Impact of measures to promote a healthier diet and physical activity
Systematic review
|Updated
Key message
Background
This report assesses interventions for improving dietary habits and/or increasing physical activity. It is the second review about effects of interventions for different socioeconomic groups.
Objective
The objectives were to assess the effects of the following interventions: 1) to improve dietary habits among different socio-economic groups, 2) to improve dietary habits in lower socio-economic groups, 3) to increase physical activity among different socioeconomic groups, and 4) to increase physical activity in lower socio-economic groups.
Methods
We searched for relevant systematic reviews and randomised controlled trials (RCTs) in international databases, and appraised and synthesized studies which fulfilled our inclusion criteria.
Results
We summarized results from five systematic reviews and 14 randomized controlled trials. The documentation does not allow us to conclude about an effect/no effect in any of the target groups.
Conclusion
We identified few randomized controlled trials of high methodological quality. The systematic reviews that we found were mostly of low quality, and only a small minority of the selected studies in the reviews included randomized trials focusing on socioeconomic differences.
Summary
Background
Previously, some Norwegian cause-effect studies of social inequality documenting a social gradient in healthy diet and physical activity and knowledge about interventions offered by the health services have been reported. Among lower socio-economic groups, fewer eat healthy foods than among higher socio-economic groups. There are few effect studies about interventions for helping lower socio-economic groups to eat healthy foods and to be physically active.
Objective
The objectives were to assess the effects of the following interventions: 1) to improve dietary habits among different socio-economic groups, 2) to improve dietary habits in lower socio-economic groups, 3) to increase physical activity among different socioeconomic groups, and 4) to increase physical activity in lower socio-economic groups.
Methods
We conducted a systematic literature search in the following electronic databases: Medline, Embase, Cochrane Library, PsychInfo, Cinahl, Social Services Abstracts, Sociological Abstracts, Eric, International Bibliography of the Social Sciences, Social Sciences Citation Index, Social Care Online, C2-SPECTR, SveMed, BiblioMap, Bibsys and Google Scholar until April 2007. Relevance and study quality is appraised according to the Knowledge Centre's methodological handbook.
We included effect studies dealing with improving diet and/or increasing physical activity in groups with low socio-economic status, or a reduction in differences in dietary quality and/or level of physical activity between groups with different socio-economic status.
Results
A total of five reviews and 14 primary studies are included in this report. We found several studies that reported socio-economic data at the start of the intervention (baseline), but they did not use background variables like income and education to analyze differences between socio-economic groups. We chose to categorize the included studies according to target group for intervention.
Target group 1: children
Target group 2: visitors in supermarkets
Target group 3: immigrants, minority groups
Target group 4: population in deprived areas
Target group 5: patients and high-risk groups
Target group 6: employees, unemployed
The documentation does not allow us to conclude about an effect/no effect in any of the target group.
Conclusion
We identified few randomized controlled trials, and they were mostly of low methodological quality. The systematic reviews that we found were also mostly of low quality, and only a small minority of the included studies in the reviews were randomized trials focusing on socio-economic differences.