Efficacy of a brief web-based intervention with and without SMS to enhance healthy eating behaviors among university students. Behavioral variables and education are predictors of dietary change in the Women's Health Trial: Feasibility Study in Minority Populations. A Prospective Study of Diet Quality and Mental Health in Adolescents Impact of a Focused Nutrition Educational Intervention Coupled With Improved Access to Fresh Produce on Purchasing Behavior and Consumption of Fruits and Vegetables in Overweight Patients With Diabetes Mellitus Predictors of adherence to a Mediterranean-type diet in the PREDIMED trial Food advertising, children’s food choices and obesity: interplay of cognitive defences and product evaluation: an experimental study The theory of planned behaviour and healthy eating: Examining additive and moderating effects of social influence variables A pilot study to examine the effects of a nutrition intervention on nutrition knowledge, behaviors, and efficacy expectations in middle school children. Comparison of price change and health message interventions in promoting healthy food choices. Use of food nutrition labels is associated with lower fat intake. Association of Western and traditional diets with depression and anxiety in women. Tailored nutritional guidance for home-dwelling AD families: The feasibility of and elements promoting positive changes in diet (NuAD-trial) Size acceptance and intuitive eating improve health for obese, female chronic dieters. The impact of a population-level school food and nutrition policy on dietary intake and body weights of Canadian children☆ Impact of group nutrition education and surplus value of Prochaska-based stage-matched information on health-related cognitions and on Mediterranean nutrition behavior. Factors influencing consumer dietary health preventative behaviours A controlled evaluation of an elementary school primary prevention program for eating problems.
BACKGROUND Healthy eating , such as the regular inclusion of fruits and vegetables in one 's diet , is essential for maintaining optimal weight , maximizing brain and immune system functioning , and reducing the risk for disease . Despite its importance , few students meet recommended guidelines for healthy dietary behavior . The current study was design ed to test the efficacy of two ehealth intervention approaches for increasing healthy eating behaviors among university students . METHODS Student volunteers from an introductory psychology class at a northeastern US university participated for class credit ( n=154 ) . Students were r and omized to either an assessment only ( AO ) , web-based nutrition intervention only ( WBO ) , or web-intervention with daily text-messaging condition ( WB+M ) . Participants completed measures of vegetable and fruit consumption and frequency of meals with design ated healthy food selection s at baseline and one-month follow-up . RESULTS Only the WB+M intervention significantly increased the likelihood of attaining vegetable consumption st and ards and increased the frequency of design ated healthy food choice options guidelines at follow-up compared to the AO condition . CONCLUSIONS Findings suggest that delivering a brief web-based intervention with daily text messages about personal nutrition and fitness goals may support healthier eating patterns among students BACKGROUND Reducing the intakes of fats and increasing consumption of fruits and vegetables are an important goal for improving population health . Analyzing the effects of nutrition education programs on subjects ' dietary intakes incorporating factors such as habit persistence in diets , unhealthy eating habits , perceptions of health risks , participation motivation , and expectancies can yield useful insights . METHODS A Food Frequency Question naire ( FFQ ) was used to measure intakes at baseline , 6 and 12 months , by 318 and 548 postmenopausal women in , respectively , the Control and Intervention groups of the Women 's Health Trial : Feasibility Study in Minority Population s ( WHTFSMP ) . Information on background , behavioral , and anthropometric variables was collected . The Intervention group met in classes led by nutritionists . Dynamic r and om effects models were estimated for the two groups using the data at baseline , 6 and 12 months on the intakes of carbohydrate , saturated , monounsaturated , and polyunsaturated fats , fiber , beta-carotene , ascorbic acid , and calcium . RESULTS The nutrition education program lowered the intakes of fats while increasing fiber , beta-carotene , and ascorbic acid intakes especially in subjects scoring high on indices reflecting concerns about health , desirability of change , and participation motivation . In addition , subjects '  education was a predictor of dietary intakes in the Intervention group . CONCLUSIONS Nutrition education can be an effective tool for improving diets , but behavioral characteristics deserve greater attention in helping to design the most effective approaches for various target groups Objectives A number of cross-sectional and prospect i ve studies have now been published demonstrating inverse relationships between diet quality and the common mental disorders in adults . However , there are