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The effectiveness of the tailored feedback in digital interventions may be limited by the quality of the dietary assessment (DA) upon which it is based. The present study systematically reviewed studies reporting the protocols for DA methods used to inform tailored feedback in digital weight loss interventions. The search included: PubMed-National Library of Medicine database, MEDLINE, Cochrane Library of Systematic Reviews, Web of Science and ProQuest. Search terms were related to five groups: dietary assessment, weight loss, clinical trials, technology and tailoring. Thirteen articles were eligible for inclusion. The most common DA method was a digital dietary record linked to a food database that provided instant feedback on daily energy intake. Only four studies provided feedback on overall diet quality and intake of fruit, vegetables and fibre. Dietary feedback was provided using text messages, email, mobile applications and online intervention websites. Most digital dietary feedback focused on reducing energy intake without providing feedback to enhance diet quality. This review highlighted the heterogeneity in DA methods used in tailored weight loss interventions, which may account for the range of outcome results reported. Future interventions should publish the protocols describing how dietary data was collected and used to inform dietary feedback., (© 2022 The British Dietetic Association Ltd.)

Background: Healthy eating behaviours are important for physical and mental well-being and developing healthy eating behaviours early in life is important. As parents are the main providers of preschool children's food the main objective of this study was to use the theory of planned behaviour, expanded to include habit and past behaviour, to predict parents' healthy feeding intention and behaviour., Methods: Theory of planned behaviour, habit strength, and past behaviour were reported at baseline by 443 mothers. One week later, 235 mothers completed a healthy feeding questionnaire on the eating behaviours of their 2-4 year old child. Data were analysed using hierarchical regression analyses to predict parent's general healthy feeding behaviour, and five sub-behaviours: parents' perceptions of their child's fruit and vegetable consumption, healthy and unhealthy snacking behaviour, as well as healthy and unhealthy drinking behaviour., Results: Intention, perceived behavioural control, habit strength and past behaviour were all positively associated with parents' general healthy feeding (47% explained variance). Perceived behavioural control was the only variable positively associated with mothers' perception of their child's fruit and vegetable consumption and unhealthy snacking behaviour. The theory did not explain the other behaviours. Moreover, habit strength only strengthened the intention-behaviour link for fruit and vegetable consumption and child's age was only positively associated with the mothers' perception of their child's unhealthy snacking behaviour., Discussion: The findings suggest important differences in the predictors of different feeding behaviours that can provide direction for future intervention development., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Assessing the implementation of nutrition interventions is important to identify characteristics and dietary patterns of individuals who benefit most. The aim was to report on young adults' experiences of receiving dietary feedback text messaging intervention. Diet was captured using an image-based 4-day mobile food record TM application (mFR TM ) and assessed to formulate two tailored feedback text messages on fruit and vegetables and energy-dense nutrient-poor (EDNP) foods and beverages. At 6-months 143 participants completed a second mFR TM and a questionnaire evaluating the dietary feedback. Participants who agreed the text messages made them think about how much vegetables they ate were more likely to increase their intake by at least half a serve than those who disagreed [odds ratio (OR) = 4.28, 95% Confidence Interval (CI): 1.76 to 10.39]. Those who agreed the text messages made them think about how much EDNP foods they ate, were twice as likely to decrease their intake by over half a serve (OR = 2.39, 95%CI: 1.12 to 5.25) than those who disagreed. Undertaking detailed dietary assessment ensured the tailored feedback was constructive and relevant. Personal contemplation about vegetable and EDNP food intake appears to be a mediator of dietary change in young adults., Competing Interests: The authors do not have any competing interests. The study was funded by Healthway who did not have any role in the study design; collection, analysis, and interpretation of data; writing the report; and the decision to submit the report for publication.

