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Effecting dietary change

Published online by Cambridge University Press:  07 March 2007

Ashley J. Adamson*
Human Nutrition Research Centre, School of Clinical Medical Sciences, Faculty of Medical Sciences, University of Newcastle,Newcastle upon Tyne, NE1 4LP, UK
John C. Mathers
Human Nutrition Research Centre, School of Clinical Medical Sciences, Faculty of Medical Sciences, University of Newcastle,Newcastle upon Tyne, NE1 4LP, UK
*Corresponding author: Dr Ashley Adamson, fax +44 191 222 5276, email
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A world epidemic of diet-related chronic disease is currently being faced. In the UK incidence of obesity alone has tripled in the last 20 years and this trend is predicted to continue. Consensus exists for the urgent need for a change in diet and other lifestyle factors and for the direction and targets for this change. The evidence for how this change can be achieved is less certain. It has been established that disease processes begin in childhood. Recent evidence indicates that dietary habits too are established in childhood but that these habits are amenable to change. While establishing a healthy lifestyle in childhood is paramount, interventions have the potential to promote positive change throughout the life course. Success in reversing current trends in diet-related disease will depend on commitment from legislators, health professionals, industry and individuals, and this collaboration must seek to address not only the food choices of the individual but also the environment that influences such choices. Recent public health policy development in England, if fully supported and implemented, is a positive move towards this goal. Evidence for effective strategies to promote dietary change at the individual level is emerging and three reviews of this evidence are discussed. In addition, three recent dietary intervention studies, in three different settings and with different methods and aims, are presented to illustrate methods of effecting dietary change. Further work is required on what factors influence the eating behaviour and physical activity of individuals. There is a need for further theory-based research on which to develop more effective strategies to enable individuals to adopt healthier lifestyles.

Symposium on ‘Micronutrient interactions and public health’
Copyright © The Nutrition Society 2004


Adamson, AJ, Curtis, P, Loughridge, J, Rugg-Gunn, A, Spendiff, A & Mathers, J (2000) A family-based intervention to increase consumption of starchy foods. Nutrition and Food Science 30, 1923.CrossRefGoogle Scholar
Adamson, AJ, Spendiff, A, Curtis, PJ, Jones, A & Mathers, JC (2001) Relationship between consumer attitudes to starchy foods and starch consumption. Proceedings of the Nutrition Society 60, 184A.Google Scholar
Ajzen, I (1985) From intentions to actions: a theory of planned behaviour. In Action-Control: From Cognition to Behaviour, pp. 1139 [Kuhl, J, Beckman, J, editors]. Heidelberg, Germany: Springer.CrossRefGoogle Scholar
Ammerman, A, Lindquist, C & Hersey, J (2001) Evidence Report on the Efficacy of Interventions to Modify Dietary Behaviour Related to Evidence Risk Rockville, MD Agency for Healthcare Research and Quality.Google Scholar
Ammerman, AS, Lindquist, CH, Lohr, KN & Hersey, J (2002) The efficacy of behavioural interventions to modify dietary fat and fruit and vegetable intake: A review of the evidence. Preventive Medicine 35, 2541.CrossRefGoogle ScholarPubMed
Anderson, AS, Adamson, A, Hetherington, MM, Foster, E, Porteous, L & Higgins, C (2001) Results from a school-based nutrition education intervention aimed at increasing fruit and vegetable intake in primary school aged children. Proceedings of the Nutrition Society 60, 143A.Google Scholar
Baranowski, T, Davis, M, Reniscow, K, Baranowski, J, Doyle, C, Lin, LS, Smith, M & Wang, DT (2000) Gimme 5 fruit, juice, and vegetables for fun and health: outcome evaluation. Health Education and Behaviour 27, 96111.CrossRefGoogle ScholarPubMed
Craigie, AM, Lake, AA, Wood, C, Gibbons, M, Rugg-Gunn, AJ, Mathers, JC & Adamson, AJ (2003) Tracking of adiposity and dietary intake from adolescence to adulthood: a longitudinal study. International Journal of Obesity 27, Suppl.1, S9.Google Scholar
Craigie, AM, Lake, AA, Wood, C, Gibbons, M, Webster, S, Adamson, AJ, Rugg-Gunn, AJ & Mathers, JC (2002) The stability of nutrient intake between adolescence and adulthood: a 21-year follow-up. Proceedings of the Nutrition Society 61, 105A.Google Scholar
