Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified , providing a set of specific evidence -based strategies that deserve close attention and prioritization for wider implementation .
Effective interventions included specific approaches in all 6 domains evaluated for improving diet , increasing activity , and reducing tobacco use .
The writing group also identified several specific interventions in each of these domains for which current evidence was less robust , as well as other inconsistencies and evidence gaps , informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies .
This systematic review identified and grade d the evidence for a range of population -based strategies to promote lifestyle change .
BACKGROUND Poor lifestyle behaviors , including suboptimal diet , physical inactivity , and tobacco use , are leading causes of preventable diseases globally .
Although even modest population shifts in risk substantially alter health outcomes , the optimal population -level approaches to improve lifestyle are not well established .
An intervention study targeting energy and nutrient intake in worksite cafeterias.
Modifying the food environment is a promising strategy for promoting healthier eating behavior . This study aim ed to evaluate nutritional and weight changes in a program that used worksite cafeterias to reduce employees ' calorie content of purchased foods and improve their macronutrient intake . Participants were r and omly assigned to one of two conditions : 1 ) only environmental change ( i.e. , the introduction of 10 new low-energy-density ( ED ) foods and provision of labels for all foods sold at lunch , which listed ED , calories , and macronutrient content ) or 2 ) the environmental change plus pricing incentives for purchasing low-ED foods and education about low-ED eating delivered in four , 1-hour group sessions . Participant lunch choices were monitored electronically at the point of purchase for 3 months before the intervention was instituted ( i.e. , the baseline period ) and for 3 months afterward ( i.e. , intervention period ) . Participants were adults ( n=96 , BMI = 29.7+/-6.0 kg/m(2 ) ) who regularly ate lunch at their workplace cafeteria . There was no difference between groups in total energy intake over the study period . Across groups , energy and percent of energy from fat decreased and percent of energy from carbohydrate increased from baseline to the intervention period ( all p<.01 ) . Follow-up analyses , conducted by averaging Baseline Months 1 and 2 and comparing them to Intervention Month 3 as a conservative estimate of overall impact of the intervention , indicated that change in energy , carbohydrate , and fat intake remained significant ( p<.001 ) . Providing nutrition labels and reducing the ED of selected foods was associated with improved dietary intake
Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified , providing a set of specific evidence -based strategies that deserve close attention and prioritization for wider implementation .
Effective interventions included specific approaches in all 6 domains evaluated for improving diet , increasing activity , and reducing tobacco use .
The writing group also identified several specific interventions in each of these domains for which current evidence was less robust , as well as other inconsistencies and evidence gaps , informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies .
This systematic review identified and grade d the evidence for a range of population -based strategies to promote lifestyle change .
BACKGROUND Poor lifestyle behaviors , including suboptimal diet , physical inactivity , and tobacco use , are leading causes of preventable diseases globally .
Although even modest population shifts in risk substantially alter health outcomes , the optimal population -level approaches to improve lifestyle are not well established .