Improvements In Dietary Behaviors Research Articles

The effect of mindful eating on dietary behaviour and fasting blood glucose in type 2 diabetes mellitus patients

Diet plays a pivotal role in the comprehensive therapy for individuals with type 2 diabetes mellitus, contributing significantly to maintaining stable glycemic control. Mindful Eating, as an intervention, focuses on enhancing dietary behavior by directing attention, thoughts, and feelings towards eating activities. This study aimed to investigate the impact of mindful eating on dietary behavior and fasting blood glucose levels in individuals with type 2 diabetes mellitus. Employing a quasi-experimental method with a pretest-posttest control group design, the study included a sample of 63 participants (selected through convenience sampling). Data collection utilized the Personal Diabetes Questionnaire (PDQ) and a glucometer. Statistical analysis involved Wilcoxon, Mann-Whitney, and Independent T-tests. The findings revealed that mindful eating exercises had a significant influence on dietary behavior (p = 0.025) and fasting blood glucose levels (p = 0.033). The practice of mindful eating led to notable improvements in dietary behavior and ensured controlled fasting blood glucose levels by the study's conclusion. Incorporating mindful eating exercises into eating patterns is recommended as a crucial aspect of diabetes management, aiming to enhance dietary behavior and sustain stable glycemic control.

A Systematic Review of Dietary Interventions for Cancer Survivors and Their Families or Caregivers.

Family or caregiver engagement has the potential to support healthy dietary changes among cancer survivors. However, little is known about these family- or caregiver-involved dietary interventions and their effects. This systematic review aimed to identify the behavior change techniques (BCTs) used in dietary interventions for cancer survivors and their families or caregivers and to synthesize intervention effects on dietary and health outcomes. Following the PRISMA guidelines, we conducted systematic searches in three databases and identified 12 trials (16 peer-reviewed manuscripts) for inclusion in this review. Data were extracted from these manuscripts and the BCT taxonomy was used to identify the BCTs. A total of 38 BCTs were identified from 12 trials, 13 of which were used in at least half of the 12 trials. Ten studies reported significant intervention effects on health outcomes (e.g., adiposity) and six suggested significant improvements in dietary behaviors (e.g., fruit and vegetable intake). Overall, this review found that family- or caregiver-involved interventions for cancer survivors significantly improved dietary and health outcomes. Future research should identify BCTs particularly for dietary changes and develop effective dyadic strategies to facilitate diet-related interactions between survivors and their families or caregivers to enhance their engagement in healthy diets.

The Effect of Retail Food Environment Interventions on Dietary Behavior in Postsecondary Education Settings: A Systematic Review and Meta-analysis

BackgroundPostsecondary education institutions, where hundreds of millions of people work and study globally, are a key setting for retail food environment interventions. ObjectiveWe aimed to synthesize the evidence for the effectiveness of retail food environment interventions in improving the healthiness of dietary behavior of students and staff in postsecondary education settings. MethodsAcademic databases were searched for randomized controlled trials (RCTs) and quasi-experimental studies published until August 2023. Studies were eligible if they assessed the impact of a retail food environment intervention on healthiness of dietary behavior (purchases or consumption) in students or staff in postsecondary education settings and targeted one of the following food environment elements: placement, price, product, or promotion. Business-related outcomes (total sales, profit, or revenue) were included as secondary outcomes. Findings were synthesized in narrative form, organized by retail food environment element. Where comparable dietary outcome data were available from ≥10 interventions, findings were pooled using random effects meta-analysis. ResultsOf 10,126 studies initially identified, 55 (76% quasi-experimental) were included, describing 71 separate interventions (n = 49 single-element and n = 22 multi-element). Two-thirds (n = 47, 66%) of interventions (n = 32 single-element and n = 15 multi-element) demonstrated significant improvements in dietary behavior. Single-element interventions targeting placement (n = 1) and price (n = 3) improved dietary behavior. Most (n = 9/10, 90%) interventions targeting product availability or convenience (product element) improved dietary behavior, while n = 19/35 (54%) targeting promotion did. Pooled findings from 12 interventions reporting changes in energy content demonstrated a significant decrease in purchased or consumed energy (-7.9%; 95% confidence interval: -10.3%, -5.6%). Almost all interventions (n = 11/12, 92%) that evaluated the impact on business-related outcomes found either a significant increase or no change following the intervention. ConclusionsWe established encouraging evidence supporting the role of retail food environment interventions in postsecondary education settings to support healthy dietary behaviors of students and staff. RegistryPROSPERO (International Prospective Register of Systematic Reviews, URL: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=295836; registration number CRD42022295836).

