International Journal of Behavioral Nutrition and Physical Activity最新文献

Background: Continuous glucose monitoring (CGM) is increasingly being used within precision health interventions to motivate behaviour change. However, there is considerable variability and complexity in the design of behaviour change interventions that incorporate CGM-based biofeedback, making it challenging to disentangle the intervention components that are driving intervention effects. The objective of this review is to identify the behaviour change techniques and mechanisms of action commonly implemented alongside CGM-based biofeedback.

Methods: We conducted secondary analyses of a scoping review to identify health behaviour interventions (RCTs) that provided CGM-based biofeedback to promote behaviour change in adults. Two researchers applied the 93-item Behaviour Change Techniques (BCT) Taxonomy (v1) to independently code intervention content in all trial arms (i.e., intervention and comparison arms) dependent upon their targeted behaviour of CGM use, glucometer use, diet, physical activity, or medication adherence. BCTs were analysed individually and according to their corresponding category. We performed univariate linear regression analyses to examine whether the presence of individual BCTs and target behaviours influenced pre-post changes in HbA1c within CGM-based intervention arms.

Results: Thirty-one RCTs comprising 35 intervention arms and 29 comparison arms were included. Theory was reported in 4 studies (13%), most commonly Self-Efficacy Theory. Mechanisms of action (MoAs) were specified in 5 studies (16%), typically targeting beliefs about capabilities. We identified 40 (of 93 possible) unique BCTs, with intervention arms employing an average of 7.1 BCTs (SD: 4.8) compared to 5.3 BCTs (SD: 4.3) in comparison arms. The most frequently implemented BCT categories in CGM-based biofeedback interventions were 'Feedback and monitoring' (n = 35/35, 100%), 'Shaping knowledge' (n = 28/35, 80%), and 'Social support' (n = 22/35, 63%). Commonly used BCTs supporting CGM use and promoting dietary and physical activity changes included 'Biofeedback' (n = 35/35; 100%), 'Instruction on how to perform the behaviour' (n = 19/35; 54%), and 'Credible source' (n = 14/35; 40%). Univariate linear regressions did not identify any individual BCTs or targeted behaviours that significantly moderated HbA1c outcomes.

Conclusions: RCTs using CGM to change behaviour in adult populations include a range of BCTs, focusing predominantly on BCTs that support the implementation of CGM itself. Future research should examine whether BCTs operate through distinct MoAs when supporting CGM uptake and use versus when promoting broader health behaviour change in conjunction with CGM-based biofeedback.

Background: Physical activity (PA) is essential for physical and mental health, yet sustaining long-term PA engagement remains a challenge. Booster strategies-follow-up contacts delivered after the end of interventions-have been proposed as a strategy to support PA maintenance, but their effectiveness remains unclear. The primary objective of this systematic review and meta-analysis was to classify the boosters used in PA interventions depending on their type and number. The secondary objective was to explore the efficacy of boosters in supporting participants' PA maintenance.

Methods: A systematic search was conducted across seven databases, up to February 2025. Randomised controlled trials were included if they incorporated boosters and reported PA outcomes. Risk of bias was assessed using the RoB 2 tool. Meta-analysis examined changes in moderate-to-vigorous physical activity (MVPA) from baseline to the last available follow-up, and moderation analysis explored the effects of booster type, number of boosters administered, and follow-up duration on changes in MVPA. Studies not suitable for meta-analysis were synthesised narratively.

Results: Forty studies were included in the systematic review. The most common types of boosters used were phone calls and text messages, which were employed either alone or in combination with other types. 16 studies provided data for inclusion in the meta-analysis. There was conclusive evidence that including a booster in the intervention led to sustained increases in PA levels at follow-up. The estimated added effect of the booster over the intervention alone was a 6% increase. There was also conclusive evidence of increased MVPA for interventions with more boosters, and interventions that used remote and mixed-format delivery (vs in-person only) boosters. Finally, results showed conclusive evidence of increased MVPA for interventions that assessed MVPA using self-reported measures.

Conclusions: Our findings suggest a trend indicating that boosters may support the maintenance of PA. Higher number of boosters and delivery through remote or mixed formats showed promising trends. Future research should also explore optimal booster numbers and formats to clarify their role in sustaining PA.

Registration: PROSPERO (CRD42024510018); Protocol also available on Open Science Framework (OSF): https://osf.io/6abkw/?view_only=915375148520427db3dca76d2c32934d .

Background: The directionality of longitudinal associations between children's food fussiness and parental feeding behaviors remains contested. This study aimed to assess the dynamic relationship between children's food fussiness and feeding behaviors.

Methods: To disentangle these effects, this study employed cross-lagged panel models (CLPMs) and random-intercept cross-lagged panel models (RI-CLPMs) using longitudinal data from 588 Chinese children (Mean age = 3.7 years, SD = 0.3, 51.7% boys) across three waves over two years. CLPMs capture between-person associations, while RI-CLPMs isolate within-person dynamics over time. Within-person effects represent how temporary deviations predict subsequent changes beyond stable traits, whereas between-person effects reflect enduring cross-family differences.

