietary intake, in both the beginning and at
the end of the study, to verify the acceptability and compliance with the established
methodology and to reinforce the key principles of the diet