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A review of the nature and effectiveness of nutrition interventions in adult males – a guide for intervention strategies  [cached]
Taylor Pennie J,Kolt Gregory S,Vandelanotte Corneel,Caperchione Cristina M
International Journal of Behavioral Nutrition and Physical Activity , 2013, DOI: 10.1186/1479-5868-10-13
Abstract: Background Energy excess, low fruit and vegetable intake and other suboptimal dietary habits contribute to an increased poor health and the burden of disease in males. However the best way to engage males into nutrition programs remains unclear. This review provides a critical evaluation of the nature and effectiveness of nutrition interventions that target the adult male population. Methods A search for full-text publications was conducted using The Cochrane Library; Web of Science; SCOPUS; MEDLINE and CINAHL. Studies were included if 1) published from January 1990 to August 2011 and 2) male only studies (≥18 years) or 3) where males contributed to >90% of the active cohort. A study must have described, (i) a significant change (p<0.05) over time in an objective measure of body weight, expressed in kilograms (kg) OR Body Mass Index (BMI) OR (ii) at least one significant change (p<0.05) in a dietary intake measure to qualify as effective. To identify emerging patterns within the research a descriptive process was used. Results Nine studies were included. Sample sizes ranged from 53 to 5042 male participants, with study durations ranging from 12 weeks to 24 months. Overlap was seen with eight of the nine studies including a weight management component whilst six studies focused on achieving changes in dietary intake patterns relating to modifications of fruit, vegetable, dairy and total fat intakes and three studies primarily focused on achieving weight loss through caloric restriction. Intervention effectiveness was identified for seven of the nine studies. Five studies reported significant positive changes in weight (kg) and/or BMI (kg/m2) changes (p≤0.05). Four studies had effective interventions (p<0.05) targeting determinants of dietary intake and dietary behaviours and/or nutritional intake. Intervention features, which appeared to be associated with better outcomes, include the delivery of quantitative information on diet and the use of self-monitoring and tailored feedback. Conclusion Uncertainty remains as to the features of successful nutrition interventions for males due to limited details provided for nutrition intervention protocols, variability in mode of delivery and comparisons between delivery modes as well as content of information provided to participants between studies. This review offers knowledge to guide researchers in making informed decisions on how to best utilise resources in interventions to engage adult males while highlighting the need for improved reporting of intervention protocols.
A novel school-based intervention to improve nutrition knowledge in children: cluster randomised controlled trial
Rajalakshmi R Lakshman, Stephen J Sharp, Ken K Ong, Nita G Forouhi
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-123
Abstract: We developed a card game 'Top Grub' and a 'healthy eating' curriculum for use in primary schools. Thirty-eight state primary schools comprising 2519 children in years 5 and 6 (aged 9-11 years) were recruited in a pragmatic cluster randomised controlled trial. The main outcome measures were change in nutrition knowledge scores, attitudes to healthy eating and acceptability of the intervention by children and teachers.Twelve intervention and 13 control schools (comprising 1133 children) completed the trial. The main reason for non-completion was time pressure of the school curriculum. Mean total nutrition knowledge score increased by 1.1 in intervention (baseline to follow-up: 28.3 to 29.2) and 0.3 in control schools (27.3 to 27.6). Total nutrition knowledge score at follow-up, adjusted for baseline score, deprivation, and school size, was higher in intervention than in control schools (mean difference = 1.1; 95% CI: 0.05 to 2.16; p = 0.042). At follow-up, more children in the intervention schools said they 'are currently eating a healthy diet' (39.6%) or 'would try to eat a healthy diet' (35.7%) than in control schools (34.4% and 31.7% respectively; chi-square test p < 0.001). Most children (75.5%) enjoyed playing the game and teachers considered it a useful resource.The 'Top Grub' card game facilitated the enjoyable delivery of nutrition education in a sample of UK primary school age children. Further studies should determine whether improvements in nutrition knowledge are sustained and lead to changes in dietary behaviour.In England, about 10% of children are obese, with a further 20-25% of children overweight [1]. Modelling estimates suggest that 40% of Britons are likely to be obese by 2025, and by 2050 Britain could be a mainly obese society [2]. The UK Government made a public service agreement target to 'reduce the proportion of overweight and obese children to 2000 levels by 2020' in the context of a broader strategy to tackle obesity as a whole'[3]. It is es
Nutrition education to improve dietary intake and micronutrient nutriture among children in less-resourced areas: a randomised controlled intervention in Kabarole district, western Uganda
M Kabahenda, RM Mullis, JG Erhardt, C Northrop-Clewes, SY Nickols
South African Journal of Clinical Nutrition , 2011,