no existing prospect i ve studies of this association in adolescents , the onset period of most disorders , limiting inferences regarding possible causal relationships . Methods In this study , 3040 Australian adolescents , aged 11–18 years at baseline , were measured in 2005–6 and 2007–8 . Information on diet and mental health was collected by self-report and anthropometric data by trained research ers . Results There were cross-sectional , dose response relationships identified between measures of both healthy ( positive ) and unhealthy ( inverse ) diets and scores on the emotional subscale of the Pediatric Quality of Life Inventory ( PedsQL ) , where higher scores mean better mental health , before and after adjustments for age , gender , socio-economic status , dieting behaviours , body mass index and physical activity . Higher healthy diet scores at baseline also predicted higher PedsQL scores at follow-up , while higher unhealthy diet scores at baseline predicted lower PedsQL scores at follow-up . Improvements in diet quality were mirrored by improvements in mental health over the follow-up period , while deteriorating diet quality was associated with poorer psychological functioning . Finally , results did not support the reverse causality hypothesis . Conclusion This study highlights the importance of diet in adolescence and its potential role in modifying mental health over the life course . Given that the majority of common mental health problems first manifest in adolescence , intervention studies are now required to test the effectiveness of preventing the common mental disorders through dietary modification Purpose The purpose of this study was to test the impact of distributing coupons redeemable at farmers markets plus an educational intervention on fruit and vegetable ( F&V ) purchase and consumption in overweight patients with type 2 diabetes ( T2DM ) . Methods Seventy-eight participants with T2DM being followed at Jacobi Medical Center , a large public hospital in the Bronx , New York , were r and omized to receive the st and ard of care or a 1-hour session focused on benefits of F&V consumption and $ 6 in coupons . Question naires assessed demographics , F&V intake , and farmers market purchasing at baseline and 12 weeks . Clinical parameters were obtained through chart review at baseline and at 12 weeks . Results Participants were predominantly Latino , females , and low income . At 12 weeks , there was a statistically significant increase in the number of participants in the intervention arm who reported purchasing from a farmers market . In addition , there was a minimal increase in fresh fruit intake in the intervention arm at 12 weeks . Conclusion Focused education combined with a small economic incentive result ed in an increase in purchasing behavior and fresh fruit intake per day . A more intense behavioral intervention combined with increased access may result in a significant impact on obesity and diabetes , particularly among low-income and racially diverse communities Background Determinants of dietary changes obtained with a nutritional intervention promoting the Mediterranean diet have been rarely evaluated . Aim To identify predictors of higher success of an intervention aim ed to increase adherence to a Mediterranean diet ( MeDiet ) in individuals at high cardiovascular risk participating in a trial for primary prevention of cardiovascular disease : the PREDIMED ( PREvención con DIeta MEDiterránea ) trial . C and i date predictors included demographic and socioeconomic characteristics , cardiovascular risk factors , and baseline dietary habits . Methods A total of 1,048 asymptomatic subjects aged 55–80 years allocated to the active intervention groups ( subjects in the control group were excluded ) . Participants ’ characteristics were assessed at baseline among subjects . Dietary changes were evaluated after 12 months . Main outcome measures were : attained changes in five dietary goals : increases in ( 1 ) fruit consumption , ( 2 ) vegetable consumption , ( 3 ) monounsaturated fatty acid (MUFA)/saturated fatty acid ( SFA ) ratio , and decreases in ( 4 ) sweets and pastries consumption , ( 5 ) and meat consumption . Univariate and multivariate logistic regression analyses were used to examine associations between the c and i date predictors and likelihood of attaining optimum dietary change ( improved adherence to a MeDiet  ) . Results Among men , positive changes toward better compliance with the MeDiet  were more frequent among non-diabetics , and among those with worse dietary habits at baseline ( higher consumption of meat , higher SFA intake , lower consumption of fruit and vegetables ) . Among women , marital status ( married ) and worse baseline dietary habits ( high in meats , low in fruits and vegetables ) were the strongest predictors of success in improving adherence to the MeDiet . Conclusions Some participant characteristics ( marital status and baseline dietary habits ) could contribute to predicting the likelihood of achieving dietary goals in interventions aim ed to improve adherence to a MeDiet , and may be useful for promoting individualized long-term dietary changes and improving the effectiveness of dietary counseling Objectives : To