Introduction: A strict lifelong gluten free diet (GFD) is the only treatment for coeliac disease (CD). Theory-based research has focused predominantly on initiation, rational, and motivational processes in predicting adherence. The aim of this study was to evaluate an expanded collection of theoretical constructs specifically relevant to the maintenance of behaviour change, in the understanding and prediction of GFD adherence., Methods: Respondents with CD (N = 5573) completed measures of GFD adherence, psychological distress, intentions, self-efficacy, and the maintenance-relevant constructs of self-regulation, habit, temptation and intentional and unintentional lapses (cognitive and behavioural consequences of lowered or fluctuating psychological resources and self-control), motivation, social and environmental support, and goal priority, conflict, and facilitation. Correlations and multiple regression were used to determine their influence on adherence, over and above intention and self-efficacy, and how relationships changed in the presence of distress., Results: Better adherence was associated with greater self-regulation, habit, self-efficacy, priority, facilitation, and support; and lower psychological distress, conflict, and fewer self-control lapses (e.g., when busy/stressed). Autonomous and wellbeing-based, but not controlled motivations, were related to adherence. In the presence of distress, the influence of self-regulation and intentional lapses on adherence were increased, while temptation and unintentional lapses were decreased., Discussion: The findings point to the importance of considering intentional, volitional, automatic, and emotional processes in the understanding and prediction of GFD adherence. Behaviour change interventions and psychological support are now needed so that theoretical knowledge can be translated into evidence-based care, including a role for psychologists within the multi-disciplinary treatment team., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Establishing the sequence in which risk factors for eating disorders (ED) emerge would enable more effective ED prevention. Thus, in our study we investigated reciprocal and indirect associations between three cognitive and behavioral ED determinants (appearance orientation, appearance worries, and dieting) emphasized in the transdiagnostic model of ED., Methods: Data were collected in a non-clinical group of adolescents at Time 1 (T1), and then 2-months (Time 2, T2) and 13-months later (Time 3, T3). Participants (N = 1260) aged 13-19 completed a questionnaire encompassing their nutrition behaviors, beliefs about appearance, health and well-being. Weight and height were measured objectively., Results: Higher levels of appearance orientation (T1) were associated with higher levels of appearance worries (T2) which in turn predicted dieting (T3). Dieting (T1) predicted higher levels of appearance orientation (T2) which in turn predicted higher levels of appearance worries (T3). Higher levels of appearance worries (T1) were associated with higher levels of appearance orientation (T2) which in turn predicted dieting (T3). Also, higher levels of appearance worries (T1) were associated with dieting (T2), and higher levels of appearance orientation (T3)., Conclusions: The three transdiagnostic model variables formed a vicious cycle. Therefore, higher levels of one of ED determinants (appearance orientation, appearance worries or dieting) increase the likelihood of the elevated levels of two other ED determinants at follow-ups and thus enhances the risk for ED.