Social Media Interventions for Nutrition Education Among Adolescents: Scoping Review.

Adolescence is a critical period for reinforcing healthy dietary behaviors and supporting the development of cooking skills. Social media may be an avenue for supporting these behaviors, as it is popular among adolescents and can improve access to nutrition education interventions. This study sought to understand the optimal implementation of effective social media-based nutrition education interventions to inform the implementation of future social media-based nutrition education interventions. A scoping review of the characteristics, feasibility, effectiveness, and factors influencing social media-based nutrition education interventions for adolescents was conducted. We searched MEDLINE, Embase, CINAHL, Web of Science, and PsycINFO databases using a predefined search strategy. Primary research articles were independently screened and included if they involved adolescent populations (10-18 years old) and delivered nutrition education through social media. The information on intervention characteristics, feasibility, effectiveness, and factors influencing social media-based nutrition education interventions was extracted. A total of 28 publications out of 20,557 met the eligibility criteria. Twenty-five nutrition interventions were examined by 28 studies. Fourteen interventions used homegrown social media platforms, 8 used Facebook, and 2 used Instagram. Feasibility outcomes were infrequently reported, and the cost of intervention delivery was not reported. Engagement with interventions was variable; high engagement was not required to elicit significant improvements in dietary behaviors. Tailoring interventions, offering practical content, meaningful peer support, and involving families and communities facilitated successful interventions. Strategies to address engagement and technical issues were varied. Emerging evidence demonstrates that social media interventions for adolescent nutrition are acceptable and improve nutrition outcomes. Future interventions should strengthen peer support components and tailor delivery to specific populations. Further research should examine engagement, adherence, and the impact of interventions on behavioral and physical outcomes. This review is the first to examine the use of social media as the primary medium for nutrition education for adolescent populations. The analysis used in this review argues the importance of peer support in social media-based nutrition interventions and the need for user-centered design of the interventions.

Improving adolescents' dietary behaviours in the school-setting: challenges and opportunities.

Adolescence is a critical time of physical, psychological and social development, and thus, optimal nutritional intakes are required during this life stage. Despite this, adolescence is recognised as a period of nutritional vulnerability, with many reportedly failing to meet current dietary guidelines. The school-setting presents a favourable environment to intervene and promote positive dietary behaviours and is also inclusive regardless of socio-economic status. However, a lack of consensus exists on how best to utilise schools to facilitate improvements in dietary behaviours among this age group. Whilst previous research has focused on identifying the factors motivating dietary choices within the school-setting, less is known on the optimum strategies to enhance these dietary choices which could positively contribute to the design of future interventions. It is reported that adolescents have good nutritional knowledge, although this does not appear to be a central consideration when making their dietary choices. Alternative factors at the individual (taste, visual appeal, familiarity, food quality, price, portion size, value for money, time/ convenience), social (peer influence), physical (product placement) and macro environment (food availability) levels have been frequently cited as important influences on adolescents' dietary choices in school. Although school-based interventions have shown potential in achieving positive dietary change among adolescents, more research is needed to determine the most effective methods in improving dietary behaviours in schools. This review summarises the key factors which influence adolescents' school-based dietary choices and the effectiveness of previously conducted interventions, identifying promising components for consideration when developing future dietary interventions within the school-setting.

