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Interventions and public health nutrition

Effectiveness of interventions aimed at improving dietary behaviours among people at higher risk of or with chronic non-communicable diseases: an overview of systematic reviews

European Journal of Clinical Nutrition volume 73, pages 9–23 (2019)Cite this article

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Abstract

Programmes that promote dietary behaviour change for the prevention of chronic disease must include components that are rooted in best practice and associated with effectiveness. The purpose of this overview of systematic reviews was to examine the characteristics and dietary behaviour change outcomes of nutrition interventions among populations with or at risk of non-communicable chronic diseases. Systematic reviews of randomised controlled trials (RCTs) testing dietary behaviour change interventions published between January 2006 and November 2015 were identified via searches in Cochrane Library, PubMed, EMBASE and PsycINFO. Quality of reviews were appraised using AMSTAR. Dietary behaviour change and intervention details were extracted and systematically summarised. Fifteen articles met the inclusion criteria. Dietary behaviour changes in response to nutrition interventions were significant in over half of interventions. Reducing dietary fat and increasing fruits and vegetables were the most common behaviour changes. The characteristics of nutrition interventions and their relationship to effectiveness for dietary behaviour change among chronic disease or at-risk populations were reported inconsistently. However, associative evidence exists to support more frequent contacts and the use of specific behaviour change techniques. No clear relationships were found between effectiveness and intervention setting, mode of delivery or intervention provider, although some population-specific relationships were identified. Interventions that promote long-term maintenance of dietary behaviour changes are lacking in the literature. This comprehensive umbrella review identifies specific characteristics of interventions that are associated with effectiveness in interventions that promote dietary behaviour change among different at-risk populations. In order to maximise outcomes, public health, health promotion and healthcare organisations should consider these results in order to inform the development and improvement of nutrition programmes.

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References

  1. World Health Organisation. Global status report on noncommunicable disease. Geneva: WHO; 2014.

    Google Scholar 

  2. World Cancer Research Fund/American Institute for Cancer Research. Food, nutrition, physical activity and the prevention of cancer: a global perspective. Washington DC: AICR; 2007.

    Google Scholar 

  3. Estruch R, Ros E, Salas-Salvado J, Covas MI, Corella D, Aros F, et al. Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts. N Engl J Med. 2018;378:e34.

    Article  CAS  Google Scholar 

  4. Greaves CJ, Sheppard KE, Abraham C, Hardeman W, Roden M, Evans PH, et al. Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions. BMC Public Health. 2011;11:119.

    Article  Google Scholar 

  5. Sofi F, Abbate R, Gensini GF, Casini A. Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. Am J Clin Nutr. 2010;92:1189–96.

    Article  CAS  Google Scholar 

  6. Diabetes UK. Evidence-based nutrition guidelines for the prevention and management of diabetes. Diabet Med. 2018;35:541–47.

    Article  Google Scholar 

  7. National Institute for Clinical Excellence. Obesity: identification, assessment and management. Clinical Guideline 189. NICE; Manchester, UK, 2014. https://www.nice.org.uk/guidance/CG189. [Accessed 24/02/2018]

  8. National Institute for Clinical Excellence. Cardiovascular disease: risk assessment and reduction, including lipid modification. Clinical Guidance 181. NICE; Manchester, UK, 2014. https://www.nice.org.uk/guidance/CG181. [Accessed 25/02/2018]

  9. Writing Group of the Nutrition Care Process/Standardized Language C. Nutrition care process part II: using the International Dietetics and Nutrition Terminology to document the nutrition care process. J Am Diet Assoc. 2008;108:1287–93.

    Article  Google Scholar 

  10. Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, et al. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med. 2013;46:81–95.

    Article  Google Scholar 

  11. Barry MJ, Edgman-Levitan S. Shared decision making--pinnacle of patient-centered care. N Engl J Med. 2012;366:780–1.

    Article  CAS  Google Scholar 

  12. Michie S, Fixsen D, Grimshaw JM, Eccles MP. Specifying and reporting complex behaviour change interventions: the need for a scientific method. Implement Sci. 2009;4:40.

    Article  Google Scholar 

  13. Muller AM, Maher CA, Vandelanotte C, Hingle M, Middelweerd A, Lopez ML, et al. Physical activity, sedentary behavior, and diet-related eHealth and mHealth research: bibliometric analysis. J Med Internet Res. 2018;20:e122.

    Article  Google Scholar 

  14. Sahay TB, Ashbury FD, Roberts M, Rootman I. Effective components for nutrition interventions: a review and application of the literature. Health Promot Pract. 2006;7:418–27.

