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The Mediterranean Eating in Scotland Experience project: evaluation of an Internet-based intervention promoting the Mediterranean diet

Published online by Cambridge University Press:  08 March 2007

Angeliki Papadaki  and
Jane A. Scott
Angeliki Papadaki
Affiliation:
Faculty of Medicine, Division of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow Royal Infirmary, Glasgow G31 2ER, UK
Jane A. Scott*
Affiliation:
Faculty of Medicine, Division of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow Royal Infirmary, Glasgow G31 2ER, UK
*
*Corresponding author: Dr J. A. Scott, fax +44 141 211 4844, email j.a.scott@clinmed.gla.ac.uk
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Abstract

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A 6-month intervention study with a quasi-experimental design was conducted to evaluate the effectiveness of an Internet-based, stepwise, tailored-feedback intervention promoting four key components of the Mediterranean diet. Fifty-three (intervention group) and nineteen (control group) healthy females were recruited from the Universities of Glasgow and Glasgow Caledonian, Scotland, respectively. Participants in the intervention group received tailored dietary and psychosocial feedback and Internet nutrition education over a 6-month period, while participants in the control group were provided with minimal dietary feedback and general healthy-eating brochures. Internet education was provided via an innovative Mediterranean Eating Website. Dietary changes were assessed with 7 d estimated food diaries at baseline and 6 months, and data were analysed to calculate the Mediterranean Diet Score, a composite score based on the consumption of eight components of the traditional Mediterranean diet. The ‘intention-to-treat’ analyses showed that, at 6 months, participants in the intervention group had significantly increased their intake of vegetables, fruits and legumes, as well as the MUFA:saturated fatty acid ratio in their diet, and had significantly increased plasma HDL-cholesterol levels and a reduced ratio of total:HDL-cholesterol. Participants in the control group increased their intake of legumes but showed no other favourable significant changes compared with baseline. This Internet-based, tailored-feedback intervention promoting components of the Mediterranean diet holds promise in encouraging a greater consumption of plant foods, as well as increasing monounsaturated fat and decreasing saturated fat in the Scottish diet; it also shows that the Mediterranean diet can be adopted by healthy individuals in northern European countries.

Keywords

Mediterranean dietInternetNutrition interventionsTailored feedbackDietary behaviour
Type
Research Article
Information
British Journal of Nutrition , Volume 94 , Issue 2 , August 2005 , pp. 290 - 298
Copyright
Copyright © The Nutrition Society 2005