Abstract: Objective: To determine whether nutrition education targeting the child-feeding practices of low-income rural caregivers will reduce anaemia and improve vitamin A nutriture of the young children in their care. Design: A controlled intervention trial, based on experiential learning theory. Forty-six women completed a nine-session nutrition education programme, while controls (n = 43) concurrently engaged in sewing classes. Setting: Two rural farming communities in the Kabarole district, western Uganda. Subjects: Less literate, low-income rural female caregivers and the children in their care (6-48 months). Outcome measures: Caregivers’ child-feeding practices and the children’s nutritional status were assessed at baseline, one month after intervention (Follow-up 1) and one year from baseline (Follow-up 2). Results: Caregivers in the intervention group reported improved child snacking patterns, food-selection practices, meal adequacy, and food variety. Children in the intervention group recorded lower haemoglobin levels at baseline (9.86 vs. 10.70 g/dl) and caught up with controls at Follow-up 1 (10.06 vs. 10.78 g/dl). However, changes were not sustained. Mean retinol-binding protein improved from 0.68 ìmol/l (95% CI: 0.57-0.78) to 0.91 ìmol/l (95% CI: 0.78-1.03) among intervention children, but remained approximately the same in controls. Vitamin A nutriture was influenced by infections. Conclusion: Nutrition education significantly improved feeding practices and children’s nutritional status. The effectiveness and sustainability of this programme can be enhanced if nutrition education is integrated into other food-production and public health programmes
Using the intervention mapping protocol to develop a community-based intervention for the prevention of childhood obesity in a multi-centre European project: the IDEFICS intervention
Vera Verbestel, Stefaan De Henauw, Lea Maes, Leen Haerens, Staffan M?rild, Gabriele Eiben, Lauren Lissner, Luis A Moreno, Natalia Frauca, Gianvincenzo Barba, éva Kovács, Kenn Konstabel, Michael Tornaritis, Katharina Gallois, Holger Hassel, Ilse De Bourdeaudhuij
International Journal of Behavioral Nutrition and Physical Activity , 2011, DOI: 10.1186/1479-5868-8-82
Abstract: The intervention mapping protocol (IMP) was used to develop the community-based intervention for the prevention of childhood obesity in 3 to 10 years old children. It is a theory- and evidence-based tool for the structured planning and development of health promotion programs that requires the completion of six different steps. These steps were elaborated by two coordinating centers and discussed with the other participating centers until agreement was reached. Focus group research was performed in all participating centers to provide an informed basis for intervention development.The application of the IMP resulted in an overall intervention framework with ten intervention modules targeting environmental and personal factors through the family, the school and the community. The summary results of the focus group research were used to inform the development of the overall intervention. The cultural adaptation of the overall intervention was realised by using country specific focus group results. The need for cultural adaptation was considered during the entire process to improve program adoption and implementation. A plan was developed to evaluate program effectiveness and quality of implementation.The IDEFICS project developed a community-based intervention for the prevention of childhood obesity by using to the intervention mapping heuristic. The IDEFICS intervention consists of a general and standardized intervention framework that allows for cultural adaptation to make the intervention feasible and to enhance deliverability in all participating countries. The present manuscript demonstrates that the development of an intervention is a long process that needs to be done systematically. Time, human resources and finances need to be planned beforehand to make interventions evidence-based and culturally relevant.The prevalence of overweight and obesity in Europe has increased during the past decades [1,2] and is considered a significant public health problem [2]. Th
Nutrition intervention in scholars  [PDF]
Carolina Anzolin,Camila Marcon Ouriques,Doroteia Aparecida H?felmann,Tatiana Mezadri
Revista Brasileira em Promo??o da Saúde , 2010,
Abstract: Objective: To verify the effectiveness of nutrition intervention in changing dietary intake among school children aged 6 to 10 years old in private school, in the city of Itajaí - SC, Brazil. Methods: A non-randomized and uncontrolled intervention study, carried through four educational activities in the period from August to November, 2008 and food intake reassessed at the end. We evaluated the nutritional status by means of body mass index for age and sex, and waist circumference. The frequency of consumption before and after intervention was compared using the paired Student t test. Results: Joined in the survey 93 students (69.92%) of whom 48 children (54.5%) were normal weight, while 36 (40.9%) were overweight or presented obesity. The most consumed food groups, before and after intervention were: crackers and pasta; rice and fruit juice. The average frequency of sweets intake decreased after the intervention (0.54 to 0.24 times per day, p <0.001), however increased the intake of fried potatoes (0.25 to 0.65, p <0.001), pizza and hamburger (0.30 to 0.46, p = 0.028). Among girls, the intake of sweets decreased after the educational activities (0.58 to 0.12, p <0.001). Conclusions: Nutritional interventions, despite the short period of time, were effective in changing the consumption of certain foods / food groups. The results reinforce the need to carry out interventions more often and for longer periods, to promote effective changes in food consumption.