    Article  Google Scholar 

  15. Shea BJ, Hamel C, Wells GA, Bouter LM, Kristjansson E, Grimshaw J, et al. AMSTAR is a reliable and valid measurement tool to assess the methodological quality of systematic reviews. J Clin Epidemiol. 2009;62:1013–20.

    Article  Google Scholar 

  16. Janssen V, De Gucht V, Dusseldorp E, Maes S. Lifestyle modification programmes for patients with coronary heart disease: a systematic review and meta-analysis of randomized controlled trials. Eur J Prev Cardiol. 2013;20:620–40.

    Article  Google Scholar 

  17. Avery KN, Donovan JL, Horwood J, Lane JA. Behavior theory for dietary interventions for cancer prevention: a systematic review of utilization and effectiveness in creating behavior change. Cancer Causes Control. 2013;24:409–20.

    Article  Google Scholar 

  18. Spark LC, Reeves MM, Fjeldsoe BS, Eakin EG. Physical activity and/or dietary interventions in breast cancer survivors: a systematic review of the maintenance of outcomes. J Cancer Surviv. 2013;7:74–82.

    Article  Google Scholar 

  19. Johnson SS, Paiva AL, Cummins CO, Johnson JL, Dyment SJ, Wright JA, et al. Transtheoretical model-based multiple behavior intervention for weight management: effectiveness on a population basis. Prev Med. 2008;46:238–46.

    Article  Google Scholar 

  20. Jones H, Edwards L, Vallis TM, Ruggiero L, Rossi SR, Rossi JS, et al. Changes in diabetes self-care behaviors make a difference in glycemic control: the Diabetes Stages of Change (DiSC) study. Diabetes Care. 2003;26:732–7.

    Article  Google Scholar 

  21. Mastellos N, Gunn LH, Felix LM, Car J, Majeed A. Transtheoretical model stages of change for dietary and physical exercise modification in weight loss management for overweight and obese adults. Cochrane Database Syst Rev. 2014;CD008066.

  22. Allen JK, Dennison CR. Randomized trials of nursing interventions for secondary prevention in patients with coronary artery disease and heart failure: systematic review. J Cardiovasc Nurs. 2010;25:207–20.

    Article  Google Scholar 

  23. Desroches S, Lapointe A, Ratte S, Gravel K, Legare F, Turcotte S. Interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults. Cochrane Database Syst Rev. 2013;CD008722.

  24. Lara J, Evans EH, O’Brien N, Moynihan PJ, Meyer TD, Adamson AJ, et al. Association of behaviour change techniques with effectiveness of dietary interventions among adults of retirement age: a systematic review and meta-analysis of randomised controlled trials. BMC Med. 2014;12:177.

    Article  Google Scholar 

  25. Taylor PJ, Kolt GS, Vandelanotte C, Caperchione CM, Mummery WK, George ES, et al. A review of the nature and effectiveness of nutrition interventions in adult males--a guide for intervention strategies. Int J Behav Nutr Phys Act. 2013;10:13.

    Article  Google Scholar 

  26. Ghisi GL, Abdallah F, Grace SL, Thomas S, Oh P. A systematic review of patient education in cardiac patients: do they increase knowledge and promote health behavior change? Patient Educ Couns. 2014;95:160–74.

    Article  Google Scholar 

  27. Dombrowski SU, Avenell A, Sniehott FF. Behavioural interventions for obese adults with additional risk factors for morbidity: systematic review of effects on behaviour, weight and disease risk factors. Obes Facts. 2010;3:377–96.

    Article  Google Scholar 

  28. Bhattarai N, Prevost AT, Wright AJ, Charlton J, Rudisill C, Gulliford MC. Effectiveness of interventions to promote healthy diet in primary care: systematic review and meta-analysis of randomised controlled trials. BMC Public Health. 2013;13:1203.

    Article  Google Scholar 

  29. Siervo M, Lara J, Chowdhury S, Ashor A, Oggioni C, Mathers JC. Effects of the Dietary Approach to Stop Hypertension (DASH) diet on cardiovascular risk factors: a systematic review and meta-analysis. Br J Nutr. 2015;113:1–15.

    Article  CAS  Google Scholar 

  30. Martinez-Gonzalez MA, Martin-Calvo N. Mediterranean diet and life expectancy; beyond olive oil, fruits, and vegetables. Curr Opin Clin Nutr Metab Care. 2016;19:401–7.

