Systematic review and meta-analysis of remotely delivered interventions using self-monitoring or tailored feedback to change dietary behavior

Abstract

BackgroundSelf-monitoring (SM) of diet and tailored feedback (TF) have been suggested as tools for changing dietary behavior. New technologies allow users to monitor behavior remotely, potentially improving reach, adherence, and outcomes.ObjectiveWe conducted a systematic literature review and meta-analysis to address the following question: are remotely delivered standalone (i.e., no human contact) interventions that use SM or TF effective in changing eating behaviors?DesignFive databases were searched in October 2016 (updated in September 2017). Only randomized controlled trials published after 1990 were included. Trials could include any adult population with no history of disordered eating which delivered an SM or TF intervention without direct contact and recorded actual dietary consumption as an outcome. Three assessors independently screened the search results. Two reviewers extracted the study characteristics, intervention details, and outcomes, and assessed risk of bias using the Cochrane tool. Results were converted to standardized mean differences and incorporated into a 3-level (individuals and outcomes nested in studies) random effects meta-analysis.ResultsTwenty-six studies containing 21,262 participants were identified. The majority of the studies were judged to be unclear or at high risk of bias. The meta-analysis showed dietary improvement in the intervention group compared to the control group with a standardized mean difference of 0.17 (95% CI: 0.10, 0.24; P < 0.0001). The I2 statistic for the meta-analysis was 0.77, indicating substantial heterogeneity in results. A “one study removed” sensitivity analysis showed that no single study excessively influenced the results.ConclusionsStandalone interventions containing self-regulatory methods have a small but significant effect on dietary behavior, and integrating these elements could be important in future interventions. However, there was substantial variation in study results that could not be explained by the characteristics we explored, and there were risk-of-bias concerns with the majority of studies.

Genetic variants of genes in the NER pathway associated with risk of breast cancer: A large‐scale analysis of 14 published GWAS datasets in the DRIVE study

“…We used fixed‐effects models, if no heterogeneity existed among the 14 studies, and random‐effects models were used, when heterogeneity existed. To assess the robustness of the results, we performed a sensitivity analysis by omitting each study one by one . The false discovery rate (FDR) with a critical cut‐off value of 0.05 using the linear step‐up method of Benjamini and Hochberg was mainly used to correct for multiple comparisons to reduce the probability of false‐positive findings .…”

“…To assess the robustness of the results, we performed a sensitivity analysis by omitting each study one by one. 29 The false discovery rate (FDR) with a critical cut-off value of 0.05 using the linear step-up method of Benjamini and Hochberg was mainly used to correct for multiple comparisons to reduce the probability of false-positive findings. 30 To observe the combined effect of significant SNPs, we used the number of unfavorable genotypes (NUGs) of the significant SNPs as a genetic score to assess classification performance of the model.…”

Cross cultural “behavioural diagnosis” examining the uptake of the MIND diet, using the COM-B model to inform an intervention.

“…Participants from both samples reported lack of monitoring their food intake which further highlights "capability" as a barrier to uptake of the MIND diet. Previous research found that behaviour regulation was associated with changes in dietary outcomes [55] and more specifically, self-monitoring was associated with a positive change in diet [56,57]. Self-monitoring is shown to not only increase awareness of eating patterns [58,59], but also allows professionals to identify food aversions/intolerances and poor food choices [59].…”

Strategies for online personalised nutrition advice employed in the development of the eNutri web app

“…Two interventions used a French online service (Minitel) which is no longer available. Another outdated technology, a personal digital assistant (PDA), was used in 2008 (64) . The study conducted by Campbell et al did not have human contact during the nutritional feedback but used software installed in the offices where the study was conducted (65) .…”

“…Web application [1] Source: Adapted from [64] . Considering only interventions using computer technology and classifying these systems.…”