investigate the role of product evaluations , nutritional and persuasion knowledge on children ’s food choices conducted because of limited evidence about the role of product evaluations on consumer choices in conjunction with cognitive defences . Design : A r and omised controlled 2 × 2 factorial experiment with an exposure to a food and a control ( toy ) advertisement conducted in a non-laboratory setting at an annual event traditionally visited by families . Subjects : Children aged 7–13 years with biometric/weight data representative of the general Australian population . Measurements : Height and weight ( converted into body mass index z-scores ) measured in addition to children ’s nutritional and persuasion knowledge , product evaluations , age and gender . Results : The factors that undermine children ’s cognitive defences relate to taste , social appeal of foods and low nutritional and persuasion knowledge . An interplay between the above-mentioned factors was also observed , identifying four groups among young consumers , alluding to a complex and at times impulsive nature of children ’s decisions : ( 1 ) knowledgeable children with less positive product evaluations choosing a healthy snack ; ( 2 ) knowledgeable but hedonism-oriented children seeking peer conformity choosing an advertised product ; ( 3 ) knowledgeable children who chose a snack belonging to the same product category ; and ( 4 ) less knowledgeable children with positive product evaluations and low nutritional knowledge choosing snacks from the advertised product category . Obese children were more likely to belong to a cluster of less knowledgeable and hedonism-oriented children . Conclusions : The problem of consumption of less healthy foods is complex and multiple factors need to be considered by health practitioners , social marketers and parents to address the issue of childhood obesity . Nutritional knowledge alone is not sufficient to ensure children make healthier food choices and emphasis should also be placed on persuasion knowledge education , targeting of peer norms , self-efficacy and stricter regulation of advertising aim ed at children Abstract This paper examines the additive and moderating effects of social influence variables ( injunctive norms , descriptive norms , perceived social support ) within the Theory of Planned Behaviour ( TPB ) . The target behaviour is the decision to eat healthily . Question naire responses on components of the TPB , descriptive norms , perceived social support  , and subsequent healthy eating were obtained from a prospect i ve sample of 235 members of the general public . Good predictions of intentions ( 42 % of variance explained ) and behaviour ( 15 % of variance explained ) were found using the Theory of Planned Behaviour . Neither descriptive norms nor perceived social support added to these predictions of intentions over and above the TPB variables . However , perceived social support was found to act as a moderator variable on the relationship between perceived behavioral control and intention , and the relationship between attitude and intention . Implication s for exploring the role of social influence variables on decisions concerning health behavioun an discussed BACKGROUND This was a pilot study to determine the impact of the Michigan Model ( MM ) Nutrition Curriculum on nutrition knowledge , efficacy expectations , and eating behaviors in middle school students . METHODS The study was conducted in a large metropolitan setting and approved by the Institutional Review Board . The participants for this study were divided into an  intervention group ( n = 407 ) and a control group ( n = 169 ) . An MM instructor trained health teachers in the use of the curriculum , and the teacher subsequently taught the curriculum to  students  in the intervention group . A valid and reliable question naire was used to determine pre-post differences . It consisted of 3 subscales assessing eating habits , nutrition knowledge , and efficacy expectations toward healthy eating . Subscale scores were analyzed using a 2 groups ( intervention vs control ) x 2 times ( pre vs post ) analysis of variance . RESULTS The intervention group increased their nutrition knowledge at post . There was also a significant main effect for groups in the subscales " Eating Behaviors " and " Efficacy Expectations Regarding Healthy Eating . " Subsequent post hoc analysis revealed that the intervention group was significantly more likely to eat fruits and vegetables and less likely to eat junk food than the control group . Students in the intervention group also felt more confident that they could eat healthy . CONCLUSIONS The results of this pilot study suggest that the MM Nutrition Curriculum delivered by trained professionals result ed in significant positive changes in both nutrition knowledge and behaviors in middle school children . Further research needs to be conducted to determine the long-term impact This study examines the feasibility and effectiveness of an environmental intervention for improving diet by comparing the impact of health messages , lowered prices , and their combination on the purchase of healthy food items in a restaurant . Price decreases alone , rather than a combination