The Importance of Diet for the Prevention of Chronic Diseases

People have been changing their diets lately because of all the new technology. It might not be based on what the experts say but more on what people like, taste, or what is affordable. Unhealthy eating habits, such as overeating fat, sugar, salt, and not enough fruits and vegetables, are major risk factors for chronic diseases like heart disease, cancer, and diabetes. They are preventable by eating healthy foods, limiting salt, saturated fats, transfat acids, sugars, and eating more fruits and vegetables. One effective way to promote healthy living is face-to-face individual counseling or group education. However, this approach can be expensive.

The Role of Information Technology to Improve Dietary Behavior

Information technology can reach large numbers of people quickly and effectively. However, there is insufficient evidence of its effectiveness in improving dietary behavior in developing countries. It would be better if more studies are done in this area to understand better how to use information technology in improving global health.

This study was conducted to test a new way to promote healthy diet intake using an information technology-enabled intervention called “SMART Eating” compared to traditional education using pamphlets. SMART stands for Small, Measurable, and Achievable dietary changes by Reducing fat, sugar, and salt consumption and Trying different fruits and vegetables.

The Study Method on Technology-Enabled “SMART Eating” Intervention

This two-arm cluster randomized controlled trial was done in 12 different areas (or clusters) based on how much income people made, such that there were four low-income groups, four middle-income groups, and four high-income groups. The 12 clusters were randomized equally into two arms — the intervention and comparison groups. 61 families were chosen from each cluster. Thus, there were 366 families for the intervention group and another 366 families for the comparison group. To measure the change in outcomes, one adult from each family was randomly chosen as the index case, so 732 individuals participated in this study.

A multi-channel communication approach was used for the intervention group to change their behavior. This approach included sending text messages and emails, using a social media application, and interpersonal communication. The interpersonal component included distributing the ‘SMART Eating’ kit –- a kitchen calendar, dining table mat, and measuring spoons. The intervention was done for six months.

People in the comparison group received pictorial pamphlets on nutrition education. The content in the pamphlet was the same as on the dining table mat given to the other group. One side of the pamphlet had pictures and information on seasonal fruits and vegetables and dietary recommendations. The other side had pictures of measuring spoons showing the amount of fat, sugar, and salt in one spoon as per dietary recommendations; foods high in fat, sugar, and salt; and information on how to reduce their intake.

Outcome measurements were made at baseline and after the intervention.

The Results

Of the 732 who participated, only 668 completed the study. The intervention group had significantly greater net mean changes than the comparison group in dietary intakes. Fat, sugar, and salt consumption decreased, while intake of fruits and vegetables increased. Significant increases in fiber and vitamin C intake were also observed in the intervention group compared to the comparison group.

Similarly, significant net changes occurred in the intervention group compared with the comparison group for BMI, diastolic blood pressure, FPG, and triglycerides.

The Conclusion

The ‘SMART Eating’ intervention delivered using multi-channel communication approaches effectively improved dietary behaviors among urban adults from diverse socio-economic backgrounds. It enabled a significant net reduction in fat, sugar, and salt intake and a significant net increase in fruit and vegetable intake. The intervention also successfully reduced weight, maintained systolic blood pressure, and reduced diastolic blood pressure, fasting plasma glucose, and triglycerides. Overall, the study demonstrated that it is possible to give people information about healthy eating and change more than one dietary behavior at a time through technology.

Reference

Effectiveness of Information Technology-Enabled ‘SMART Eating’ Health Promotion Intervention: A Cluster Randomized Controlled Trial