Effect of a Weight Loss and Lifestyle Intervention on Dietary Behavior in Men with Obstructive Sleep Apnea: The INTERAPNEA Trial

This study investigated the effects of an eight-week interdisciplinary weight loss and lifestyle intervention on dietary behavior in men who were overweight/had obesity and moderate-to-severe obstructive sleep apnea (OSA). It was based on data from INTERAPNEA (ClinicalTrials.gov ID: NCT03851653); a randomized clinical trial conducted from April 2019 to April 2020. Men aged 18–65 years with moderate-to-severe OSA and a body mass index ≥25 kg/m2 were randomly assigned to a usual-care group or an eight-week interdisciplinary weight loss and lifestyle intervention combined with usual-care. Dietary behavior was assessed through the Food Behavior Checklist (FBC) and the Mediterranean Diet Adherence Screener (MEDAS). Of the 89 participants who underwent randomization, 75 completed the intervention endpoint assessment, 89 participants being therefore included in the intention-to-treat analyses, and 75 in the per-protocol approach. As compared with usual-care, the intervention group had greater improvements at intervention endpoint in dietary behavior, as measured by the FBC total score (20% increase in FBC total score, mean between-group difference, 8.7; 95% confidence interval, 5.7 to 11.7), and MEDAS total score (33% increase in MEDAS total score, mean between-group difference, 2.1; 95% CI 1.3 to 2.9). At 6 months after intervention, the intervention group also had greater improvements in both the FBC total score (15% increase) and MEDAS total score (25% increase), with mean between-group differences of 7.7 (CI 95%, 4.4 to 10.9) and 1.7 (CI 95%, 0.9 to 2.6), respectively. An eight-week interdisciplinary weight loss and lifestyle intervention resulted in meaningful and sustainable improvements in dietary behavior, including adherence to the Mediterranean diet in men who were overweight/ had obesity and CPAP-treated moderate-to-severe OSA.

A model exploring the relationship between nutrition knowledge, behavior, diabetes self-management and outcomes from the dining with diabetes program

To examine the relationship between changes in participant's knowledge, beliefs, dietary behavior, diabetes self-management and program outcomes in West Virginia Dinning with Diabetes (DWD) program. We used a longitudinal pre-test and post-test study design and data from 2745 individuals with diabetes who participated from 2007 to 2012. The DWD was offered in community-based settings across the state as an educational program (five classes over a 3-month period). Associations between changes in the variables were examined by structural equation modeling using a path model in which changes in nutritional knowledge, beliefs and depression predicted changes in dietary behaviors and diabetes self-management which subsequently predicted program outcomes (e.g., follow-up with healthcare providers for diabetes care and education). Standardized regression weights are presented. Participant's mean age and duration of diabetes was 63 ± 11.5 and 7.2 ± 8.0 years, respectively. The majority were females, Whites and with less than high school education. Improvements in nutrition knowledge and belief predicted improvements in dietary behavior (β = 0.60, p < .001 and β = 0.11, p < .001, respectively) and diabetes self-management (β = 0.61, p < .001 and β = 0.10, p < .001, respectively) which in turn predicted improvements in program outcome (β = 0.41, p < .001). Diabetes self-management mediated the relationship between knowledge, dietary behavior and program outcomes. The indexes of fit for the tested model indicated a good fit [TLI =0.99, CFI = 0.95, and Root Mean Square Error of Approximation (RMSEA) =0.05]. Results indicate DWD group sessions can be effective in supporting individuals with diabetes to change knowledge, dietary behaviors, adherence to self-management and follow-up provider visits for diabetes care.

Associations between Governmental Policies to Improve the Nutritional Quality of Supermarket Purchases and Individual, Retailer, and Community Health Outcomes: An Integrative Review.

Supermarkets are natural and important settings for implementing environmental interventions to improve healthy eating, and governmental policies could help improve the nutritional quality of purchases in this setting. This review aimed to: (1) identify governmental policies in the United States (U.S.), including regulatory and legislative actions of federal, tribal, state, and local governments, designed to promote healthy choices in supermarkets; and (2) synthesize evidence of these policies’ effects on retailers, consumers, and community health. We searched five policy databases and developed a list of seven policy actions that meet our inclusion criteria: calorie labeling of prepared foods in supermarkets; increasing U.S. Department of Agriculture (USDA) Supplemental Nutrition Assistance Program (SNAP) benefits; financial incentives for the purchase of fruit and vegetables; sweetened beverage taxes; revisions to the USDA Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package; financial assistance for supermarkets to open in underserved areas; and allowing online purchases with SNAP. We searched PubMed, Econlit, PsycINFO, Web of Science, and Business Source Ultimate to identify peer-reviewed, academic, English-language literature published at any time until January 2020; 147 studies were included in the review. Sweetened beverage taxes, revisions to the WIC food package, and financial incentives for fruits and vegetables were associated with improvements in dietary behaviors (food purchases and/or consumption). Providing financial incentives to supermarkets to open in underserved areas and increases in SNAP benefits were not associated with changes in food purchasing or diet quality but may improve food security. More research is needed to understand the effects of calorie labeling in supermarkets and online SNAP purchasing.