of price decreases and health messages , were associated with a higher level of increased purchases of some healthy food items as compared with control items over a 4-month period . Price decreases may be a more powerful means than health messages of increasing consumption of healthy foods . Health messages may have paradoxical effects if foods labeled as healthy are assumed to taste bad OBJECTIVE The Nutrition Labeling and Education Act of 1990 m and ated that st and ardized nutrition information appear on almost all packaged foods manufactured after May 1994 . This study describes the demographic and diet-related psychosocial correlates of nutrition label use , and examines the relationship between label use and diet . DESIGN /SUBJECTS Data are from a r and om-digit-dial telephone survey of 1,450 adult residents of Washington State . The question naire assessed nutrition label use , fat-related diet habits , fruit and vegetable consumption , diet-related psychosocial factors , health behavior , and demographic characteristics . STATISTICAL ANALYSES Analyses examined associations of demographic characteristics with nutrition label use ; diet-related psychosocial factors and health behavior with nutrition label use , controlled for demographic characteristics ; and nutrition label use with fat and fruit and vegetable intake , controlled for demographic characteristics and psychosocial factors . RESULTS  Nutrition label use was significantly higher among women , residents younger than 35 years , and residents with more than a high school education . When controlled for demographic characteristics , the strongest predictors of label use were believing in the importance of eating a low-fat diet , believing in an association between diet and cancer , and being in the maintenance stage of change for adopting a low-fat diet . Label use was significantly associated with lower fat intake and , after controlling for all demographic , psychosocial , and behavioral variables , explained 6 % of the variance in fat intake ( P < .001 ) . Label use was not associated with fruit and vegetable consumption . APPLICATIONS/ CONCLUSION Persons successfully limiting their fat intake use nutrition labels , suggesting that the new nutrition labels are helpful . Dietetics professionals can use the results of this study to emphasize to their clients the importance of reading nutrition labels in maintaining a low-fat diet OBJECTIVE Key biological factors that influence the development of depression are modified by diet . This study examined the extent to which the high-prevalence mental disorders are related to habitual diet  in 1,046 women ages 20 - 93 years r and omly selected from the population . METHOD A diet quality score was derived from answers to a food frequency question naire , and a factor analysis identified habitual dietary patterns . The  12-item General Health Question naire ( GHQ-12 )  was used to measure psychological symptoms , and a structured clinical interview was used to assess current depressive and anxiety disorders . RESULTS After adjustments for age , socioeconomic status , education , and health behaviors , a " traditional " dietary pattern characterized by vegetables , fruit , meat , fish , and whole grains was associated with lower odds for major depression or dysthymia and for anxiety disorders . A " western " diet of processed or fried foods , refined grains , sugary products , and beer was associated with a higher GHQ-12 score . There was also an inverse association between diet quality score and GHQ-12 score that was not confounded by age , socioeconomic status , education , or other health behaviors . CONCLUSIONS These results demonstrate an association between habitual diet quality and the high-prevalence mental disorders , although reverse causality and confounding can not be ruled out as explanations . Further prospect i ve studies are warranted Objectives To describe the process and feasibility of our r and omised , controlled intervention study ( NuAD trial ) that positively affected the nutrition and quality of life , and prevented falls of home-dwelling persons with Alzheimer disease ( AD ) . Design , setting , participants This qualitative study comprised 40 persons with AD and spousal caregivers of our trial . Our intervention during one year involved tailored nutritional guidance for these couples . The nutritionist ’s field notes ( about 100 pages ) and the participant feedback question naires ( N = 28 ) served to analyse the feasibility of intervention , factors promoting the application of intervention and challenges hindering it . Thematic content analysis served to analyse our data with the grounded theory approach . Results We identified several positive elements promoting better nutrition : positive attitudes on nutrition to participants including a participant-centred approach , positive feedback , findings of food diaries and practical suggestions . Home visits by the nutritionist were convenient and participants felt that someone cares . Group meetings which included protein-rich snacks strengthened the nutritional message by enabling discussion s and socialising . The oral nutritional supplements ( ONS ) helped participants to regain their energy and to motivate