Nutrition interventions in the workplace: Evidence of best practice
NP Steyn, W Parker, EV Lambert, Z Mchiza
South African Journal of Clinical Nutrition , 2009,
Abstract: Aim: The aim of this desktop study was to review all workplace interventions having a nutrition component, published in peer-reviewed literature between 1995 and 2006 by WHO, and to document activities that were successful, as well as possible barriers to their success. Methodology: A systematic review of workplace studies revealed 41 interventions, of which 30 complied with the predetermined search criteria. The following outcome measures were considered in the evaluation of the interventions: (i) changes in nutritional knowledge, attitudes, self-efficacy, intentions and stage of change; (ii) changes in dietary behaviours; (iii) changes in clinical/physical markers, such as: body weight or body-mass index (BMI), blood pressure (BP) or serum cholesterol concentrations; and (iv) process and/or policy outcomes. Results: A large number of diverse workplace interventions were successful in changing outcomes positively in the interventions evaluated. The following were key success factors: i) there was a nutrition and physical activity component; ii) dietitians were involved in nutrition education; iii) changes occurred in the cafeteria/canteen, which increased the availability of healthy food options and advertised them accordingly; iv) tailored feedback on diet (and clinical values) was given to subjects; v) employees were involved in planning and managing programmes; vi) the reduced prices (of healthy food items) in vending machines encouraged employees to buy healthier options; and vii) the stages of change theory was most commonly associated with best practice outcomes. Conclusions: Numerous workplace interventions have shown significant improvements in employees’ health and behaviours. However, it is necessary to plan intervention programmes based on the existing evidence of best practice.
A 10-Week Multimodal Nutrition Education Intervention Improves Dietary Intake among University Students: Cluster Randomised Controlled Trial  [PDF]
Mohd Razif Shahril,Wan Putri Elena Wan Dali,Pei Lin Lua
Journal of Nutrition and Metabolism , 2013, DOI: 10.1155/2013/658642
Abstract: The aim of the study was to evaluate the effectiveness of implementing multimodal nutrition education intervention (NEI) to improve dietary intake among university students. The design of study used was cluster randomised controlled design at four public universities in East Coast of Malaysia. A total of 417 university students participated in the study. They were randomly selected and assigned into two arms, that is, intervention group (IG) or control group (CG) according to their cluster. The IG received 10-week multimodal intervention using three modes (conventional lecture, brochures, and text messages) while CG did not receive any intervention. Dietary intake was assessed before and after intervention and outcomes reported as nutrient intakes as well as average daily servings of food intake. Analysis of covariance (ANCOVA) and adjusted effect size were used to determine difference in dietary changes between groups and time. Results showed that, compared to CG, participants in IG significantly improved their dietary intake by increasing their energy intake, carbohydrate, calcium, vitamin C and thiamine, fruits and 100% fruit juice, fish, egg, milk, and dairy products while at the same time significantly decreased their processed food intake. In conclusion, multimodal NEI focusing on healthy eating promotion is an effective approach to improve dietary intakes among university students. 1. Introduction The transition from adolescence to young adulthood which is mostly spent at colleges or universities is gaining recognition as an important time for health promotion and disease prevention [1]. This is the critical time during which young people establish independence and adopt lasting health behaviour patterns. Although once considered to be an age of optimal health and well-being, it is well documented that university students nowadays have poor dietary habits [2, 3]. University students often fail to meet recommended target for fruits and vegetables (FV) [4, 5], whole grain, milk, and dairy products [6, 7] compared to their adolescence years. They also tend to skip meals especially breakfast [8, 9] and have higher consumption of fast food, snacks, and soft drinks [10–12]. Poor eating habits in earlier stage of life have been directly linked to serious health consequences later in life such as osteoporosis, obesity, hyperlipidemia, and diabetes [13, 14]. Therefore early interventions are needed to improve health behaviours in this age group [15]. Currently only a few nutrition education interventions (NEI) have targeted college or university students
Evaluation of a Nutrition Intervention through a School-Based Food Garden to Improve Dietary Consumption, Habits and Practices in Children from the Third to Fifth Grade in Chile  [PDF]
Diego Vinueza, Lydia Lera, Judith Salinas, Carmen Gloria González, Lorena Barrios, Fernando Vio
Food and Nutrition Sciences (FNS) , 2016, DOI: 10.4236/fns.2016.710088
Abstract: Objective: Use a school-based food garden as an instrument to improve healthy dietary consumption, habits, and practices among children from the third to fifth grade in public schools in Chile. Design: Quasi-experimental, six-month intervention with an evaluation of dietary consumption, habits, and practices and use of the school-based food garden among the 3rd to 5th grade students. Setting: Two municipal schools in a low-middle income district in Santiago de Chile; one with a school garden intervention and a control school without a garden. Subjects: 155 third to fifth grade children, 63 in the intervention school and 92 in the control school (average age 10 years old, 58% boys). Results: In the intervened school, there was a significant improvement in the children’s dietary habits, such as peeling and slicing fruit (p < 0.05), making sandwiches (p < 0.05), and increased motivation to cook (p < 0.05). Fruit purchases at the school rose from 4% to 37% (p < 0.05) by the end of the intervention. Interest in growing vegetables or fruits at home increased from 48% to 70% (p < 0.05). The school children at the intervention school significantly increased their knowledge about 16 of 21 garden crops (p < 0.05), expanding the spectrum of the vegetables they can consume. There were no significant changes in the control school. Conclusions: The school-based food garden was effective in achieving change in dietary habits and practices among the third to fifth grade children. The project should be carried out for a longer period of time, so that the changes will be reflected in the students’ food consumption and nutritional status.
