The Promotion of Eating Behaviour Change through Digital Interventions.

Diet-related chronic disease is a global health epidemic giving rise to a high incidence of morbidity and mortality. With the rise of the digital revolution, there has been increased interest in using digital technology for eating behavioural change as a mean of diet-related chronic disease prevention. However, evidence on digital dietary behaviour change is relatively scarce. To address this problem, this review considers the digital interventions currently being used in dietary behaviour change studies. A literature search was conducted in databases like PubMed, Cochrane Library, CINAHL, Medline, and PsycInfo. Among 119 articles screened, 15 were selected for the study as they met all the inclusion criteria according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) search strategy. Four primary digital intervention methods were noted: use of personal digital assistants, use of the internet as an educational tool, use of video games and use of mobile phone applications. The efficiency of all the interventions increased when coupled with tailored feedback and counselling. It was established that the scalable and sustainable properties of digital interventions have the potential to bring about adequate changes in the eating behaviour of individuals. Further research should concentrate on the appropriate personalisation of the interventions, according to the requirements of the individuals, and proper integration of behaviour change techniques to motivate long-term adherence

Nudging using the ‘dish of the day’ strategy does not work for plant-based meals in a Danish sample of adolescent and older people

© 2018 John Wiley & Sons Ltd Adequate nutrition is an important factor for health and well-being in adolescents and later years. Fruits and vegetables are part of a healthy diet as important source of nutrients, but their intakes are lower than the recommendations in European countries. This study aimed to compare the choices made by adolescents and older people between three similar dishes, one based on meat, one on fish and one on vegetables, in two different conditions: a neutral (control) situation and an intervention situation in which the vegetable-based meal was designated ‘dish of the day’. The comparisons of choices will be made within the same age group (adolescents in the control group vs. adolescents in the intervention group; older people in the control group vs. older people in the intervention group). A quasi-randomised field trial design was used with a sample of 94 adolescents (aged 10–19 years) and 97 older people (aged ≥65 years), who were randomly allocated to intervention or control groups. In the control situation participants were asked to choose between three similar meals, one meat, one fish and one the VeggiEat dish. In the intervention, the VeggiEat dish was labelled the ‘Dish of the day’. All dishes were provided free of charge, displayed side by side in the same order and served in same portions. The dish choices showed no differences between the control and intervention groups in both age groups, and no differences were found among the other variables analysed. This nudging strategy, ‘dish of the day’, seems not to work for the Danish sample of adolescents and older people. Future nudging studies with these populations are needed in order to find the best strategy to move adolescents' and older people's food habits toward a healthier pattern

A Systematic Review of Behavioural Interventions Promoting Healthy Eating among Older People.

Because eating habits are inseparably linked with people's physical health, effective behaviour interventions are highly demanded to promote healthy eating among older people. The aim of this systematic review was to identify effective diet interventions for older people and provide useful evidence and direction for further research. Three electronic bibliographic databases-PubMed, Scopus and Web of Science Core Collection were used to conduct a systematic literature search based on fixed inclusion and exclusion criteria. English language peer-reviewed journal articles published between 2011 and 2016 were selected for data extraction and quality assessment. Finally, a total of 16 studies were identified. The studies' duration ranged from three weeks to seven years. The majority of studies were carried out in European countries. Seven studies had a moderate quality while the remaining studies were at a less than moderate level. Three dietary educational interventions and all meal service related interventions reported improvements in older people's dietary variety, nutrition status, or other health-related eating behaviours. Multicomponent dietary interventions mainly contributed to the reduction of risk of chronic disease. The results supported that older people could achieve a better dietary quality if they make diet-related changes by receiving either dietary education or healthier meal service. Further high-quality studies are required to promote healthy eating among older people by taking regional diet patterns, advanced information technology, and nudging strategies into account

Increasing Vegetable Intakes: An Updated Systematic Review of Published Interventions

Vegetable consumption is important for a variety of health reasons, yet intakes are typically lower than recommended. Interventions to improve fruit and vegetable consumption are available, but these interventions are typically more successful for fruit consumption, while vegetable intakes remain low. This chapter details the interventions currently available that focus specifically on improving vegetable intakes. A systematic review of the published literature was conducted in 2015, and this has been updated for this chapter. Databases - PubMed, PsychInfo and Medline were searched over all years of records until January 2017 using pre-specified terms. Our searches identified 119 studies, detailing 206 interventions. Interventions aimed to use or change hedonic factors, such as taste, liking and familiarity (n=103), use or change environmental factors (n=54), use or change cognitive factors (n=28), or a combination of strategies (n=21). Increased vegetable acceptance, selection and/or consumption were reported to some degree in 186 (90%) interventions. Greatest success appears to be achieved in interventions that improve education, change the environment or use multiple approaches, but long-term success and cost-effectiveness are rarely considered. A focus on long-term benefits and sustained behaviour change is required

Impact of a nudging intervention and factors associated with vegetable dish choice among European adolescents.