Crowe, TC, Fontaine, HL, Gibbons, CJ, Cameron-Smith, D & Swinburn, BA (2004) Energy density of foods and beverages in the Australian food supply: influence of macronutrients and comparison to dietary intake. European Journal of Clinical Nutrition – available as advanced online publication: doi:10.1038/sj.ejcn.1601994.CrossRefGoogle ScholarPubMed
Curtis, PJ, Adamson, AJ & Mathers, JC (2001 a) Associations between fruit and vegetable, starch and fat consumption. Proceedings of the Nutrition Society 60, 183A.Google Scholar
Curtis, PJ, Adamson, AJ & Mathers, JC (2001 b) The relationship between starch and fat consumption. Proceedings of the Nutrition Society 60, 70A.Google Scholar
Curtis, PJ, Webster, S, Adamson, AJ & Mathers, JC (2002) Parental change in starch and fat intake, after a ‘starchy food’ intervention. Proceedings of the Nutrition Society 61, 106A.Google Scholar
De Bourdeaudhuij, I, Brug, J (2000) Tailoring dietary feedback to reduce fat intake: an intervention at the family level. Health Education Research 15, 449462.CrossRefGoogle ScholarPubMed
Department of Health (1991) Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Report on Health and Social Subjects no. 41. London: H. M. Stationery Office.Google Scholar
Department of Health (2000) The NHS Cancer Plan. London: The Stationery Office.Google Scholar
Department of Health (2002) Health improvement and prevention. National service frameworks: a practical aid to implementation in primary care. Scholar
Department of Health (2004 a) Choosing Health? Choosing a Better Diet: A Consultation on Priorities for a Food and Health Action Plan. London: The Stationery Office.Google Scholar
Department of Health (2003) Health Check: On the state of the public health. Annual report of Chief Medical Officer 2002. Scholar
Diabetes Prevention Program Research Group (2002) Reduction in the incidence of type II diabetes with lifestyle intervention or metformin. New England Journal of Medicine 346, 343403.Google Scholar
Egger, G, Swinburn, B & Rossner, S (2003) Dusting off the epidemiological triad: could it work with obesity. Obesity Reviews 4, 115119.CrossRefGoogle ScholarPubMed
Ehtisham, S, Hattersley, AT, Dunger, DB & Barrett, TG (2004) First UK survey of paediatric type 2 diabetes and MODY. Archives of Disease in Childhood 89, 526529.CrossRefGoogle ScholarPubMed
Gregory, J, Lowe, S, Bates, CJ, Prentice, A, Jackson, LJ, Smithers, G, Wenlock, R & Farron, M (2000) National Diet and Nutrition Survey: Young People Aged 4–18 Years. 1: Report of the Diet and Nutrition Survey. London: The Stationery Office.Google Scholar
Hackett, AF, Rugg-Gunn, AJ, Appleton, DR, Eastoe, JE & Jenkins, GN (1984) A 2-year longitudinal nutritional survey of 405 Northumberland children initially aged 11.5 years. British Journal of Nutrition 51, 6775.CrossRefGoogle ScholarPubMed
Harvey, EL, Glenny, AM, Kirk, SF & Summerbell, CD (1999) A systematic review of interventions to improve health professionals' management of obesity. International Journal of Obesity and Related Metabolic Disorders 23, 12131222.CrossRefGoogle ScholarPubMed
Havas, S, Heimendinger, J, Reynolds, K, Baranowski, T, Nicklas, TA, Bishop, D, Buller, D, Sorensen, G, Baresford, SA, Cowan, A & Damron, D (1994) 5 a day for better health: A new research initiative. Journal of the American Dietetic Association 94, 3236.CrossRefGoogle Scholar
Health Education Authority, Department of Health and Ministry of Agriculture Fisheries and Food (1994) The Balance of Good Health. London: H. M. Stationery Office.Google Scholar
Henderson, L & Gregory, J (2002) The National Diet and Nutrition Survey: Adults Aged 19 to 64 Years. 1: Types and Quantities of Foods Consumed. London: The Stationery Office.Google Scholar
Higgins, C, Hetherington, MM, Anderson, AS, Porteous, LEG, Foster, E & Adamson, AJ (2001) Children's understanding of fruits and vegetables: implications for nutrition education. Proceedings of the Nutrition Society 60, 2A.Google Scholar
Hu, FB, Manson, JE, Stamfer, MJ, Colditz, G, Liu, S, Solomon, CG & Willett, WC (2001) Diet, lifestyle, and the risk of type II diabetes mellitus in women. New England Journal of Medicine 345, 790797.CrossRefGoogle ScholarPubMed
Key, TJ, Allen, NE, Spencer, EA & Travis, RC (2002) The effect of diet on risk of cancer. Lancet 14, 861868.CrossRefGoogle Scholar
Lake, AA, Rugg-Gunn, AJ, Hyland, RM, Craigie, AC, Wood, CE, Gibbons, MR, Mathers, JC & Adamson, AJ (2004) Longitudinal dietary change from adolescence to adulthood: perceptions, attributions and evidence. Appetite 42, 255263.CrossRefGoogle ScholarPubMed