Results: Analyses revealed distinct patterns depending on the feeding behavior and model type: for restrictions, the CLPM showed parent-driven effects (restrictions at 3.7 years→ fussiness at 4.8 years, β = -0.104, p = 0.003), whereas the RI-CLPM identified child-driven effects (fussiness at 4.8 years → restrictions at 5.7 years, β = 0.179, p = 0.033). Both models consistently revealed child-driven effects for pressure to eat (CLPM: β = 0.151, p = 0.002; RI-CLPM: β = 0.218, p = 0.013). Food as a reward showed bidirectionality in CLPM (reward at 4.8 years → fussiness at 5.7 years: β = 0.112, p < 0.001; fussiness at 4.8 years→ reward at 5.7 years: β = 0.144, p = 0.005) but no significant cross-lagged paths in the RI-CLPM. Notably, the multi-group analysis revealed no moderating effect of child sex.

Conclusions: After accounting for stable between-person differences, RI-CLPM findings reveal that child food fussiness prospectively drives increases in parental use of restriction and pressure to eat at the within-person level. This suggests that these specific feeding behaviors may function more as reactive responses to children's eating behaviors than as caregiver-initiated strategies.

Background: Encouraging the shift towards more plant-based diets in new generations is one of the major current challenges to preserve population and planetary health. Personal pledges to reduce meat consumption could motivate behaviour change, but have received limited scientific testing. We examined the effect of a "Eat Less Meat" one-month challenge on immediate and long-term meat consumption of university students.

Methods: In January 2023, 366 university students (21 ± 3.2 years old) consented to participate in the "Eat Less Meat" one-month challenge and were randomized to the intervention group (n = 187, challenge in February 2023) or the wait list control group (n = 179, challenge in June 2023). Neither participants nor investigators were masked to group assignment. Participants chose between three meat reduction objectives: consuming meat 0, 3, or 6 times a week. They received a meat-free recipe book and followed an Instagram account where motivational information was posted daily during one month. All the participants completed a food frequency questionnaire in January (T0, before), February (T1, during), and May 2023 (T2, three months after the challenge) and data on meat consumption were analysed using linear mixed models.

Results: The participants in the "Eat less meat" one-month challenge reduced their meat consumption by -67 g/day (95% CI [-82; -53]) during the challenge and by -50 g/day (95% CI [-68; -31]) three months later. The decrease was greater than in the control group by -34 g/day (95% CI [-55; -14]) during the challenge, but there was no significant difference between intervention and control group at three months follow-up.

Conclusions: The "Eat Less Meat" one-month challenge may be a promising strategy to drive short-term reductions in meat consumption and further work to improve longer-term effectiveness is now warranted.

Trial registration: The trial was pre-registered prior to data collection at Clinicaltrials.gov (NCT05752786).

Background: While food marketing to youth is associated with harmful behavioural and dietary outcomes, few studies have assessed differences in this relationship between countries. This study examined the association between exposure to food marketing and dietary intakes among youth in six countries.

Methods: A cross-sectional analysis of International Food Policy Study 2023 Youth Survey data examined the relationship between self-reported exposure to marketing for less healthy (fast food, sugary drinks, sugary cereals, snacks, desserts/treats) and healthy (fruits, vegetables) food categories across various media/settings in the past 30 days and consumption of these foods yesterday among youth 10-17 years-old in Canada, Australia, Chile, Mexico, the United Kingdom and the United States (n=9057). Associations of food consumption with exposure to marketing of food categories and marketing techniques (e.g., characters, famous people) in food advertisements, and differences in associations between countries, were examined using binary and ordinal logistic regression.

Results: In all countries, youth reporting more frequent exposure to marketing of all less healthy food categories had higher odds of having consumed those foods yesterday (p < 0.05 for all), except snacks in Mexico. Compared with no exposure to marketing techniques, exposure to ≥ 1 marketing technique(s) in less healthy food advertisements was associated with higher odds of having consumed sugary drinks (AOR: 1.44; 95% CI: 1.21, 1.72), fast food (AOR: 1.69; 95% CI: 1.40, 2.03), sugary cereals (AOR: 1.26; 95% CI: 1.05, 1.51) and desserts/treats yesterday (AOR: 1.42; 95% CI: 1.18, 1.71) among youth in all countries. Consumption of snacks was associated with exposure to ≥ 1 marketing technique(s) in less healthy food advertisements in Australia (AOR: 1.61; 95% CI: 1.09, 2.34), Chile (AOR: 1.63; 95% CI: 1.12, 2.36) and Mexico (AOR: 2.13; 95% CI: 1.39, 3.26). Positive associations between frequency of exposure to marketing of fruits and vegetables and the number of times these foods were consumed yesterday were observed in all countries (p < 0.05), except vegetable consumption in the UK.

Conclusions: These results support the association between exposure to food marketing and consumption of marketed foods. Findings were similar between countries, reinforcing the need for global implementation of restrictions on food marketing to youth.