Web-Based Interventions for Dietary Behavior in Adults With Type 2 Diabetes: Systematic Review of Randomized Controlled Trials.

BackgroundType 2 diabetes mellitus (T2DM) is among the most prevalent noncommunicable health conditions worldwide, affecting over 500 million people globally. Diet is a key aspect of T2DM management with dietary modification shown to elicit clinically meaningful outcomes such as improved glycemic control, and reductions in weight and cardiovascular disease risk factors. Web-based interventions provide a potentially convenient and accessible method for delivering dietary education, but its effects on dietary behavior in people with T2DM are unknown.ObjectiveThe objective of this review was to determine the effectiveness of web-based interventions on dietary behavior change and glycemic control in people with T2DM.MethodsPer PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, systematic literature searches were performed using Medline, Embase, The Cochrane Library, and CINAHL to retrieve papers from January 2013 to May 2019. Randomized controlled trials of web-based interventions in adults with T2DM with reported dietary assessment were included. Population and intervention characteristics, dietary guidelines and assessments, and significant clinical outcomes were extracted. Differences between groups and within groups were assessed for dietary behavior and clinical outcomes.ResultsThere were 714 records screened, and five studies comprising 1056 adults were included. Studies measured dietary changes by assessing overall diet quality, changes in specific dietary components, or dietary knowledge scores. Significant improvements in dietary behavior were reported in four out of the five studies, representing healthier food choices, improvements in eating habits, reductions in carbohydrates, added sugar, sodium, saturated fat and overall fat intake, and/or increases in dietary knowledge. Three studies found significant mean reductions for hemoglobin A1c ranging from –0.3% to –0.8%, and/or weight ranging from –2.3 kg to –12.7 kg, fasting blood glucose (–1 mmol/L), waist circumference (–1 cm), and triglycerides (–60.1 mg/dL). These studies provided varied dietary recommendations from standard dietary guidelines, national health program guidelines, and a very low carbohydrate ketogenic diet.ConclusionsThis review provided evidence that web-based interventions may be an effective way to support dietary behavior change in people with T2DM, potentially leading to changes in glycemic control and other clinical outcomes. However, the evidence should be viewed as preliminary as there were only five studies included with considerable heterogeneity in terms of the diets recommended, the dietary assessment measures used, the complexity of the interventions, and the modes and methods of delivery.

¡Sí, Yo Puedo Vivir Sano con Diabetes! A Self-Management Randomized Controlled Pilot Trial for Low-Income Adults with Type 2 Diabetes in Mexico City.

BackgroundType 2 diabetes (T2D) is a worldwide epidemic and a leading cause of death in Mexico, with a prevalence of 15.9%, and >70% of diagnosed adults have poor glycemic control [glycated hemoglobin (HbA1c) >7.5%]. We developed a diabetes self-management education program contextualized to the study population, including dietary preferences, health literacy, and health system.ObjectivesWe aimed to evaluate the efficacy of a self-management + text message program (¡Sí, Yo Puedo Vivir Sano con Diabetes!) on primary (HbA1c), and secondary behavioral (self-management), clinical, and psychosocial outcomes in adults with T2D in Mexico City.MethodsParticipants were recruited at public primary healthcare centers (Seguro Popular), and randomly allocated to treatment (n = 26) or wait-list control groups (n = 21) with data collected at 3 and 6 mo. The program included 7 weekly sessions and 6 mo of daily text/picture messages. Descriptive statistics and a generalized linear mixed model with intent-to-treat analysis were calculated.ResultsParticipants were 55.5 ± 8.8 y of age (mean ± SD), 68% female, 88.6% overweight/obese, and 57% lived in food-insecure households. Mean ± SD T2D duration was 11.9 ± 7.8 y and HbA1c was 9.2% ± 1.5%. There was 89% attendance at sessions and 6.4% attrition across both groups at 6 mo. Group-by-time effects were seen in self-monitoring of blood glucose (P < 0.01) and diabetes self-efficacy (P < 0.04); and a trend for lower HbA1c was seen in the intervention group at 6 mo (P = 0.11). Significant improvements in dietary behavior (P < 0.01) were demonstrated in the intervention group over time, but this did not reach statistical significance compared with the control group.ConclusionsThe program was associated with clinically significant improvements in T2D self-management, self-efficacy, and HbA1c over time. Thus, T2D self-management skills, including diet, were improved in a vulnerable metropolitan population.This trial was registered at clinicaltrials.gov as NCT03159299.