PURPOSE: To test the impact of a nudge strategy (dish of the day strategy) and the factors associated with vegetable dish choice, upon food selection by European adolescents in a real foodservice setting. METHODS: A cross-sectional quasi-experimental study was implemented in restaurants in four European countries: Denmark, France, Italy and United Kingdom. In total, 360 individuals aged 12-19 years were allocated into control or intervention groups, and asked to select from meat-based, fish-based, or vegetable-based meals. All three dishes were identically presented in appearance (balls with similar size and weight) and with the same sauce (tomato sauce) and side dishes (pasta and salad). In the intervention condition, the vegetable-based option was presented as the "dish of the day" and numbers of dishes chosen by each group were compared using the Pearson chi-square test. Multivariate logistic regression analysis was run to assess associations between choice of vegetable-based dish and its potential associated factors (adherence to Mediterranean diet, food neophobia, attitudes towards nudging for vegetables, food choice questionnaire, human values scale, social norms and self-estimated health, country, gender and belonging to control or intervention groups). All analyses were run in SPSS 22.0. RESULTS: The nudging strategy (dish of the day) did not show a difference on the choice of the vegetable-based option among adolescents tested (p = 0.80 for Denmark and France and p = 0.69 and p = 0.53 for Italy and UK, respectively). However, natural dimension of food choice questionnaire, social norms and attitudes towards vegetable nudging were all positively associated with the choice of the vegetable-based dish. Being male was negatively associated with choosing the vegetable-based dish. CONCLUSIONS: The "dish of the day" strategy did not work under the study conditions. Choice of the vegetable-based dish was predicted by natural dimension, social norms, gender and attitudes towards vegetable nudging. An understanding of factors related to choosing vegetable based dishes is necessary for the development and implementation of public policy interventions aiming to increase the consumption of vegetables among adolescents

Increasing vegetable consumption out-of-home: VeggiEAT and Veg+projects

© 2020 The Authors. Nutrition Bulletin published by John Wiley & Sons Ltd on behalf of British Nutrition Foundation Adequate vegetable consumption is fundamental to a healthy, balanced diet; however, global compliance with recommendations to increase consumption is poor. There is a growing interest in the sustainability of current dietary patterns in light of expected climate change and an expanding global population where part of the response is increasing vegetable intake. Two international projects, VeggiEAT and Veg+, explored the determinants of vegetable liking and consumption in different age groups and countries and the effect of a nudging strategy on vegetable consumption in an out-of-home setting. The projects found that the importance given by consumers to natural or healthy ingredients, social norms, female gender and positive attitudes towards nudging all influenced vegetable consumption. Some sensory factors, such as bitterness and sourness, had a negative loading, while others, such as sweetness, had a positive effect on liking for vegetables. ‘Dish of the day’, as a nudging strategy in a workplace canteen setting, increased vegetable dish selection for some of the sample (adolescent females) but not for males or older people. Globally, there is a strong need to promote the consumption of vegetables as a public health issue but also to improve their availability and uptake, especially within out-of-home foodservice

Shaping smarter consumer food choices: The FoodSMART project.

Compared to meals prepared at home, meals eaten out of home tend to contain more energy, total fat and saturated fat and it is here where consumers can have very little knowledge of the nutrient profile of the dish they are eating. The aim of the European Union-funded FoodSMART project (www.foodsmartproject.net) was to develop an innovative technical menu solution ‘app’ that enables informed consumer food choice, which takes into account individual preferences (such as dietary requirements) as well as food product specifications, in a workplace canteen setting. A best–worst scaling questionnaire was conducted to identify consumers’ functional app requirements and inform the development of personalised food choice messages. Proof of concept was tested using the System Usability Scale in consumers from four European countries (Denmark, France, Greece and the UK). Information on ingredients, nutrition, food ‘naturalness’ and value for money were those most valued by consumers, with this presented ideally in a personalised way and using a traffic light model. Field trials of the FoodSMART app indicated that consumers found it to be simple, easy to use and attractive for frequent use. By gaining insight into the needs of consumers, dietary information can be better tailored and provided in an appropriate format to enable informed food choice

Liking and consumption of vegetables with more appealing and less appealing sensory properties: Associations with attitudes, food neophobia and food choice motivations in European adolescents

© 2019 Elsevier Ltd Vegetable consumption in adolescents is reported to be low, at least in part, due to the unappealing sensory properties of vegetables, such as bitter tastes. However, not all vegetables have unappealing sensory properties, and strategies to improve vegetable consumption may benefit from wider consideration. This work aimed to understand the individual characteristics in adolescents from four European countries associated with the regular consumption and liking of vegetables with more appealing and less appealing sensory properties. Adolescents from Denmark (N = 178), the UK (N = 155), France (N = 206) and Italy (N = 197) completed self-report questionnaires to assess all variables. We found higher self-reported consumption and liking of vegetables with more appealing than less appealing sensory properties. Regular consumption of both types of vegetable was associated with healthier eating habits and a higher liking for each vegetable type. Liking for vegetables with more appealing sensory properties was higher in individuals with lower food neophobia, healthier eating habits, higher interest in consuming foods for sensory reasons and higher liking for vegetables with less appealing properties. Liking for vegetables with less appealing sensory properties was higher in individuals with lower food neophobia, higher concern for the consumption of natural foods, and higher liking for vegetables with more appealing properties. Some gender and country-specific differences were also found. Our findings suggest that strategies to increase vegetable consumption in adolescents should focus on increasing healthy eating in general, increasing vegetable liking, and may benefit from reducing food neophobia and enhancing the positive sensory and natural aspects of vegetables