'Reboot' for healthier results

As lifestyles get busier and waistlines get bigger; many people are turning to online nutrition programs. In promotion of healthful nutrition behaviors, computer-tailored nutrition education has been identified as a promising health education strategy, especially in the promotion of lower fat intake. However, a study in the September/October 2011 issue of the Journal of Nutrition Education and Behavior reveals no evidence of the efficacy of such computer-tailored education using empirical data based on blood cholesterol and lipids.

Investigators from the Vrije Universiteit Amsterdam, Maastricht University, and Erasmus University in the Netherlands assessed 442 healthy Dutch adults to determine the effectiveness of a computer-tailored intervention aimed at the reduction of fat intake. Instead of just looking at self-reported dietary recalls to evaluate dietary fat intake, which can be skewed by portion size errors, underreporting, and socially desirable answers, the researchers evaluated a more reliable outcome — blood lipids (total, HDL, and LDL cholesterol and triglycerides). The computer program aimed at reducing saturated fat intake had no effect on the blood values.

Drs. Willemieke Kroeze, PhD, and Johannes Brug, PhD, Assistant Professor and Professor, respectively, at the Vrije Universiteit, state, “Computer- tailored intervention with a single dose, aimed at reduction of (saturated) fat intake, for which meaningful effects based on self-reports have been reported, was not sufficient to produce detectable changes in blood lipids in the current study.” When asked how to improve outcomes from consulting online nutrition advice websites, Dr. Kroeze suggests exploring methods “to increase the feasibility of objectively assessing the impact of computer-tailored nutrition education interventions aimed at primary prevention in real-life settings. In addition, strategies should be developed to improve the intensity and duration of computer-tailored interventions, and to incorporate social interaction in the intervention.”

This study documents the importance of identifying key factors that influence an individual's ability to change dietary behaviors especially through online nutrition education. It also illustrates the importance of critical evaluation of nutrition education efforts, as interventions often are developed online as a cost-savings and venue to increase the program's reach.

The article is “Biomarker Evaluation Does Not Confirm Efficacy of Computer-tailored Nutrition Education” by Willemieke Kroeze, PhD; Pieter C. Dagnelie, PhD; Martijn W. Heymans, PhD; Anke Oenema, PhD; Johannes Brug, PhD. It appears in the Journal of Nutrition Education and Behavior, Volume 43, Issue 3 (September/October 2011) published by Elsevier.

In an accompanying podcast, Willemieke Kroeze, PhD, discusses the results and implications this study. It is available at www.jneb.org/content/podcast