References

Altman, D (1992) Practical Statistics for Medical Research. London: Chapman & Hall.Google Scholar
Bandura, A (1986) Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
Brug, J (1999) Dutch research into the development and impact of computer tailored nutrition education. Eur J Clin Nutr 53, 78–82.Google Scholar
Brug, J, Campbell, M & Van Assema, P (1999 a) The application and impact of computer-generated personalised nutrition education: a review of the literature. Patient Educ Counsel 36, 145–156.CrossRefGoogle ScholarPubMed
Brug, J, Glanz, K, Van Assema, P, Kok, G & Van Breukelen, GJP (1998) The impact of computer-tailored feedback and iterative feedback on fat, fruit and vegetable intake. Health Educ Behav 25, 517–531.Google Scholar
Brug, J, Steenhuis, I, Van Assema, P & De Vries, H (1996) The impact of a computer-tailored nutrition intervention. Prev Med 25, 236–242.CrossRefGoogle ScholarPubMed
Brug, J, Steenhuis, I, Van Assema, P, Glanz, K & De Vries, H (1999 b) Computer-tailored nutrition education: differences between two interventions. Health Educ Res 14, 249–256.Google Scholar
Brug, J & Van Assema, P (2000) Differences in use and impact of computer-tailored dietary fat-feedback according to stage of change and education. Appetite 34, 285–293.CrossRefGoogle ScholarPubMed
Campbell, M, DeVellis, B, Strecher, V, Ammerman, A, DeVellis, R & Sandler, R (1994) Improving dietary behavior: the effectiveness of tailored messages in primary care settings. Am J Public Health 84, 783–787.Google Scholar
de Lorgeril, M, Salen, P, Martin, JL, Monjaud, I, Boucher, P & Mamelle, N (1998) Mediterranean dietary pattern in a randomized trial: prolonged survival and possible reduced cancer rate. Arch Intern Med 158, 1181–1187.CrossRefGoogle Scholar
De Vries, H & Brug, J (1999) Computer-tailored interventions motivating people to adopt health promoting behaviors: Introduction to a new approach. Patient Educ Counsel 36, 99–105.Google Scholar
Dijkstra, A, De Vries, H (1999) The development of computer-generated tailored interventions. Patient Educ Counsel 36, 193–203.Google Scholar
Fletcher, DJ & Rogers, DA (1985) Diet and coronary heart disease: helping patients reduce serum cholesterol level. Postgrad Med 77, 319–328.Google Scholar
Food Standards Agency Scotland (2002) Better eating in scotland. Bridging the gap between awareness and behaviour: qualitative research findings. Aberdeen: Food Standards Agency Scotland.Google Scholar
Glanz, K, Kristal, AR, Sorensen, G, Palombo, R, Heimendinger, J & Probart, C (1993) Development and validation of measures of psychosocial factors influencing fat- and fibre-related dietary behavior. Prev Med 22, 373–387.CrossRefGoogle Scholar
Hakim, I (1998) Mediterranean diets and cancer prevention. Arch Intern Med 158, 1169–1170.CrossRefGoogle ScholarPubMed
Harnack, L, Story, M, Martinson, B, Neumark-Sztainer, D & Stang, J (1998) Guess who's cooking? The role of men in meal planning, shopping, and preparation in US families. J Am Diet Assoc 98, 995–1000.Google Scholar
Keys, A (1970) Coronary heart disease in seven countries. Circulation 41, 1–211.Google Scholar
Kouris-Blazos, A, Gnardellis, C, Wahlqvist, ML, Trichopoulos, D, Lukito, W & Trichopoulou, A (1999) Are the advantages of the Mediterranean diet transferable to other populations? A cohort study in Melbourne, Australia. Br J Nutr 82, 57–61.CrossRefGoogle ScholarPubMed
Lenert, L, Muñoz, RF, Stoddard, J, Delucchi, K, Bansod, A, Skoczen, S & Pérez-Stable, EJ (2003) Design and pilot evaluation of an internet smoking cessation program. J Am Med Inform Assoc 10, 16–20.Google Scholar
Linke, S, Brown, A & Wallace, P (2004) Down your drink: a web-based intervention for people with excessive alcohol consumption. Alcohol Alcohol 39, 29–32.Google Scholar
Lloyd, HM, Paisley, CM & Mela, DJ (1995) Barriers to the adoption of reduced-fat diets in a UK population. J Am Diet Assoc 95, 316–322.Google Scholar
Napolitano, MA, Fotheringham, M, Tate, D, Sciamanna, C, Leslie, E, Owen, N, Bauman, A & Marcus, B (2003) Evaluation of an internet-based physical activity intervention: a preliminary investigation. Ann Behav Med 25, 92–99.Google Scholar
