A systematic review of interventions to increase breakfast consumption: a socio-cognitive perspective.

OBJECTIVE: Regular breakfast skipping is related to unhealthy dietary behaviours, such as consuming an overall poorer quality diet and lower rates of physical activity, both of which are linked to a higher BMI. Adolescent breakfast skippers struggle with mental focus, sleep issues and lower grades. Solutions that can be implemented to overcome breakfast skipping are needed. DESIGN: A systematic literature review was undertaken to identify programmes that aimed to increase breakfast eating. Following the PRISMA framework, studies were sourced to examine details of behaviour change, evidence of theory use and other important programme learnings and outcomes. SETTING: Breakfast consumption empirical studies published from 2000 onwards. PARTICIPANTS: Nineteen empirical studies that aimed to improve breakfast eating behaviour. RESULTS: Out of the nineteen studies examined, ten studies reported an increase in breakfast consumption frequency for the entire study group or subgroups. Seven studies found no change, one was inconclusive and one observed a decrease in breakfast frequency. Positive changes to the dietary quality of breakfast were observed in five of the studies that did not observe increased frequency of breakfast consumption. Only six studies reported using theory in the intervention. CONCLUSIONS: This evidence review points needed to extend theory application to establish a reliable evidence base that can be followed by practitioners seeking to increase breakfast eating rates in their target population.

The Influence of Training on New Army Recruits' Energy and Macronutrient Intakes and Performance: A Systematic Literature Review.

BACKGROUND: New army recruits undertake initial training to develop their skillset and physical and mental preparedness for military service. Recruits experience a range of stressors both physical and psychological, often at extremes, and in combination. These stressors place recruits at risk of suboptimal energy and macronutrient intakes, which may negatively influence their performance. OBJECTIVE: The objectives of this systematic literature review are to examine, against the Military Recommended Dietary Intakes (MRDIs), the energy, carbohydrate, protein, and fat intakes of army recruits and trainees undertaking initial training internationally, and identify any associated influence on their performance. DESIGN: A systematic literature review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses guidelines. Information sources were searched from their inception until May 2019. MAIN OUTCOME MEASURES: Outcome data included dietary intakes of energy, carbohydrate, protein, and fat before, during, and/or after army initial training, as well as measures of physical fitness and performance. A custom tool was used to assess the quality of included studies. RESULTS: The results of 14 studies were synthesized. Six were conducted in the United States and four in each of Australia and Israel. Average energy intake represented 69% to 120% of the MRDIs before training commencement, 69% to 106% of the MRDIs in the early weeks of training and 56% to 77% of the MRDIs in the later weeks of training. Average carbohydrate and protein intakes represented 49% to 121% and 64% to 143% of the MRDIs, respectively, across the various time points. Three studies measured physical fitness and/or performance outcomes, with one showing a significant improvement in push-up performance when extra protein was provided. CONCLUSIONS: The novel findings of this systematic literature review are that army recruits, internationally, are likely to be underconsuming energy for extended periods of their initial training, with greater deficits in carbohydrate intake compared with other macronutrients. Only a handful of studies investigated the subsequent influents on performance, with no definitive conclusions drawn in most instances. Further research is needed to understand the influence of suboptimal dietary intake on military relevant performance indicators to help better inform key stakeholders when devising nutrition guidance and strategies for army recruits in the future.

A picture's worth a thousand words: a food-selection observational method.

Issue addressed: Methods are needed to accurately measure and describe behaviour so that social marketers and other behaviour change researchers can gain consumer insights before designing behaviour change strategies and so, in time, they can measure the impact of strategies or interventions when implemented. This paper describes a photographic method developed to meet these needs.Methods: Direct observation and photographic methods were developed and used to capture food-selection behaviour and examine those selections according to their healthfulness. Four meals (two lunches and two dinners) were observed at a workplace buffet-style cafeteria over a 1-week period. The healthfulness of individual meals was assessed using a classification scheme developed for the present study and based on the Australian Dietary Guidelines.Results: Approximately 27% of meals (n = 168) were photographed. Agreement was high between raters classifying dishes using the scheme, as well as between researchers when coding photographs. The subset of photographs was representative of patterns observed in the entire dining room. Diners chose main dishes in line with the proportions presented, but in opposition to the proportions presented for side dishes.Conclusions: The present study developed a rigorous observational method to investigate food choice behaviour. The comprehensive food classification scheme produced consistent classifications of foods. The photographic data collection method was found to be robust and accurate. Combining the two observation methods allows researchers and/or practitioners to accurately measure and interpret food selections. Consumer insights gained suggest that, in this setting, increasing the availability of green (healthful) offerings for main dishes would assist in improving healthfulness, whereas other strategies (e.g. promotion) may be needed for side dishes.So what?: Visual observation methods that accurately measure and interpret food-selection behaviour provide both insight for those developing healthy eating interventions and a means to evaluate the effect of implemented interventions on food selection.

Eating for the better: a social marketing review (2000-2012).

OBJECTIVE: The present study sought to identify both the ingredients for success and the potential impediments to social marketing effectiveness for healthy eating behaviour, focusing on studies conducted over the last 10 years. DESIGN: A comprehensive literature review was undertaken examining seventeen databases to identify studies reporting the use of social marketing to address healthy eating. Thirty-four empirical studies were analysed to examine the effectiveness of social marketing interventions to improve healthy eating behaviour using Andreasen's (2002) social marketing benchmark criteria. Statistical analysis was undertaken to quantitatively evaluate whether effectiveness varied between study categories (subsets). SETTING: Healthy eating empirical studies published from 2000 onwards. SUBJECTS: Empirical studies that self-identified as social marketing. RESULTS: Sixteen social marketing studies (subset 1) were identified in the review. These were systematic studies which sought to change behaviour through tailored solutions (e.g. use of marketing tools beyond communication was clearly evident) that delivered value to the target audience. For these sixteen studies, the mean number of criteria identified was five. Six studies met all six criteria. Positive change to healthy eating behaviour was found in fourteen of sixteen studies. The sixteen studies that met the definition of social marketing used significantly more of Andreasen's (2002) criteria and were more effective in achieving behavioural change than the eighteen studies in subset 2. CONCLUSIONS: Social marketing is an involved process and it is important that studies identifying as social marketing adopt social marketing benchmark criteria. Social marketing when employed to its full extent offers the potential to change healthy eating.