A review of community based healthy eating interventions

Abstract

Background: Across the world the burden of diet related chronic disease is increasing rapidly (World Health Organization, 2003). Several global, European and national strategies acknowledge the issue and set targets for change but limited work has been carried out into the effectiveness of interventions to change the dietary behaviour of individuals. The aim of this study was to review the effect of community based healthy eating interventions on dietary behaviour within the general population.Methods: A literature review using a systematic approach was carried out using the electronic databases CINAHL, EMBASE, PubMed and Medline with the search terms ‘nutrition’, ‘healthy eating’, ‘community interventions’, and ‘evaluation’. The search was limited to primary research studies, published in English from 1996 to March 2006, conducted in westernised countries and reporting outcome indicators related to obesity and coronary heart disease. Studies focusing on older people, pre‐school children pregnant or breastfeeding women were excluded. In order to assess the methodological quality of the studies included in the review, an assessment tool was developed based on similar tools used in other reviews (Ammerman et al.,2002; Pomerleau et al., 2005).Results: Thirty‐one studies were retrieved and reviewed. These included 17 randomised controlled trials, 10 intervention studies and four evaluation studies. The mean methodological quality score was 58 (maximum possible score 100). In total there were six adult studies (three targeting adults living on a low income) five family studies (three targeting Black and Minority Ethnic groups), 15 children and adolescent studies (six targeting Black and Minority Ethnic groups) and five public policy development and evaluation studies. High intensity, multi‐faceted interventions had a greater effect on positive dietary changes than lower intensity interventions although innovative interventions using the Internet, videos, the media and supermarkets were a success.Discussion: The implications of this review for practice are varied and must be considered alongside government policy for improving health. The review has found that high intensity, multi faceted interventions are the most effective in promoting dietary change but without an increase in current resource for such interventions, low‐cost, low intensity interventions are more readily available.Conclusions: Community based healthy eating interventions were effective in changing dietary behaviour in the general population. The small number of studies retrieved and the methodological problems highlighted indicate that further, more robust research is needed to inform public health policy and practice in the future.References Ammerman, A.S., Lindquist, C.H., Lohr, K.N. & Hersey, J. (2002) The efficacy of behavioral interventions to modify dietary fat and fruit and vegetable intake: a review of the evidence. Prev. Med. 35, 25–41.Pomerleau, J., Lock, K., Knai, C. & McKee, M. (2005) Interventions designed to increase adult fruit and vegetable intake can be effective: a systematic review of the literature. J. Nutr. 135, 2486–2495.World Health Organization. (2003) Diet, Nutrition and the Prevention of Chronic Disease. World Health Organization, Technical Report Series 916.