P30 Transtheoretical Model-Based Nutritional Interventions in Adolescents: A Systematic Review

Background Literature has shown a tendency of inadequate eating habits among youth, consequently, nutritional interventions are required. The Transtheoretical Model (TTM) classifies individuals based on their readiness to change. Objective This work aimed to describe how the TTM was applied to nutritional interventions for adolescents. Study Design, Settings, Participants This systematic review followed the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We searched seven databases for randomized controlled trials and quasi-experimental designs written in English, Spanish and Portuguese that applied the TTM to nutritional interventions targeting adolescents. Measurable Outcome/Analysis The primary question was “How was the TTM applied in the nutritional interventions?” The secondar question was “Were these nutritional interventions effective?” Data extraction occurred through the usage of an adaptation of the table model from Melo et al. 2017. That model follows instructions of the Centre for Reviews and Dissemination for Undertaking Reviews in Healthcare. Quality and risk of bias were assessed through a questionnaire, developed by the Effective Public Health Practice Project. Results The initial search in seven databases yielded 3,779 results, resulting in 10 final included papers. Adolescents were mostly recruited from schools, and the duration of the studies ranged from a month to three years. Eight interventions had positive results regarding improvements in dietary behaviors or TTM's measurements. Nine studies assessed stages of change, seven decisional balance, and five of them measured self-efficacy. Conclusion The results from assessed studies showed that TTM based nutritional interventions for adolescents are way more effective than those that do not use the model, what is probably because it personalizes the intervention for every participant. This study is useful in the sense that it provides information about the usage of the model for this age group, describing its positive aspects as well as offering alternatives to deal with its weaknesses.

Supporting Engagement, Adherence, and Behavior Change in Online Dietary Interventions

IntroductionPoor diet is a leading cause of death and disease globally. This epidemic requires effective and accessible interventions to stop the increasing number of diet-related deaths and the health and economic impacts of diet-related disease. Online interventions provide flexibility and accessibility. With the ubiquitous use of smartphones, they can be intertwined with daily activities such as shopping and eating. The aim of this review is to determine what features and behavior change techniques employed in online dietary interventions for adult populations promoting dietary behavior change. MethodsThe researchers conducted a systematic search of Cumulative Index of Nursing and Allied Health, Cochrane Library, Global Health, MEDLINE, PsychINFO, and psychological and behavioral sciences electronic bibliography databases, and specialist electronic health (e-health) journals from database inception to January, 2018. Studies were included if they were randomized controlled trials of online dietary interventions with active comparator conditions in adult populations, and with reported dietary change measures. A quality score was applied to each study calculated by a developed scoring system. The review analyzed intervention dietary change measures, attrition (nonuse and dropout), engagement (metrics and intensity of use), adherence (defined as compliance to the treatment protocol), behavior change techniques employed to achieve dietary change, and techniques employed in successful (those who achieved significant results in the targeted dietary behavior) vs unsuccessful interventions as reported by the studies. ResultsA total of 21 studies composed of a total of 7,455 adults and reporting on 19 different e-health interventions were included from 1,237 records. These studies targeted dietary change as measured by reduced energy intake (5) or changes in specific dietary components (15) and overall diet quality (4). Dietary change was a behavior target in general healthy populations (12) and for managing diseases such as obesity and cardiovascular disease (7), or for improving quality of life for those with chronic conditions (1). Improvements in dietary behavior were seen in 14 of the 19 interventions reported. DiscussionThe results suggest that online interventions can be successful in achieving dietary behavior change across a range of defined populations. However, disparate reporting of engagement and limited reporting of nonuse attrition rates limited the analysis of which behavior change techniques were most effective in achieving this change. Implications for Research and PracticeThe results of this review support the potential of online and smartphone dietary interventions as a method to achieve change in diet in defined populations. However, further work needs to be done in examining how users engage with interventions, and thus which behavior change techniques are most effective.

