Effectiveness of Interventions and Behaviour Change Techniques for Improving Dietary Intake in Young Adults: A Systematic Review and Meta-Analysis of RCTs.

Ashton Ashton,Hutchesson Hutchesson,Williams Williams,Collins Collins,Sharkey Sharkey,Whatnall Whatnall,Aguiar Aguiar,Bezzina Bezzina

doi:10.3390/nu11040825

Ashton Ashton, Hutchesson Hutchesson + Show 6 more

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https://doi.org/10.3390/nu11040825

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Abstract

Poor eating habits are common during young adulthood and influence chronic disease morbidity. This systematic review evaluates the effectiveness of interventions aiming to improve dietary intake among young adults and, identifies which behaviour change techniques (BCTs) are most effective. Six electronic databases were searched for RCTs published until October 2018, and evaluating behavioural interventions assessing change in dietary intake in young adults (17–35 years). Of the 18,779 articles identified, 54 were included. Forty studies focused on fruit and/or vegetable intake, of which 63% showed a significant between-group difference in favour of the intervention group. Meta-analysis (n = 17) demonstrated a significant increase in fruit and vegetable intake of +68.6 g/day after three months of intervention and +65.8 g/day for interventions >3 months when compared to control. A meta-analysis (n = 5) on total energy intake found no significant differences between groups. The BCTs with the highest effectiveness ratio were habit formation (100%), salience of consequences (83%) and adding objects to the environment (70%). The review highlights the potential of behavioural interventions to improve young adults’ fruit and vegetable intake but was less convincing for other dietary outcomes. Due to the lack of studies including each BCT, the BCTs imperative to success could not be identified.

Highlights

Young adults have some of the unhealthiest eating habits compared to other age groups.In a systematic assessment of diet quality among adults in 187 countries, those aged 20–29 years had the lowest diet quality score compared to any other age group [1]
The results show no particular pattern as to whether fewer or more behaviour change techniques (BCTs) were associated with effectiveness
This systematic review and meta-analysis highlights the potential of lifestyle behavioural interventions to improve young adults’ fruit and vegetable intake, but the evidence was less convincing for other dietary outcomes

Summary

Introduction

Young adults have some of the unhealthiest eating habits compared to other age groups.In a systematic assessment of diet quality among adults in 187 countries, those aged 20–29 years had the lowest diet quality score (mean 36 ± 10 out of a maximum of 100 with higher score indicating better diet quality) compared to any other age group [1]. The key transitions include changes in the living situation, with individuals often moving out of the family home to live independently; changes in the social environment and social influences; moving from family dependence towards stronger peer networks and partner relationships; changes in work and/or study from secondary to tertiary education and into employment or unemployment; and changes in financial status with young adults becoming financially independent [3] These key life transitions are associated with negative changes to the diet [4] and present an opportunity to target improvement in eating habits during this life stage. Poor diet quality is one of the leading causes of mortality and disability worldwide [5], and intervening while adults are still young is central to the prevention of noncommunicable chronic diseases and promotion of healthy ageing [6]

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