Improvement in Healthy Meal Index, Lunch Quality, and Diversity Scores Following an Integrated Nutritional Intervention in a Communal Dining Room: The NEKST Study.

Ofira Katz-Shufan,Danit R Shahar,Liron Sabag,Tzahit Simon-Tuval

doi:10.3390/nu12061741

Abstract

The objective of the NEKST (Nutrition Environmental Kibbutzim Study), a nonrandomized interventional study, was to evaluate the effect of an integrated intervention program on participants’ lunch quality and diversity in two communal dining rooms (intervention n = 58 vs. control n = 54). The intervention included recipe modification, environmental changes, and an education program. The outcomes included simple healthy meal index (SHMI), lunch quality (LQS), and diversity scores (LDS) calculated based on photographs of lunch trays. A nutrition questionnaire assessed the changes in fruit and vegetable intake at baseline and 3 months following the intervention. The mean SHMI, LQS, and LDS increased in the intervention group (0.51, p < 0.001; 0.27, p = 0.045; 0.95, p < 0.001, respectively) but not in the control group (p = 0.865; p = 0.339; p = 0.354, respectively). Multivariable linear models demonstrate an increase in the SHMI (β = 0.26, 95% CI [0.12–0.76], p = 0.015), LQS (β = 0.23, 95% CI [0.06–0.83], p = 0.024), and LDS (β = 0.34, 95% CI [0.41–1.39], p < 0.001) of the participants in the intervention group. More participants in the intervention group raised their daily fruit intake compared with the control. We conclude that this integrated intervention program was effective in improving lunch healthy meal index, quality, and diversity in a communal dining room, with a modest halo effect of the intervention throughout the day.

Highlights

Nutritional quality is a cornerstone in preventing chronic diseases and maintaining health [1].One of its key expressions is the increased intake of desirable food groups such as fruits, vegetables, whole grains, nuts, and legumes, and limited intake of saturated and trans fats, added sugars, and sodium [2,3]
This study evaluated the effect of an integrated intervention program versus an educational program only on the food choices of regular diners in a communal dining room
We found that the intervention program was effective in improving the food quality and diversity of participants’ food choices during lunch, mainly due to an increase in the choice of fruits and vegetables

Summary

Introduction

One of its key expressions is the increased intake of desirable food groups such as fruits, vegetables, whole grains, nuts, and legumes, and limited intake of saturated and trans fats, added sugars, and sodium [2,3]. These components, the intake of fruits and vegetables, have consistently been shown to be associated with health outcomes [4,5]. Focusing on improving diet quality and diversity and increasing fruit and vegetable intake through an intervention program may be beneficial in improving public health.

Methods

Results

Conclusion