The improvement of dietary behaviors among Iranian adolescent girls: a theory-based randomized controlled trial.

This study aims to evaluate the impact of a social cognitive theory (SCT)-based intervention on dietary behaviors and behavioral determinants. A randomized controlled trial was conducted with 230 adolescent girls (13-15 years old) in the intervention (n=115), and control group (n = 115), in Isfahan, Iran. Interventions were focused on changing SCT determinants including, knowledge, self-efficacy, intention, situation, self-regulation, social support, outcome expectations and expectancies. The intervention program included multicomponent intervention packages for adolescents, parents and teachers. A self-report questionnaire was used to assess dietary behaviors and SCT determinants at 3- and 6-month follow-ups. At 3- and 6-month follow-ups, differences between the intervention and control groups were reported in terms of the changes in all behavioral determinants and dietary behaviors. The changes in most behavioral determinants were significantly associated with the changes in dietary behaviors. The results showed that the nutrition education intervention based on SCT is effective in improving adolescents' dietary behaviors but dietary behaviors of adolescents in this study not yet reached to ideal status.

Systematic Review: Frameworks Used in School-Based Interventions, the Impact on Hispanic Children's Obesity-Related Outcomes.

Childhood obesity among Hispanic children is a public health concern in the United States and Mexico. Although experiences from school-based intervention programs aimed at influencing obesity-related behaviors have been positive, the understanding of those framework elements that are associated with successful outcomes is limited. The purpose of this study was to examine the frameworks used within school-based intervention programs in the United States and Mexico that showed improvements in obesity-related outcomes among Hispanic children. A systematic review of the literature was conducted using 4 electronic databases. Inclusion criteria included: incorporating a framework or aspects of frameworks within an intervention, more than 50% of Hispanic children used in the study and obesity-related outcomes (eg, dietary behaviors and anthropometric measurements). Data extraction and evaluation were completed using the Academy of Nutrition and Dietetics Evidence Analysis Manual. Ten articles (United States = 4; Mexico = 6) meeting inclusion criteria were evaluated. Eight studies that included a community-based framework, intensive nutrition education, and continuous communication among stakeholders resulted in improvements in dietary behaviors and anthropometric measurements among children compared to control groups. Incorporating community-based frameworks may increase the efficacy of school-based intervention programs to reduce obesity-related outcomes among Hispanic children.

Effects of a Self-Directed Nutrition Intervention Among Adults With Chronic Health Conditions.

Chronic diseases are common among adults. A healthy diet may be beneficial for managing the consequences of such conditions. The purpose of this study was to evaluate the effects of a self-directed nutrition program on dietary behaviors among adults with chronic health conditions. As part of a larger trial examining the effects of a self-directed exercise program, participants with arthritis were randomized to a 12-week self-directed exercise or nutrition intervention. Self-reported fruit and vegetable consumption, fat- and fiber-related behaviors were assessed at baseline, 12 weeks, and 9 months. Repeated measures analyses of covariance examined Group × Time changes in dietary behaviors. Effect sizes were computed. Participants ( n = 321) were, on average, 56.5 ± 10.5 years old, had a mean body mass index of 32.9 ± 8.3 kg/m2, and had 2.0 ± 1.0 chronic health conditions; 88% were female, 65% White, 88% had at least some college education, and 62% married. There were significant Group × Time interactions favoring the nutrition group at 12 weeks for all dietary behaviors ( p < .05) but not at 9 months. Between-group effect sizes were small at 12 weeks and decreased at 9 months. Within-group effect sizes were larger for the nutrition group (small to medium) than the exercise group (none to small) at both time points. A self-directed nutrition intervention can result in meaningful improvements in dietary behaviors among adults with chronic health conditions in the short term.

