Interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults

Abstract

Background-It has been recognized that poor adherence can be a serious risk to the health and wellbeing of patients, and greater adherence to dietary advice is a critical component in preventing and managing chronic diseases. Objectives-To assess the effects of interventions for enhancing adherence to dietary advice for preventing and managing chronic diseases in adults. Search methods-We searched the following electronic databases up to 29 September 2010: The Cochrane Library (issue 9 2010), PubMed, EMBASE (Embase.com), CINAHL (Ebsco) and PsycINFO (PsycNET) with no language restrictions. We also reviewed: a) recent years of relevant conferences, symposium and colloquium proceedings and abstracts; b) web-based registries of clinical trials; and c) the bibliographies of included studies. Selection criteria-We included randomized controlled trials that evaluated interventions enhancing adherence to dietary advice for preventing and managing chronic diseases in adults.

Dietitians’ Perspectives on Interventions to Enhance Adherence to Dietary Advice for Chronic Diseases in Adults

“…For example, Zhao and Wong [27] evaluated the effects of telephone follow-up as well as individual sessions with a dietitian combined with goal setting in patients with coronary heart disease, and they reported a higher proportion of clients with high adherence to the diet in the intervention group compared with the usual care group at 4 and 12 weeks. In our Cochrane systematic review [11], other studies of multiple interventions also showed the most positive effect on diet adherence outcomes compared with control groups [28][29][30][31]. However, dietitians in our study mentioned time constraints as a barrier to use of multiple interventions and underlined the fact that it requires them to learn many new skills.…”

“…From the list of effective interventions identified in a Cochrane systematic review [11], Canadian dietitians ranked 3 interventions as the most important and applicable for enhancing dietary adherence: feedback based on self-monitoring, use of multiple interventions, and portion size awareness.…”

“…It must be emphasized that in our Cochrane systematic review, interventions for enhancing diet adherence were designated as promising if they improved at least 1 diet adherence outcome, such as adherence to a potassium-restricted diet, to a sodium-restricted diet, or to energy intake targets [11]. However, for other diet adherence outcomes, these interventions showed no difference compared with the control or usual care group, making the results inconclusive about the most effective intervention for enhancing adherence to dietary advice.…”

“…For the purpose of our Cochrane systematic review, an intervention was defined as a method used to facilitate changes in dietary habits through dietary advice [11]. Table 1 presents the definitions of the 8 interventions selected from the review.…”

“…As greater adherence to dietary advice is an essential component for preventing the onset and progression of many diet-related chronic diseases, interventions to improve patient adherence to dietary advice using various techniques have been developed [9,10]. To identify these interventions, we conducted a Cochrane systematic review to assess the effects of interventions enhancing adherence to dietary advice for preventing and managing chronic diseases in adults [11]. Eight interventions to enhance adherence to dietary advice (behavioural contracts, exchange lists, feedback based on self-monitoring, individualized menu suggestions, multiple interventions, portion size awareness, telephone follow-up, and videos) were identified as promising on the basis of their positive effect on at least 1 diet adherence outcome.…”