Fruit and vegetables intake among elderly Iranians: a theory-based interventional study using the five-a-day program

Abstract

BackgroundThe benefit of FV intake in old age is well documented. However, there is evidence that old people do not consume enough FV. The purpose of this study was to evaluate the effectiveness of a tailored nutrition intervention that aimed to increase the FV intake among elderly Iranians aged 60 and over.MethodsThis quasi-experimental study was performed among a community-based sample of elderly in Tehran, Iran in year 2008 to 2009. Data were collected at baseline and 4 weeks follow-up. At baseline face-to-face interviews were conducted using a structured questionnaire including items on demographic information, stages of change, self-efficacy, decisional balance, daily servings of FV intake. Follow-up data were collected after implementing the intervention.ResultsIn all 400 elderly were entered into the study (200 individuals in intervention group and 200 in control group). The mean age of participants was 64.06 ± 4.48 years and overall two-third of participants were female. At baseline total FV intake was not differed between two groups but it was significantly increased in the intervention group at posttest assessment (mean serving/day in intervention group 3.08 ± 1.35 vs. 1.79 ± 1.08 in control group; P = 0.001). Further analysis also indicated that elderly in intervention group had higher FV intake, perceived benefits and self-efficacy, and lower perceived barriers. Compared with control group, greater proportions of elderly in intervention group moved from pre-contemplation to contemplation/preparation and action/maintenance stages (P < 0.0001), and from contemplation/preparation to action/maintenance stages (P = 0.004) from pretest to posttest assessments.ConclusionThis study suggests that the Transtheoretical Model is a useful model that can be applied to dietary behavior change, more specifically FV consumption among elderly population in Iran and perhaps elsewhere with similar conditions.

Predictors of Stages of Change in Fruit/Vegetable Consumption based on Trans-Theoretical Model: A Population-based Study

“…However, a quasi-experimental study showed that even more improvement in lifestyle (i.e. eating more FV) can be obtained in an elderly population with proper interventions (9). There are not any reports about FV consumption using TTM model regarding stages of change from the developing countries; so, it seems difficult to compare our findings with them.…”

“…Hence, interventions on changing FV consumption may aim to reduce the importance of negative beliefs arising from behavior change (20). The efficacy of stagetailored nutrition education has been demonstrated in several studies though there were some differences (9,36,37,38). Although some studies have failed to find any significant pros factor for predicting the stages of change (20,39), in the present study, we found that maintaining an ideal weight, being healthy, and inducing a variation in the diet are all among the significant benefits of FV consumption.…”

“…Some studies report the insufficient consumption of FV in elderly in different countries (9)(10)(11)(12). Such observations indicate that there is an urgent need for health promotion programs in order to increase FV consumption among this specific age group.…”

Selected individual determinants of cereal, fruit and vegetable consumption among menopausal women in view of potential health risks

“…Cognitive and behavioral activities promoting the level of self-efficacy and optimism, and increasing the level of satisfaction with life can be useful in the improvement of nutrition in various population groups [34], including menopausal women. Previous studies revealed that reliable education programs promote internal locus of control and self-efficacy of women [35].…”

Changes in maternal conception about breastfeeding

“…According to Tung et al, 21 to alter the conception about the conditions of discouragement to the desired behavior can result in the effects of long duration of this behavior. After an extensive literature review, there has been no studies investigating the effect of the interventions based on the Decisional Balance in relation to breastfeeding, however Salehi et al 22 demonstrated a reduction in the conception of the discouraging conditions by increasing the consumption of fruit and vegetables for elderly Iranians. The Decisional Balance construct assessment contributed to the knowledge of the interfering factors in the decision making process of breastfeeding in the studied group.…”