Physical activity and nutrition behaviour outcomes of a cluster-randomized controlled trial for adults with metabolic syndrome in Vietnam

BackgroundMetabolic syndrome is prevalent among Vietnamese adults, especially those aged 50–65 years. This study evaluated the effectiveness of a 6 month community-based lifestyle intervention to increase physical activity levels and improve dietary behaviours for adults with metabolic syndrome in Vietnam.MethodsTen communes, involving participants aged 50–65 years with metabolic syndrome, were recruited from Hanam province in northern Vietnam. The communes were randomly allocated to either the intervention (five communes, n = 214) or the control group (five communes, n = 203). Intervention group participants received a health promotion package, consisting of an information booklet, education sessions, a walking group, and a resistance band. Control group participants received one session of standard advice during the 6 month period. Data were collected at baseline and after the intervention to evaluate programme effectiveness. The International Physical Activity Questionnaire – Short Form and a modified STEPS questionnaire were used to assess physical activity and dietary behaviours, respectively, in both groups. Pedometers were worn by the intervention participants only for 7 consecutive days at baseline and post-intervention testing. To accommodate the repeated measures and the clustering of individuals within communes, multilevel mixed regression models with random effects were fitted to determine the impacts of intervention on changes in outcome variables over time and between groups.ResultsWith a retention rate of 80.8%, the final sample comprised 175 intervention and 162 control participants. After controlling for demographic and other confounding factors, the intervention participants showed significant increases in moderate intensity activity (P = 0.018), walking (P < 0.001) and total physical activity (P = 0.001), as well as a decrease in mean sitting time (P < 0.001), relative to their control counterparts. Significant improvements in dietary behaviours were also observed, particularly reductions in intake of animal internal organs (P = 0.001) and in using cooking oil for daily meal preparation (P = 0.001).ConclusionsThe prescribed community-based physical activity and nutrition intervention programme successfully improved physical activity and dietary behaviours for adults with metabolic syndrome in Vietnam.Trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12614000811606. Registered on 31 July 2014

A Mobile Health Lifestyle Program for Prevention of Weight Gain in Young Adults (TXT2BFiT): Nine-Month Outcomes of a Randomized Controlled Trial.

BackgroundThe unprecedented rise in obesity among young adults, who have limited interaction with health services, has not been successfully abated.ObjectiveThe objective of this study was to assess the maintenance outcomes of a 12-week mHealth intervention on prevention of weight gain in young adults and lifestyle behaviors at 9 months from baseline.MethodsA two-arm, parallel, randomized controlled trial (RCT) with subjects allocated to intervention or control 1:1 was conducted in a community setting in Greater Sydney, Australia. From November 2012 to July 2014, 18- to 35-year-old overweight individuals with a body mass index (BMI) of 25-31.99 kg/m2 and those with a BMI ≥ 23 kg/m2 and a self-reported weight gain of ≥ 2 kg in the past 12 months were recruited. A 12-week mHealth program “TXT2BFiT” was administered to the intervention arm. This included 5 coaching calls, 96 text messages, 12 emails, apps, and downloadable resources from the study website. Lifestyle behaviors addressed were intake of fruits, vegetables, sugar-sweetened beverages (SSBs), take-out meals, and physical activity. The control group received 1 phone call to introduce them to study procedures and 4 text messages over 12 weeks. After 12 weeks, the intervention arm received 2 further coaching calls, 6 text messages, and 6 emails with continued access to the study website during 6-month follow-up. Control arm received no further contact. The primary outcome was weight change (kg) with weight measured at baseline and at 12 weeks and self-report at baseline, 12 weeks, and 9 months. Secondary outcomes were change in physical activity (metabolic equivalent of task, MET-mins) and categories of intake for fruits, vegetables, SSBs, and take-out meals. These were assessed via Web-based surveys. ResultsTwo hundred and fifty young adults enrolled in the RCT. Intervention participants weighed less at 12 weeks compared with controls (model β=−3.7, 95% CI −6.1 to −1.3) and after 9 months (model β=− 4.3, 95% CI − 6.9 to − 1.8). No differences in physical activity were found but all diet behaviors showed that the intervention group, compared with controls at 9 months, had greater odds of meeting recommendations for fruits (OR 3.83, 95% CI 2.10-6.99); for vegetables (OR 2.42, 95% CI 1.32-4.44); for SSB (OR 3.11, 95% CI 1.47-6.59); and for take-out meals (OR 1.88, 95% CI 1.07-3.30).ConclusionsDelivery of an mHealth intervention for prevention of weight gain resulted in modest weight loss at 12 weeks with further loss at 9 months in 18- to 35-year-olds. Although there was no evidence of change in physical activity, improvements in dietary behaviors occurred, and were maintained at 9 months. Owing to its scalable potential for widespread adoption, replication trials should be conducted in diverse populations of overweight young adults.Trial RegistrationAustralian and New Zealand Clinical Trials Registry (ANZCTR): ACTRN12612000924853; (Archived by WebCite at http://www.webcitation.org/6i6iRag55)