Introduction: Previous research suggests that depletion (the state ensuing from self-control exertion) engenders lapses in health behaviours. The present study tested for that effect in relation to the health behaviour of limiting snacking, and investigated whether health goal-priming might facilitate such health behaviours even under depletion conditions., Method: A laboratory study was conducted involving an analytic sample of 85 undergraduates (mean age = 20.08, SD = 3.96; female: n= 63). Depletion was manipulated by having participants watch a humorous video while suppressing their responses (depletion condition) or remaining natural (non-depletion condition). The activation of participants' health goals was then manipulated by subtly exposing (goal-priming condition) or not exposing (non-priming condition) participants to health-related words in a Scrambled Sentence Task. Finally, snacking was measured using a bogus taste-test., Results and Discussion: Controlling for initial hunger, snacking was higher among depleted compared to non-depleted participants. Snacking was lower among primed compared to non-primed participants. The interaction between depletion and goal-priming was not significant. These findings suggest that depletion should be recognised as a risk factor for lapses in health behaviours, and that health goal-priming may be a useful technique for facilitating such behaviours even when individuals are depleted., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Inhibitory control training has been shown to influence eating behaviour in the laboratory; however, the reliability of these effects is not yet established outside the laboratory, nor are the mechanisms responsible for change in behaviour. Two online Stop-Signal Task training interventions were conducted to address these points. In Study 1, 72 participants completed baseline and follow-up measures of inhibitory control, self-regulatory depletion, fat intake and body-mass index. Participants were randomly assigned to complete one of three Stop-Signal Tasks daily for ten days: food-specific inhibition--inhibition in response to unhealthy food stimuli only, general inhibition--inhibition was not contingent on type of stimuli, and control--no inhibition. While fat intake did not decrease, body-mass index decreased in the food-specific condition and change in this outcome was mediated by changes in vulnerability to depletion. In Study 2, the reliability and longevity of these effects were tested by replicating the intervention with a third measurement time-point. Seventy participants completed baseline, post-intervention and follow-up measures. While inhibitory control and vulnerability to depletion improved in both training conditions post-intervention, eating behaviour and body-mass index did not. Further, improvements in self-regulatory outcomes were not maintained at follow-up. It appears that while the training paradigm employed in the current studies may improve self-regulatory outcomes, it may not necessarily improve health outcomes. It is suggested that this may be due to the task parameters, and that a training paradigm that utilises a higher proportion of stop-signals may be necessary to change behaviour. In addition, improvements in self-regulation do not appear to persist over time. These findings further current conceptualisations of the nature of self-regulation and have implications for the efficacy of online interventions designed to improve eating behaviour., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Executive function has been shown to influence the performance of health behaviours. Healthy eating involves both the inhibitory behaviour of consuming low amounts of saturated fat, and the initiatory behaviour of consuming fruit and vegetables. Based on this distinction, it was hypothesised that these behaviours would have different determinants. Measures of inhibitory control and updating were administered to 115 participants across 2 days. One week later saturated fat intake and fruit and vegetable consumption were measured. Regression analyses revealed a double dissociation effect between the different executive function variables and the prediction of eating behaviours. Specifically, inhibitory control, but not updating, predict saturated fat intake, whilst updating, but not inhibitory control, was related to fruit and vegetable consumption. In both cases, better executive function capacity was associated with healthier eating behaviour. The results support the idea that behaviours that require stopping a response such as limiting saturated fat intake, have different determinants to those that require the initiation of a response such as fruit and vegetable consumption. The findings suggest that interventions aimed at improving these behaviours should address the relevant facet of executive function., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Background: Breakfast consumption is important to health; however, adolescents often skip breakfast, and an increased understanding of the breakfast consumption patterns of adolescents is needed. The purpose of this study was to identify the predictors of breakfast eating, including the content and context, in an adolescent sample from Australia and England., Methods: Four-hundred and eighty-one students completed an online questionnaire measuring breakfast skipping, and breakfast content (what was eaten) and context (who they ate with, involvement in preparation). Logistic regression was conducted to investigate the predictors of skipping breakfast, breakfast context, and consumption of the ten most commonly consumed foods. Chi-square analyses were used to examine differences in breakfast content according to context., Results: Most students (88%) had consumed breakfast on the day of the survey; breakfast skipping was more common in England (18%) than in Australia (8%). Country, gender, socioeconomic status, and body mass index (BMI) were all predictors of breakfast content and context. Whether adolescents ate with others and/or were involved in breakfast preparation predicted the content of breakfast consumed., Conclusions: This study provides a comprehensive examination of the factors underlying breakfast consumption (content and context) and has important implications for the development of evidence-based interventions to improve rates of breakfast consumption and the quality of food consumed amongst adolescents.

This study investigated feasibility and acceptability of a new email-delivered intervention promoting fruit and vegetable consumption in a university-based population of Australian young adults. The study explored whether there are differences in the reported feasibility and acceptability between demographic groups within the population of interest and at three levels of intervention intensity. The email-delivered intervention program consists of an implementation intention 'planning task' and between 3 and 15 short email messages over a 15-day study period. The intervention program was developed using the Theory of Planned Behaviour and was designed to modify perceived behavioural control. One hundred and ten participants (mean age = 19.21 years, 25.6% male) completed the feasibility and acceptability questionnaire at Day 15. This questionnaire contained items about all intervention components. High acceptability and feasibility scores were found for all intervention parts and at all levels of intervention intensity. There were few significant differences in the reported acceptability of items between key demographic sub-groups, and no differences in reported acceptability at different levels of intervention intensity. These results suggest that this email-delivered intervention is an acceptable and feasible tool for promoting fruit and vegetable consumption for participants in the target population.