them to exercise and make changes in their diets . Obstacles to making changes in diets included participants ’ false ideas about nutrition , especially with regard to weight gain . Health problems and functional limitations hampered food management , and some families had inveterate eating habits . The positive feedback from participants indicated the feasibility of our tailored nutritional guidance . Conclusions Assessment -based , tailored nutritional guidance implemented with a personal and positive approach may inspire and empower AD families to make positive changes in their diets , leading them to improved nutrition and quality of life OBJECTIVE Examine a model that encourages health at every size as opposed to weight loss . The health at every size concept supports homeostatic regulation and eating intuitively ( ie , in response to internal cues of hunger , satiety , and appetite ) . DESIGN Six-month , r and omized clinical trial ; 2-year follow-up . SUBJECTS White , obese , female chronic dieters , aged 30 to 45 years ( N=78 ) . SETTING Free-living , general community . INTERVENTIONS Six months of weekly group intervention ( health at every size program or diet program ) , followed by 6 months of monthly aftercare group support . MAIN OUTCOME MEASURES Anthropometry ( weight , body mass index ) , metabolic fitness ( blood pressure , blood lipids ) , energy expenditure , eating behavior ( restraint , eating disorder pathology ) , and psychology ( self-esteem , depression , body image ) . Attrition , attendance , and participant evaluations of treatment helpfulness were also monitored . STATISTICAL ANALYSIS PERFORMED Analysis of variance . RESULTS Cognitive restraint decreased in the health at every size group and increased in the diet group , indicating that both groups implemented their programs . Attrition ( 6 months ) was high in the diet group ( 41 % ) , compared with 8 % in the health at every size group . Fifty percent of both groups returned for 2-year evaluation . Health at every size group members maintained weight , improved in all outcome variables , and sustained improvements . Diet group participants lost weight and showed initial improvement in many variables at 1 year ; weight was regained and little improvement was sustained . CONCLUSIONS The health at every size approach enabled participants to maintain long-term behavior change ; the diet approach did not . Encouraging size acceptance , reduction in dieting behavior , and heightened awareness and response to body signals result ed in improved health risk indicators for obese women Objective The objective of this study is to assess population -level trends in children 's dietary intake and weight status before and after the implementation of a  provincial school nutrition policy in the province of Nova Scotia , Canada . Method Self-reported dietary behavior and nutrient intake and measured body mass index were collected as part of a population -level study with grade 5 students in 2003 ( n = 5215 ) and 2011 ( 5508 ) , prior to and following implementation of the policy . We applied r and om effects regression methods to assess the effect of the policy on dietary and health outcomes . Results In 2011 , students reported consuming more milk products , while there was no difference in mean consumption of vegetables and fruits in adjusted models . Adjusted regression analysis revealed a statistically significant decrease in sugar-sweetened beverage consumption . Despite significant temporal decreases in dietary energy intake and increases in diet quality , prevalence rates of overweight and obesity continued to increase . Conclusion This population -level intervention research suggests a positive influence of school nutrition policies on diet quality , energy intake and healthy beverage consumption , and that more action beyond schools is needed to curb the increases in the prevalence of childhood obesity This study compares the effect of two interventions focussed on the promotion of Mediterranean nutrition behavior .  The target groups are persons with three risk factors for development of cardiovascular disease . The study region is a socio-economically deprived area in the Netherl and s. The first intervention consisted of three meetings in which the positive health effects of a Mediterranean diet were discussed in group sessions . In the additional intervention stage-matched information based on the Transtheoretical Model of behavior change was given . Both intervention groups were compared with a control group , which received only a printed leaflet with the Dutch nutritional guidelines . At baseline the three subgroups were comparable and after 16 weeks both intervention strategies result ed in significant changes in comparison with the control condition . For fish consumption , both strategies result ed in more positive attitudes , social norms , stronger intentions , more progress in stage of change and better nutritional intake . For fruit/vegetables consumption , the effects of both strategies were limited to stage of change and nutritional intake . Additional individually stage-matched tailored letters did not result in more progress on any of the dependent variables . We conclude that substantial