Mathers, JC (2004) Chairman's introduction: What can we expect to learn from genomics. Proceedings of the Nutrition Society 63, 14.CrossRefGoogle ScholarPubMed
Moore, H, Greenwood, D, Gill, T, Waine, C, Soutter, J & Adamson, AJ (2003 a) A cluster randomised trial to evaluate a nutrition training programme. British Journal of General Practitioners 53, 271277.Google ScholarPubMed
Moore, H, Summerbell, CD, Greenwood, DC, Tovey, P, Griffiths, J, Henderson, M, Hesketh, K, Woolgar, S & Adamson, AJ (2003 b) Improving management of obesity in primary care: cluster randomised trial. British Medical Journal 327, 1085.CrossRefGoogle ScholarPubMed
Moore, H, Summerbell, CD, Vail, A, Greenwood, DC & Adamson, AJ (2001) The design features and practicalities of conducting a pragmatic cluster randomised trial of obesity management in primary care. Statistics in Medicine 20, 331340.3.0.CO;2-K>CrossRefGoogle ScholarPubMed
National Audit Office (2001) Tackling Obesity in England: Report by the Comptroller and Auditor General London The Stationery Office 0001/0001220es.pdf.Google Scholar
Nicklas, TA, Johnson, CC, Myers, L, Farris, RP & Cunningham, A (1998) Outcomes of a high school program to increase fruit and vegetable consumption: Gimme 5 – a fresh nutrition concept for students. Journal of School Health 68, 248253.CrossRefGoogle ScholarPubMed
Pignone, MP, Ammerman, A, Fernandez, L, Orleans, CT, Pender, N, Woolf, S, Lohr, K & Sutton, S (2003) Counselling to promote a healthy diet in adults: A summary of the evidence for the U.S. Preventive Services Task Force. American Journal of Preventive Medicine 24, 7592.CrossRefGoogle ScholarPubMed
Prentice, AM & Jebb, SA (2003) Fast foods, energy density and obesity: a possible mechanistic link. Obesity Reviews 4, 187194.CrossRefGoogle ScholarPubMed
Roe, L, Hunt, P, Bradshaw, H & Rayner, M (1997) Health Promotion Interventions to Promote Healthy Eating in the General Population: A Review. London: Health Education Authority.Google Scholar
Sallis, JF, McKenzie, TL, Conway, TL, Elder, JP, Prochaska, JJ, Brown, M, Zive, MM, Marshall, SJ & Alcaraz, JE (2003) Environmental interventions for eating and physical activity: a randomised controlled trial in middle schools. American Journal of Preventive Medicine 24, 209217.CrossRefGoogle ScholarPubMed
Stampfer, MJ, Hu, FB, Manson, JE, Rimm, EB & Willett, WC (2000) Primary prevention of coronary heart disease in women through diet and lifestyle. New England Journal of Medicine 343, 1622.CrossRefGoogle ScholarPubMed
Stubenitsky, K & Mela, DJ (2000) UK consumer perceptions of starchy foods. British Journal of Nutrition 83, 277285.CrossRefGoogle ScholarPubMed
Tohill, UR, Curtis, PJ, Adamson, AJ & Mathers, JC (2001) Individual's perception of diet with regard to health compared with recorded intake. Proceedings of the Nutrition Society 60, 181A.Google Scholar
Trudeau, E, Kristal, AR, Li, S & Patterson, RE (1998) Demographic and psychosocial predictors of fruit and vegetable intakes differ: implications for dietary interventions. Journal of the American Dietetic Association 98, 14121417.CrossRefGoogle ScholarPubMed
Tuomilehto, J, Jousilahti, P, Rastenyte, D, Moltchanov, V, Tanskanen, A, Pietinen, P & Nissinen, A (2001) Urinary sodium excretion and cardiovascular mortality in Finland: a prospective study. Lancet 357, 848851.CrossRefGoogle ScholarPubMed
Van Assema, P, Martens, M, Ruiter, RA & Brug, J (2001) Framing of nutrition education messages in persuading consumers of the advantages of a healthy diet. Journal of Human Nutrition and Dietetics 14, 435442.CrossRefGoogle ScholarPubMed
Wardle, J (1995) Parental influences on children's diets. Proceedings of the Nutrition Society 54, 747758.CrossRefGoogle ScholarPubMed
Williams, CL, Strobino, BA, Bollella, M & Brotanek, J (2004) Cardiovascular risk reduction in preschool children: the ‘Healthy Start’ project. Journal of the American College of Nutrition 23, 117123.CrossRefGoogle ScholarPubMed
World Health Organization (2002) The World Health Report 2002: Reducing Risks, Promoting Healthy Life.GenevaWHO.Google Scholar
World Health Organization (2003) Report of WHO/FAO Expert Consultation. Diet, Nutrition and the Prevention of Chronic Diseases WHO Technical Report SeriesGenevaWHO.Google Scholar
Wright, CM, Parker, L, Lamont, D & Craft, AW (2001) Implications of childhood obesity for health; findings from the thousand families cohort study. British Medical Journal 323, 12801284.CrossRefGoogle ScholarPubMed