Psychosocial predictors of changes in adolescent girls' physical activity and dietary behaviors over the course of the Go Girls! group-based mentoring program.

Changes in social cognitions targeted within a group-based mentoring program for adolescent girls were examined as predictors of changes in physical activity (PA) and dietary behavior (in two separate models) over the course of the 7-week program. Data were collected from 310 participants who participated in the program. Multilevel path models were used to assess changes in psychosocial variables predicting changes in behavioral outcomes from pre- to post-program. Analyses revealed that 24.4 and 12.3% of the variance in increases in PA and dietary behavior, respectively, was explained by increases in affective and instrumental attitudes, self-regulatory efficacy (SRE), and intentions. Increases in intentions partially mediated the effects of increases in SRE and affective attitudes on increases in PA behavior. In relation to improvements in dietary behavior, increases in intentions and SRE directly predicted improvements in dietary behavior. These findings suggest potential psychological mechanisms through which a group-based mentoring program may lead to changes in adolescent girls' health-enhancing PA and dietary behaviors.

The Impact of Culinary Skills Training on the Dietary Attitudes and Behaviors of Children and Parents

Background: Summer camps can serve as a modality for dietary interventions. However, camp-based strategies that improve dietary behaviors of children are unclear. Poor diet disproportionately affects low-income and minority children, making the examination of camp-based dietary interventions an important focus. Purpose: To assess the impact of a camp's culinary skills sessions on perceptions of child involvement in meal preparation and changes in attitudes and self-efficacy related to cooking. Methods: A mixed-methods design with quantitative pre–post assessments and interviews. Results: Parents positively received the program, especially lessons on kitchen safety. Participants and parents highlighted the camp's focus on healthy eating as important. They also noted increases in participants' enjoyment of cooking, willingness to try new foods, and culinary abilities. Quantitative data showed increases in participants' frequency of involvement in home meal preparation and self-efficacy for culinary skills. Discussion: Incorporating hands-on, culinary training in a summer camp aimed at low-income, minority children was feasible and well accepted, and showed improvements in dietary behaviors. Future studies should focus on increasing parent involvement and incorporating take-home lessons. Translation to Health Education Practice: Hands-on, culinary skills training should be incorporated into camps aimed at dietary change to increase children's self-efficacy and potentially influence home food environments.

Effect of nutrition care provided by primary health professionals on adults' dietary behaviours: a systematic review.

'Nutrition care' refers to any practice conducted by a health professional to support a patient to improve their dietary behaviours. Better understanding about the effectiveness of nutrition care is required to identify ways to enhance success of future interventions. Systematically review literature that investigated the effect of nutrition care provided by primary health professionals on adult patients' dietary behaviours. The systematic review included all studies published between January 2000 and January 2015 that involved nutrition care by one or more primary health professionals to adult patients and incorporated at least one quantified food-related outcome measure (e.g. daily intake of vegetables in grams, weekly servings of lean meats). After data extraction, the methodological quality of each study was appraised using the Mixed Methods Appraisal Tool. Twenty-one studies, totalling 12497 participants were included. The design, intensity, theoretical underpinning and follow-up period of interventions were diverse. Twelve studies found significant improvements in participants' dietary behaviours, such as increased daily consumption of fruit, vegetables, high-fibre bread and fish. However, seven studies did not identify any improvement in dietary behaviours; one observed equal improvements among participants in the intervention and control groups and one found a reduction in participants' daily fruit and vegetable intake. Interventions involving nutrition care provided by primary health professionals have the potential to improve patients' dietary behaviours. However, the consistency and clinical significance of intervention outcomes are unclear. Further consideration of factors that may influence the effectiveness of interventions, but not traditionally measured, are required.