nutritional behavior change can be achieved by interactive group education in socio-economically deprived population groups Background The deterioration of the health status of the Romanian population during the economic transition from a central ly planned to a free market economy has been linked to lifestyles factors ( e.g. diet ) regarded as a main determinants of the disparity in life expectancy between Eastern and Western Europe . Reforms in the health care system in this transition economy aim to focus on preventive action . The purpose of this study was to identify the factors that impact on the individual decision to engage in  Dietary Health Preventive Behaviour  ( DHPB ) and investigate their influence in the context of an adapted health cognition model . Methods A population -based study recruited 485 adult respondents using r and om route sampling and face-to-face administered question naires .  Results and discussion Respondents ' health motivation , beliefs that diet can prevent disease , knowledge about nutrition , level of education attainment and age have a positive influence on DHPB . Perceived barriers to healthy eating have a negative impact on alcohol moderation . The information acquisition behaviour ( frequency of reading food labels ) is negatively predicted by age and positively predicted by health motivation , education , self-reported knowledge about nutrition and household financial status . A significant segment of respondents believe they are not susceptible to the elicited diseases . Health promotion strategies should aim to change the judgments of health risk . Conclusion The adaptation of the Health Belief Model and the Theory of Health Preventive Behaviour represents a valid framework of predicting DHPB . The negative sign of perceived threat of disease on DHPB may suggest that , under an income constraint , consumers tend to trade off long-term health benefits for short-term benefits . This caution s against the use of negative messages in public health campaigns . Raising the awareness of diet-disease relationships , knowledge about nutrition ( particularly sources and risks associated with dietary fat and cholesterol ) may induce people to adopt preventive dietary habits Research ers have recently called for the development of primary prevention of eating disorders programs aim ed at elementary school students . The present study reports on the development of a curriculum for fifth grade rs design ed to encourage healthy eating , exercise , and body image while discouraging calorie-restrictive dieting , exercising for weight loss , and the development of body dissatisfaction . The program consisted of ten lessons taught by the classroom teachers . The influence of the curriculum on ( 1 ) knowledge about nutrition , body fat , and dieting ; ( 2 ) attitudes about fat people and own body ( body esteem ) ; and ( 3 ) behaviors , including attempts at weight reduction , consumption of fruits and vegetables  , and  exercising  , were evaluated in a pre-post controlled experimental design . There were 222 white public school children who participated in both the pre- and posttesting , 167 of whom were in the classrooms receiving the curriculum . Results indicated that knowledge was broadly improved by the curriculum . There were information improvements in terms of nutrition , effects of dieting , and causes of body fat . Attitudinal changes were less pronounced , although the curriculum did positively affect attitudes about fat people . Behavior , including eating patterns , exercise patterns , weight reduction attempts , and teasing of fat children , was not changed by participation in the curriculum
RESULTS Our findings suggest that consumers have a relatively poor underst and ing of a healthy diet .
The literature also demonstrates that there is poor evidence on the health protective effects of single foods or nutrients .
We further show that low SES is the single consistent risk factor for not adhering to a healthy diet .
Our review of the literature on determinants demonstrates that intentions , habits , self-regulatory skills , and the social and physical environment are the most important determinants of a healthy diet , which are in turn amenable to change by intervention strategies with varying levels of effectiveness .
Educational interventions generally show a limited effect on practising a healthy diet whereas interventions targeting habitual behaviour and /or the physical environment seem more promising .
In view of the large number of people who are concerned about their diets and make attempts to change their dietary patterns , we conclude that it is crucial to gain a better underst and ing of both the automatic and environmental influences that are responsible for people not acting upon their good intentions for diet change
OBJECTIVE To discuss healthy diet from a psychological perspective by considering definitions of healthy diet in terms of consumer underst and ing ; the health effects of specific dietary elements in terms of overweight and ( chronic ) illness ; the prevalence of healthy diet ; the psychological and environmental determinants of healthy diet ; and the psychological interventions that have been design ed to promote healthy diet .