Interventions on diet and physical activity – what works; primary health care.

From: World Health Organisation

Journal rating:
rating: 90%
Study Quality:
rating: 10%
%

Overall Reliability

Article Quality:
rating: 5%
Partcipants
rating: 0%

Participants/situation

  • The paper is a review of the existing literature.

Study

  • This report by the World Health Organisation was published in 2009 and was a review of the eligible studies investigating diet and/or physical activity that included human participants and were published in English between January 1995 and June 2006.
  • 937 diet studies were chosen for inclusion and 776 physical activity studies.

Results

Effective Interventions

  1. Interventions targeting chronic disease risk groups that:

  • include persons who are inactive, consume less than five servings of fruits and vegetables daily, consume a lot of dietary fat, are overweight, or have a family history of obesity, heart disease, cancer and/or type 2 diabetes; and

  • include at least one session (health risk appraisal) with a health-care profes sional, with brief negotiation or discussion to decide on reasonable, attainable goals, and a follow-up consultation with trained personnel;

  • are supported by targeted information;

  • are linked and/or coordinated with other stakeholders such as community sports organisations or ongoing mass media physical activity campaigns

Moderately Effective Interventions

  1. Cholesterol screening programmes that provide clients with their results and follow-up education, ideally in person.

  2. Weight loss programmes using health professionals with:

  • personal or telephone/Internet consultations over a period of at least four weeks, and

  • a self-help programme that includes self-monitoring.

Example Interventions

  1. The Green Prescription in New Zealand targets physically inactive people seeking primary health care. A brief consultation with a primary care professional involves a discussion on the benefits of increased physical activity and joint agreement on goals. The agreed goal is then "prescribed" to the patient on green paper and faxed to the local sports foundation. Exercise specialists follow up with at least three telephone calls and the participant receives quarterly newsletters outlining opportunities for activity with the foundation. Results have shown an increase of 975 kcal/week in total energy expenditure among those in the intervention group and an increase in leisure energy expenditure of 247 kcal/week. Leisure time minutes of physical activity have also increased by 33.6 minutes per week, and those in the intervention group report an increased feeling of well-being. Green Prescription has been shown to be effective in changing physical activity behaviour and self-reported quality of life, and is cost-effective. The success of the programme is corroborated by the fact that, since it was first piloted in 1995, it now operates nationwide in New Zealand

Additional

  1. "Routine enquiries as to key dietary habits and physical activity, combined with simple information and skill-building to change behaviour, taking a life-course approach, can reach a large part of the population and be a cost-effective intervention."

Answer

  • As per the results above

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Editors Notes

  • Noncommunicable diseases (chronic disease which are not passed from person to person) are by far the leading cause of death in the world today, and their impact is steadily growing. In 2005, 35 million people died from NCDs, which represents 60% of the total number of global deaths in that year.
  • A small set of common risk factors is responsible for most of the major noncommunicable diseases: unhealthy diet, physical inactivity and tobacco use. Elimination of these modifiable risk factors would prevent 80% of premature heart disease, 80% of premature stroke, 80% of type 2 diabetes and 40% of cancer.

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