WHO: Interventions on Diet & Physical Activity: what works?
In 2009, the World Health Organisation (WHO) published its report Interventions on diet and physical activity: what works. One of the responsibilities of the WHO is to “identify and disseminate information on evidence based interventions, policies and structures”. The report provides policy makers, health professionals and others with a summary of tried and tested diet and physical activity interventions that aim to reduce the risk of chronic non-communicable diseases.
The report is presented as three documents: Summary Report, Methodology and Evidence tables. These documents can be downloaded from the WHO website
The Summary Report
The Summary Report provides a summary of the evidence evaluating the effectiveness of diet and physical activity interventions to prevent chronic non-communicable diseases. The report was developed in four phases, including a systematic review of the evidence and an internal consultation.
Details of the search strategy and inclusion criteria for studies are detailed in the report. A total of 395 peer-reviewed publications were identified, describing 261 different interventions. Each study was rated on three primary outcome measures: psychological changes, behavioural changes, and physical and clinical changes, as either effective, moderately effective, promising/insufficient evidence, minimally effective, insufficient evidence/not shown to be effective or not reported/not measured.
The report presents those interventions that were rated either ‘effective’ or ‘moderately effective’ in eight setting or life course stage categories for easy reference, namely:
1. policy and the environment;
2. mass media;
3. school settings;
4. the workplace;
5. the community;
6. primary health care;
7. older adults; and
8. religious settings.
Each category also provides an overview of the relevance of interventions for the setting/life-course stage, examples of ‘model’ interventions, and a synopsis of the three primary outcomes.
The authors conclude that there is non one-size-fits-all approach for selecting interventions, but that the review provides a summary of diet and physical activity interventions that have been shown to support and enable individuals to make healthy choices. However, the authors did make the following observations:
- Multi-component interventions that are adapted to the local context were the most successful (e.g. school programmes with interventions targeting the school environment, its food services and the classroom curriculum).
- Interventions that used the existing social structures of a community (e.g. schools) reduced barriers to implementation.
- Interventions that involved participants in the planning and implementation stages were more effective (e.g. community leaders in community and religion-related programmes).
- © British Nutrition Foundation 2011