Evaluation of the effectiveness of a nutrition education intervention performed by primary school teachers
Erminia Agozzino,Umberto Del Prete,Chiara Leone,Elisabetta Manzi
Italian Journal of Public Health , 2007, DOI: 10.2427/5865
Abstract: Background: Long-term interventions based on the active involvement of students, carried out by properly prepared staff using didactic support material (brochures, games etc.) including the participation/involvement of mothers or associates in community interventions; seem to be the most effective ones. This study evaluates the effectiveness of nutrition education interventions carried out by teachers with active didactic methodologies. Methods: The research was carried out by administering a frequency of food intake questionnaire, before and after the intervention. To compare the answers given before and after the educational intervention the Wilcoxon-test was applied to dependent data discriminating the group with “sufficient implementation” of the project versus “insufficient implementation”. Results: Our data demonstrates that a substantial percentage of children do not report an adequate nutritional intake, making education interventions not only opportune but necessary. In both groups there was an increase in the number of subjects having breakfast, particularly in terms of bread and biscuits intake. In the group with “sufficient implementation” there was an increase in the intake of all kinds of food with respect to the previous day’s intake and a decrease in the intake of meat, fish and legumes consumed during the previous week; in the group with “insufficient implementation” only fish intake increased significantly while vegetable intake decreased in a non-significant way. So this educational intervention appears to have been particularly effective in modifying breakfast habits and reducing snack.
Planning, design and implementation of the enhancing child nutrition through animal source food management (ENAM) project
EK Colecraft, GS Marquis, O Sakyi-Dawson, A Lartey, LM Butler, B Ahunu, MB Reddy, HH Jensen, E Huff-Lonergan, E Canacoo
African Journal of Food, Agriculture, Nutrition and Development , 2012,
Abstract: The Global-Livestock Collaborative Research Support Program’s (GL-CRSP) Child Nutrition Project, a controlled feeding trial in rural Kenya, demonstrated the importance of Animal Source Foods (ASF) for children’s micronutrient status and cognitive development. These findings prompted research efforts to understand the constraints to ASF in children’s diets in Africa so as to design targeted interventions to improve the ASF quality of children’s diets. The Enhancing Child Nutrition through Animal Source Management (ENAM) project (2004-2009) emanated from participatory formative research that identified six principal constraints to the inclusion of Animal Source Foods (ASF) in children’s diets in Ghana, including low income of caregivers, poor producer-consumer linkages, inadequate nutrition knowledge and skills of extension staff and caregivers, cultural beliefs, and inequitable household food distribution. To address these constraints, the ENAM project undertook a multidisciplinary community development, research and capacity building initiative with the goal of augmenting caregivers’ access to and use of ASF in children’s diets. Participatory processes were used to implement an integrated microcredit, entrepreneurship and nutrition education intervention with 181 caregivers of children 2- to5-years old in six rural communities across three agro-ecological zones (Guinea Savannah, Forest-Savannah Transitional and Coastal Savannah) of Ghana. Six matched communities from the same ecological zones served as comparison sites. Quantitative methods that included surveys, child anthropometry, and dietary assessment as well as qualitative case studies were used to assess the effect of the intervention on household, caregiver and child outcomes of interest. This paper presents the key features of the planning, design and implementation of the community intervention and the research processes undertaken to assess the project’s impacts. The ENAM project model presents a unique approach for addressing caregivers’ income and knowledge barriers to improve child nutrition in rural Ghana and may be a promising intervention model for scale-up in Ghana and other African countries.
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