    Article  CAS  Google Scholar 

  31. Pierce JP, Natarajan L, Caan BJ, Parker BA, Greenberg ER, Flatt SW, et al. Influence of a diet very high in vegetables, fruit, and fiber and low in fat on prognosis following treatment for breast cancer: the Women’s Healthy Eating and Living (WHEL) randomized trial. JAMA. 2007;298:289–98.

    Article  CAS  Google Scholar 

  32. Pakiz B, Flatt SW, Mills KC, Jordan LJ, Carethers JM, Rock CL. Quality of life and diet intervention in individuals at risk for recurrence of colorectal adenomas. Psychooncology. 2005;14:85–93.

    Article  Google Scholar 

  33. Bradbury KE, Appleby PN, Key TJ. Fruit, vegetable, and fiber intake in relation to cancer risk: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC). Am J Clin Nutr. 2014;100(Suppl 1):394S–8S.

    Article  CAS  Google Scholar 

  34. Patterson RE, Neuhouser ML, Hedderson MM, Schwartz SM, Standish LJ, Bowen DJ. Changes in diet, physical activity, and supplement use among adults diagnosed with cancer. J Am Diet Assoc. 2003;103:323–8.

    PubMed  Google Scholar 

  35. Ball L, Johnson C, Desbrow B, Leveritt M. General practitioners can offer effective nutrition care to patients with lifestyle-related chronic disease. J Prim Health Care. 2013;5:59–69.

    Article  Google Scholar 

  36. Harris J, Felix L, Miners A, Murray E, Michie S, Ferguson E, et al. Adaptive e-learning to improve dietary behaviour: a systematic review and cost-effectiveness analysis. Health Technol Assess. 2011;15:1–160.

    Article  CAS  Google Scholar 

  37. Pagoto SL, Schneider KL, Oleski JL, Luciani JM, Bodenlos JS, Whited MC. Male inclusion in randomized controlled trials of lifestyle weight loss interventions. Obesity (Silver Spring). 2012;20:1234–9.

    Article  Google Scholar 

  38. Pfaeffli Dale L, Dobson R, Whittaker R, Maddison R. The effectiveness of mobile-health behaviour change interventions for cardiovascular disease self-management: a systematic review. Eur J Prev Cardiol. 2016;23:801–17.

    Article  Google Scholar 

  39. Prochaska JJ, Spring B, Nigg CR. Multiple health behavior change research: an introduction and overview. Prev Med. 2008;46:181–8.

    Article  Google Scholar 

  40. Horodyska K, Luszczynska A, Hayes CB, O’Shea MP, Langoien LJ, Roos G, et al. Implementation conditions for diet and physical activity interventions and policies: an umbrella review. BMC Public Health. 2015;15:1250.

    Article  Google Scholar 

  41. Aguiar EJ, Morgan PJ, Collins CE, Plotnikoff RC, Callister R. Efficacy of interventions that include diet, aerobic and resistance training components for type 2 diabetes prevention: a systematic review with meta-analysis. Int J Behav Nutr Phys Act. 2014;11:2.

    Article  Google Scholar 

  42. Lin JS, O’Connor E, Evans CV, Senger CA, Rowland MG, Groom HC. Behavioral counseling to promote a healthy lifestyle in persons with cardiovascular risk factors: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2014;161:568–78.

    Article  Google Scholar 

  43. Aldcroft SA, Taylor NF, Blackstock FC, O’Halloran PD. Psychoeducational rehabilitation for health behavior change in coronary artery disease: a systematic review of controlled trials. J Cardiopulm Rehabil Prev. 2011;31:273–81.

    Article  Google Scholar 

  44. World Health Organisation. Interventions on diet and physical activity: what works. Geneva: WHO; 2009.

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Acknowledgements

This article was produced as part of the project ‘664258/Emp-H’, which has received funding from the European Union’s Health Programme (2014-2020).

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Authors and Affiliations

  1. School Health & Human Performance, Dublin City University, Dublin, Ireland

    Sarah Browne & Davide Susta

  2. Universita’ del Piemonte Orientale, Dipartimento di Medicina Traslazionale, Novara, Italy

    Silvia Minozzi & Cristina Bellisario

  3. School Nursing & Human Sciences, Dublin City University, Dublin, Ireland

    Mary Rose Sweeney

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Correspondence to Davide Susta.

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Browne, S., Minozzi, S., Bellisario, C. et al. Effectiveness of interventions aimed at improving dietary behaviours among people at higher risk of or with chronic non-communicable diseases: an overview of systematic reviews. Eur J Clin Nutr 73, 9–23 (2019). https://doi.org/10.1038/s41430-018-0327-3

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