The aim of this study was to explore whether two aspects of self-regulation (impulsivity and temporal orientation) could reduce the intention–behaviour gap for two dietary behaviours: fruit and vegetable consumption and saturated fat consumption. Australian undergraduate students (N = 154) completed questionnaires (the Barratt impulsiveness scale and the consideration of future consequences scale) and intention measures, and 1 week later behaviour was measured using the Block rapid food screener. After controlling for demographics, intention was associated with fruit and vegetable consumption, but the self-regulation measures did not further improve the variance accounted for. For saturated fat, gender was associated with consumption, such that males tended to consume more saturated fat. Intention was significantly associated with consumption, and impulsivity further improved the model such that those who were more impulsive tended to consume more saturated fat. These findings suggest that health protective and health risk behaviours, such as those investigated in the current study, may have different determinants.

Consumption of saturated fat (SF) is associated with obesity, cardiovascular disease and cancer; which are among the leading causes of death in Australia and worldwide. A causal relationship between subjective well-being and positive health outcomes has been established, although few studies have specifically focused on health-enhancing or health-risk behaviours. The aim of this research was to develop an improved understanding of the processes underlying SF consumption by exploring the relationship between subjective well-being and SF consumption, within the Theory of Planned Behaviour framework. Questionnaires related to the TPB variables, subjective well-being and SF intake were administered online to 96 participants. Perceived behavioural control (PBC) was found to be a significant predictor of intention to limit SF intake. Intention and PBC accounted for 25% of variance in behaviour; with PBC the only significant predictor of SF consumption. While subjective well-being variables were not significant unique predictors of SF consumption, these variables contributed an additional 2% to the prediction of behaviour, and this model was significant. The addition of subjective well-being to the TPB is novel and the results partially support the potential of subjective well-being in improving the prediction of this health-risk behaviour. Future research will need to replicate and extend these preliminary findings before such a framework may be translated into an intervention targeting SF consumption.

The aim of this study is to examine the determinants of fruit and vegetable (F&V) consumption with the application of the Theory of Planned Behaviour (TPB) and the additional variables of self-schema, habit and self-regulation. While it has been shown that those with a healthy-eater self-schema are more likely to carry out their healthy dietary intentions, the underlying processes that influence this relationship have received limited empirical attention. Recent findings on dietary behaviour suggest that self-regulatory ability and habit strength may have dissimilar effects on the intention-behaviour relationship within schematics and non-schematics. Self-report questionnaires regarding F&V consumption cognitions and two tests of self-regulation were administered to 209 university students. One week later, participants completed questionnaires on their behaviour. The TPB significantly predicted intentions and prospective behaviour. Self-schema did not moderate the relationship between intention and behaviour. However, within healthy-eater schematics, those with high intention and high self-regulatory ability were more likely to consume F&V, while within non-schematics, those with low intention and high habit strength were more likely to consume F&V. The findings support the use of the TPB in predicting F&V consumption and the validity of the self-schema distinction. Implications for designing interventions are discussed.

This study evaluated the efficacy of a theory of planned behaviour (TPB) based intervention to increase fruit and vegetable consumption. The extent to which fruit and vegetable consumption and change in intake could be explained by the TPB was also examined. Participants were randomly assigned to two levels of intervention frequency matched for intervention content (low frequency n=92, high frequency n=102). Participants received TPB-based email messages designed to increase fruit and vegetable consumption, messages targeted attitude, subjective norm and perceived behavioural control (PBC). Baseline and post-intervention measures of TPB variables and behaviour were collected. Across the entire study cohort, fruit and vegetable consumption increased by 0.83 servings/day between baseline and follow-up. Intention, attitude, subjective norm and PBC also increased (p<.05). The TPB successfully modelled fruit and vegetable consumption at both time points but not behaviour change. The increase of fruit and vegetable consumption is a promising preliminary finding for those primarily interested in increasing fruit and vegetable consumption. However, those interested in theory development may have concerns about the use of this model to explain behaviour change in this context. More high quality experimental tests of the theory are needed to confirm this result., (Copyright © 2012 Elsevier Ltd. All rights reserved.)