Nutrition Research Reviews

Research Article

The transtheoretical model as applied to dietary behaviour and outcomes

Leslie Spencera1 c1, Christopher Whartona2, Sheila Moylea1 and Troy Adamsa3

a1 Department of Health and Exercise Science, Rowan University, 201 Mullica Hill Road, Glassboro, NJ 08028, USA

a2 Rudd Center for Food Policy and Obesity, Yale University, New Haven, CT, USA

a3 Rocky Mountain University of Health Professions, Provo, UT, USA


The transtheoretical model (TTM) is a behavioural theory that describes behaviour change as occurring in five stages, ranging from precontemplation to maintenance. The purpose of the present paper is to review and synthesise the literature published since 1999 on applications of the TTM to dietary behaviour so that the evidence for the use of assessment tools and interventions based on this model might be evaluated. Six databases were identified and searched using combinations of key words. Sixty-five original, peer-reviewed studies were identified and summarised in one of three tables using the following categories: population (n 21), intervention (n 25) and validation (n 19). Internal validity ratings were given to each intervention, and the body of intervention studies as a whole was rated. The evidence for using stage-based interventions is rated as suggestive in the areas of fruit and vegetable consumption and dietary fat reduction. Valid and reliable staging algorithms are available for fruit and vegetable consumption and dietary fat intake, and are being developed for other dietary behaviours. Few assessment tools have been developed for other TTM constructs. Given the popularity of TTM-based assessments and interventions, more research is warranted to identify valid and reliable assessment tools and effective interventions. While the evidence supports the validity of the TTM to describe populations and to form interventions, evidence of the effectiveness of TTM-based interventions is not conclusive.


c1 *Corresponding author: Associate Professor Leslie Spencer, fax +1 856 256 5613, email


Abbreviations: TTM, transtheoretical model