Interventions promoting healthy eating as a tool for reducing social inequalities in diet in low- and middle-income countries: a systematic review.
Interventions promoting healthy eating as a tool for reducing social inequalities in diet in low- and middle-income countries: a systematic review.
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DOI：
10.1186/s12939-016-0489-3
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发表时间：
2016-12-22
影响因子：
4.8
通讯作者：
Stringhini S
中科院分区：
文献类型：
--
作者：
Mayén AL;de Mestral C;Zamora G;Paccaud F;Marques-Vidal P;Bovet P;Stringhini S
饮食是非传染性疾病(NCDs)的主要风险因素，也受到社会经济因素的强烈影响。促进健康饮食的干预措施是否能减少低收入和中等收入国家在饮食方面的社会不平等仍不确定。本文旨在总结当前关于促进低收入人群健康饮食的干预措施的证据，并确定它们是否减少了饮食方面的社会不平等。系统审查Pubmed、SciELO和谷歌学者数据库中的横断面或准实验研究(干预措施评估前后)，包括LMICs中的成年人，评估健康饮食的至少一个结果，并显示按社会经济地位分层的结果。在七个LMIC(巴西、智利、哥伦比亚、伊朗、巴拿马、特立尼达和多巴哥和突尼斯)进行的包括促进健康饮食在内的七项干预研究符合我们的纳入标准。为了促进健康饮食，所有干预措施都使用了营养教育，其中三项干预措施将营养教育与改善获得食物或社会支持的机会相结合。干预措施主要针对妇女，在传播工具和营养教育课程的持续时间方面差异很大。大多数干预措施使用印刷材料、媒体使用或面对面培训，持续时间从6周到5年。四项干预措施针对弱势群体，三项干预措施针对整个人口。在针对弱势人群的四项干预措施中，有三项改善了健康饮食结果，这表明它们可能减少饮食方面的社会不平等。所有针对所有人口的干预措施都显示，所有社会阶层的健康饮食结果都有所改善，并被认为对饮食方面的社会不平等没有影响。在LMIC中，促进健康饮食的代理干预措施减少了专门针对弱势群体的饮食方面的社会不平等。进一步的研究应该评估促进健康饮食的干预措施中的代理和结构方法相结合对饮食方面的社会不平等的影响。本文的在线版本(doi：10.1186/s12939-0160489-3)包含补充材料，授权用户可以使用。
Diet is a major risk factor for non-communicable diseases (NCDs) and is also strongly patterned by socioeconomic factors. Whether interventions promoting healthy eating reduce social inequalities in diet in low- and middle-income countries (LMICs) remains uncertain. This paper aims to summarize current evidence on interventions promoting healthy eating in LMICs, and to establish whether they reduce social inequalities in diet. Systematic review of cross-sectional or quasi-experimental studies (pre- and post-assessment of interventions) in Pubmed, Scielo and Google Scholar databases, including adults in LMICs, assessing at least one outcome of healthy eating and showing results stratified by socioeconomic status. Seven intervention studies including healthy eating promotion, conducted in seven LMICs (Brazil, Chile, Colombia, Iran, Panama, Trinidad and Tobago, and Tunisia), met our inclusion criteria. To promote healthy eating, all interventions used nutrition education and three of them combined nutrition education with improved acces to foods or social support. Interventions targeted mostly women and varied widely regarding communication tools and duration of the nutrition education sessions. Most interventions used printed material, media use or face-to-face training and lasted from 6 weeks to 5 years. Four interventions targeted disadvantaged populations, and three targeted the entire population. In three out of four interventions targeting disadvantaged populations, healthy eating outcomes were improved suggesting they were likely to reduce social inequalities in diet. All interventions directed to the entire population showed improved healthy eating outcomes in all social strata, and were considered as having no impact on social inequalities in diet. In LMICs, agentic interventions promoting healthy eating reduced social inequalities in diet when specifically targeting disadvantaged populations. Further research should assess the impact on social inequalities in diet of a combination of agentic and structural approaches in interventions promoting healthy eating. The online version of this article (doi:10.1186/s12939-016-0489-3) contains supplementary material, which is available to authorized users.
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DOI：
10.1097/jom.0000000000000500
发表时间：
2015-07-01
影响因子：
3.2
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