Clifford D, Ozier A, Bundros J, Moore J, Kreiser A, Morris MN. Impact of non-diet approaches on attitudes, behaviors, and health outcomes: a systematic review.
JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2015;
47:143-55.e1. [PMID:
25754299 DOI:
10.1016/j.jneb.2014.12.002]
[Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 12/03/2014] [Accepted: 12/03/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE
To determine the overall effect of non-diet, weight-neutral interventions on factors such as weight, biochemical measures, food and activity behavior, body image, and mental health.
DESIGN
Systematic review of intervention literature.
SETTING
Group classes in community and worksite settings (14 studies), and individual counseling (1) and online education (1) in college settings.
PARTICIPANTS
Eighteen research articles (representing 16 studies) evaluating non-diet interventions using quasi-experimental and randomized study designs with either a comparison or control group.
MAIN OUTCOME MEASURES
Anthropometric, physiological, psychological, and dietary intake.
ANALYSIS
Systematic search of 168 articles and review of 18 articles meeting inclusionary criteria.
RESULTS
Non-diet interventions resulted in statistically significant improvements in disordered eating patterns, self-esteem, and depression. None of the interventions resulted in significant weight gain or worsening of blood pressure, blood glucose, or cholesterol, and in 2 studies biochemical measures improved significantly compared with the control or diet group. Primary limitations were inconsistent definitions of non-diet approaches and the use of different assessment instruments for measuring outcomes.
CONCLUSIONS AND IMPLICATIONS
Because of the long-term ineffectiveness of weight-focused interventions, the psychological improvements seen in weight-neutral, non-diet interventions warrant further investigation.
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