Nestle, M (1995) Mediterranean diets: historical and research overview. Am J Clin Nutr 61, 1313S–1320S.Google Scholar
Oenema, A, Brug, J & Lechner, L (2001) Web-based tailored nutrition education: results of a randomized trial. Health Educ Res 16, 647–660.CrossRefGoogle Scholar
Office for National Statistics (2002) The National Diet and Nutrition Survey: Adults Aged 19 to 64 Years. Norwich: HMSO.Google Scholar
Paisley, CM, Lloyd, HM, Sparks, P & Mela, DJ (1995) Consumer perceptions of dietary changes for reducing fat intake. Nutr Res 15, 1755–1766.Google Scholar
Parmenter, K & Wardle, J (1999) Development of a general nutrition knowledge questionnaire for adults. Eur J Clin Nutr 53, 298–308.CrossRefGoogle ScholarPubMed
Patrick, K, Robinson, TN, Alemi, F & Eng, TR & the Science Panel on Interactive Communication and Health (1999) Policy issues relevant to evaluation of interactive health communication applications. Am J Prev Med 16, 35–42.Google Scholar
Pinnock, CB & Jones, C & the Education Committee of the Australian Prostate Cancer Collaboration (2003) Meeting the information needs of Australian men with prostate cancer by way of the internet. Urology 61, 1198–1203.CrossRefGoogle ScholarPubMed
Prochaska, JO & Velicer, WF (1997) The transtheoretical model of health behavior change. Am J Health Prom 12, 38–48.Google Scholar
Renaud, S, de Lorgeril, M, Delaye, J, Guidollet, J, Jacquard, F, Mamelle, N, Martin, JL, Monjaud, I, Salen, P & Toubol, P (1995) Cretan Mediterranean diet for prevention of coronary heart disease. Am J Clin Nutr 61, 1360S–1367S.Google Scholar
Scherrer-Bannerman, A, Fofonoff, D, Minshall, D, Downie, S, Brown, M, Leslie, F & McGowan, P (2000) Web-based education and support for patients on the cardiac surgery waiting list. J Telemed Telecare 6, 72–74.CrossRefGoogle ScholarPubMed
Scottish Office (1996) Eating for Health: A Diet Action Plan for Scotland. Edinburgh: HMSO/Scottish Office Department of Health.Google Scholar
Skinner, CS, Siegfried, JC, Kegler, MC & Strecher, VJ (1993) The potential of computers in patient education. Patient Educ Counsel 22, 27–34.CrossRefGoogle ScholarPubMed
Tate, DF, Wing, RR & Winett, RA (2001) Using internet technology to deliver a behavioral weight loss program. JAMA 285, 1172–1177.Google Scholar
Trichopoulou, A, Costacou, T, Bamia, C & Trichopoulos, D (2003) Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 348, 2599–2608.Google Scholar
Trichopoulou, A, Kouris-Blazos, A, Wahlqvist, ML, Gnardellis, C, Lagiou, P, Polychronopoulos, E, Vassilakou, T, Lipworth, L & Trichopoulos, D (1995) Diet and overall survival in elderly people. BMJ 311, 1457–1460.Google Scholar
Van Dillen, SME, Hiddink, GJ, Koelen, MA, De Graaf, C & Van Woerkum, CMJ (2003) Understanding nutrition communication between health professionals and consumers: development of a model for nutrition awareness based on qualitative consumer research. Am J Clin Nutr 77, 1065S–1072S.Google Scholar
Velicer, WF & Prochaska, JO (1999) An expert system intervention for smoking cessation. Patient Educ Counsel 36, 119–129.Google Scholar
Weinstein, ND (1988) The precaution adoption process. Health Psychol 7, 355–386.Google Scholar
Willett, WC, Sacks, F, Trichopoulou, A, Drescher, G, Ferro-Luzzi, A, Helsing, E & Trichopoulos, D (1995) Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr 61, 1402S–1406S.Google Scholar
Williams, P, Nicholas, D, Huntington, P & McClean, F (2002) Surfing for health: user evaluation of a health information web site. Part 1, Literature review. Health Info Libr J 19, 98–108.Google Scholar
Wilson, AS, Kitas, GD, Llewellyn, P, Carruthers, DM, Cheseldine, DC, Harris, S, Huissoon, AP, Bacon, PA & Young, SP (2001) Provision of internet-based rheumatology education (http://rheuma.bham.ac.uk). Rheumatology (Oxford) 40, 645–651.Google Scholar
Young, SP, Henderson, E, Cheseldine, DL, et al. (2002) Development and assessment of a World Wide Web site for systemic lupus erythematosus patient information. Lupus 11, 478–484.CrossRefGoogle ScholarPubMed