A Smartphone Intervention to Promote a Sustainable Healthy Diet: Protocol for a Pilot Study.

BACKGROUND: Changing current dietary patterns into sustainable healthy diets (ie, healthy diets with low environmental impact and socioeconomic fairness) is urgent. So far, few eating behavior change interventions have addressed all the dimensions of sustainable healthy diets at once and used cutting-edge methods from the field of digital health behavior change. OBJECTIVE: The primary objectives of this pilot study were to assess the feasibility and effectiveness of an individual behavior change intervention toward the adoption of a more environmentally sustainable healthy diet as a whole and changes in specific relevant food groups, food waste, and obtaining food from fair sources. The secondary objectives included the identification of mechanisms of action that potentially mediate the effect of the intervention on behaviors, identification of potential spillover effects and covariations among different food outcomes, and identification of the role of socioeconomic status in behavior changes. METHODS: We will run a series of ABA n-of-1 trials over a year, with the first A phase corresponding to a 2-week baseline evaluation, the B phase to a 22-week intervention, and the second A phase to a 24-week postintervention follow-up. We plan to enroll 21 participants from low, middle, and high socioeconomic statuses, with 7 from each socioeconomic group. The intervention will involve sending text messages and providing brief individualized web-based feedback sessions based on regular app-based assessments of eating behavior. The text messages will contain brief educational messages on human health and the environmental and socioeconomic effects of dietary choices; motivational messages to encourage the adoption of sustainable healthy diets by participants, providing tips to achieve their own behavioral goals; or links to recipes. Both quantitative and qualitative data will be collected. Quantitative data (eg, on eating behaviors and motivation) will be collected through self-reported questionnaires on several weekly bursts spread through the study. Qualitative data will be collected through 3 individual semistructured interviews before the intervention period, at the end of the intervention period, and at the end of the study. Analyses will be performed at both the individual and group levels depending on the outcome and objective. RESULTS: The first participants were recruited in October 2022. The final results are expected by October 2023. CONCLUSIONS: The results of this pilot study will be useful for designing future larger interventions on individual behavior change for sustainable healthy diets. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/41443.

Effect of the COVID-19 pandemic on weight loss of Korean athletes: changes in athletes' physical activity and eating behavior.

PURPOSE: This study aims to examine the physical activity and eating habits of elite athletes to identify changes in their weight and participation levels in competitions pre- and post-COVID-19, and to establish a database of the abovementioned factors for the post-COVID-19 period. METHODS: This study surveyed 913 elite adult athletes from 22 sports. They were divided into two groups: weight loss athletes' group (WLG) and non-weight loss athletes' group (NWLG). In addition to demographic factors, the questionnaire included questions about physical activity, sleep, and eating habits pre- and post-COVID-19 pandemic. The survey included 46 questions requiring short subjective answers. Statistical significance was set at p<0.05. RESULTS: In the post-COVID-19 pandemic period, physical activity and sitting decreased in athletes of both groups. The difference in the number of meals consumed by both groups varied, and the number of tournaments the athletes participated in decreased for all sports. The success or failure of weight loss is essential for maintaining athletes' performance and health. CONCLUSION: Coaches play an important role in investigating and managing the weight loss regimen of athletes during crisis situations like a pandemic. Additionally, athletes must find the best way to maintain their competencies to the standards set before COVID-19. Adhering to such a regimen will have the greatest impact on their tournament participation in the post-COVID-19 pandemic period.

Susceptibility to COVID-19 Nutrition Misinformation and Eating Behavior Change during Lockdowns: An International Web-Based Survey.

To understand the susceptibility to nutrition-health misinformation related to preventing, treating, or mitigating the risk of COVID-19 during the initial lockdowns around the world, the present international web-based survey study (15 April-15 May 2020) gauged participants' (n = 3707) level of nutrition-health misinformation discernment by presenting them with 25 statements (including unfounded or unproven claims circulated at the time), alongside the influence of information sources of varying quality on the frequency of changes in their eating behavior and the extent of misinformation held, depending on the source used for such changes. Results revealed widespread misinformation about food, eating, and health practices related to COVID-19, with the 25 statements put to participants receiving up to 43% misinformed answers (e.g., 'It is safe to eat fruits and vegetables that have been washed with soap or diluted bleach'). Whereas higher quality information sources (nutrition scientists, nutrition professionals) had the biggest influence on eating behavior change, we found greater misinformation susceptibility when relying on poor quality sources for changing diet. Appropriate discernment of misinformation was weakest amongst participants who more frequently changed their eating behavior because of information from poor quality sources, suggesting disparities in the health risks/safety of the changes performed.

Diet-Nutrition Information Seeking, Source Trustworthiness, and Eating Behavior Changes: An International Web-Based Survey.

To understand the extent to which different sources of diet and nutrition information are sought, trusted, and relied upon for making dietary changes, the present international web-based survey study gauged participants' (n = 3419) diet-nutrition information-seeking behaviors from 22 interpersonal and general sources with varying quality, trust levels in these sources, and reliance on each source for making dietary changes. Qualitative insights were also captured regarding trustworthiness formation. The results revealed a disconnect between source popularity and perceived trustworthiness. While nutrition-health websites, Google-Internet searches, and diet-health books were most commonly consulted, participants placed the highest level of trust in nutrition scientists, nutrition professionals, and scientific journals, suggesting that frequent information seeking from a subpar source may not be a reliable predictor of the level of trust assigned to it. Although the frequency of source-seeking behaviors and source trustworthiness both contributed to dietary changes, the latter appeared to have a more pronounced influence. When a source was less trusted, there was a reduced likelihood of relying on it for changing diet. Additionally, source seeking may not always translate into effective dietary change, as shown by the less strong correlation between the two. These associations significantly differed depending on the source.

Effect of motivational interviewing health education based on trans-theoretical model on healthy diet cognition and behavior change of patients with cerebral infarction / 中国实用护理杂志

Objective To investigate the intervention effect of motivational interviewing health education based on trans-theoretical model to hospitalized patients with cerebral infarction on their healthy diet cognition and behavior change.Methods 60 patients with cerebral infarction were selected with convenient sampling method,and in accordance with the incorporating order randomly divided them into the intervention group and the control group,each with 30 cases.The intervention group received the motivational interviewing health education based on the trans-theoretical model,which mainly focused on a healthy diet,while the control group received regular health diet education.The intervention effect was compared between two groups.Results The comparative difference of baseline data between the two groups before intervention had no statistical significance,while after intervention the change on knowledge and attitude of these two groups both had statistical significance,but the intervention group improved more obviously than the control group; In regards to behavior change phrase,comparing the healthy eating behavior phase of the intervention group patients before and after the intervention,it was found that before the intervention only 4 cases were on the stage of about-to-change,accounting for 13.3％,but after the intervention the proportion was up to 40.0％ with 12 cases.Using chi-square test to compare the behavior phrase difference of the patients before and after the intervention,the difference was statistically significant.Conclusions Motivational interviewing technique based on the trans-theoretical model is an effective method in terms of cognitive and behavioral change,and the health education will improve the cognition on healthy diet and the behavior of the hospitalized patients with cerebral infarction.