Effectiveness of nutrition interventions on improving diet quality and nutrition knowledge in military populations: a systematic review.

CONTEXT: Optimizing nutrition in military groups through improved diet quality and nutrition knowledge is key in supporting the high physical and cognitive demands. OBJECTIVE: The objective of this investigation was to systematically review the effectiveness of nutrition interventions among military personnel in improving diet quality and/or nutrition knowledge. DATA SOURCES: Medline, Embase, CINAHL, and Scopus were searched from the earliest records to May 2020. DATA EXTRACTION: Data were extracted by 2 reviewers. The primary outcomes were diet quality and/or nutrition knowledge. DATA ANALYSIS: Twenty studies were included. The main intervention approaches identified were nutrition education of individuals (i.e., education-based studies; EB) (n = 12), and manipulation of the food service environment (i.e., dining facility studies; DFACs) (n = 8). The most common strategies were face-to-face lectures (n = 8) for EB, and healthier menus (n = 7) and education of catering staff (n = 6) for DFAC interventions. Most studies (18/20) demonstrated favorable within-group effects; however, dietary changes were inconsistent. Five of 10 studies using a comparator group demonstrated positive between-group differences. CONCLUSION: Although potential exists for improving diet quality and nutrition knowledge in military populations, the heterogeneity of the studies to date limits conclusions on the most efficacious strategies.