Determinants of dietary behavior among youth: an umbrella review.

Ester F C Sleddens,Leonie F M Kohl,Elizabeth Velema,Johannes Brug,Willemieke Kroeze,Pam J Kaspers,Stef P J Kremers,Laura M Bolten

doi:10.1186/s12966-015-0164-x

Abstract

BackgroundThe literature on determinants of dietary behavior among youth is extensive and unwieldy. We conducted an umbrella review or review-of-reviews to present a comprehensive overview of the current knowledge.MethodsTherefore, we included systematic reviews identified in four databases (i.e. PubMed, PsycINFO, The Cochrane Library and Web of Science) that summarized determinants of observable child and adolescent dietary behaviors. Data extraction included a judgment of the importance of determinants, strength of evidence and evaluation of the methodological quality of the eligible reviews.ResultsIn total, 17 reviews were considered eligible. Whereas social-cognitive determinants were addressed most intensively towards the end of the 20th century, environmental determinants (particularly social and physical environmental) have been studied most extensively during the past decade, thereby representing a paradigm shift.With regard to environmental determinants, mixed findings were reported. Sedentary behavior and intention were found to be significant determinants of a wide range of dietary behaviors in most reviews with limited suggestive evidence due to the cross-sectional study designs. Other potential determinants such as automaticity, self-regulation and subjective norm have been studied in relatively few studies, but results are promising.ConclusionThe multitude of studies conducted on potential determinants of dietary behavior provides quite convincing evidence of the importance of several determinants (i.e. quite some variables were significantly related to dietary behavior). However, because of the often used weak research designs in the studies covered in the available reviews, the evidence for true determinants is suggestive at best.

Highlights

The literature on determinants of dietary behavior among youth is extensive and unwieldy
Main results The multitude of studies conducted on determinants of dietary behavior among youth provides mixed and sometimes quite convincing evidence regarding associations between potential determinants and a range of dietary behaviors
The evidence gathered in our umbrella review suggests that intention and sedentary behavior have the strongest evidence base as determinants of healthy and unhealthy dietary behavior in youth

Summary

Introduction

The literature on determinants of dietary behavior among youth is extensive and unwieldy. Interventions to improve health-related behaviors should be tailored to the most important and changeable determinants of these behaviors, preferably applying behavior change theories [3]. To facilitate improvement of relevant, effective programs and policies promoting healthy eating targeting dietary behavior it is important to identify the various factors that may influence children’s and adolescents’ food consumption. Socio-cognitive models of (health) behavior and behavior change, such as the Theory of Planned Behavior [4], Social-Cognitive Theory [5], and the Health Belief Model [6] have been applied frequently in development of nutrition education interventions. In very general terms -and not paying attention to the richness of and differences between these models- these theories regard nutrition behavior to be determined by beliefs and conscious decisions, rational considerations of pros and cons of the behavior, perceived social influences, and assessment of personal efficacy and control.

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