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The purpose of this paper is to focus specifically on the benefits of using mixed methods to investigate dietary change from adolescence to adulthood exemplified using the findings from the ASH30 longitudinal study. The ASH30 study is a longitudinal dietary survey which provided quantitative evidence of dietary change and investigated factors influencing dietary change from adolescence to adulthood.

Two three‐day food diaries were collected both in 1980 (aged 11‐12 years) and 2000 (aged 31‐32 years) from the same 198 respondents in North East England. In 2,000 questionnaires were used to collect perceptions of, and attributions for, dietary change and open‐ended responses were analysed using content analysis.

The use of mixed methods brings added breadth and depth to the research which cannot be achieved by a single discipline or method. Determining what has influenced change in dietary behaviour from adolescence to adulthood is a complex and multifaceted task. Eating habits are influenced by multiple factors throughout the life course. Change in food intake between adolescence and adulthood related to life‐course events and trajectories. The qualitative findings highlighted relevant contextual information such as themes of moral panics, the concept of “convenience” and “fresh” foods.

Adopting mixed method approaches to exploring dietary change should offer a rich perspective from which to base realistic interventions.

Longitudinal dietary surveys present an opportunity to understand the complex process of dietary change throughout the life course in terms both of how diets have changed but also of why they have changed.

The majority of studies examining nutrition knowledge and dietary behaviour have been cross‐sectional. In contrast, this longitudinal study aims to examine changes in individuals’ nutrition knowledge and dietary behaviour over time. Participants were a cohort of mothers who in 1993 completed questionnaires on nutrition knowledge and dietary behaviour and who reported that they intended to change their diets over the next 12 months. This study administered the same questionnaires in 1994, with additional questions to examine further changes in eating habits. Results and implications are discussed.

Young adults frequently engage in sub-optimal dietary behaviours, such as inadequate intakes of fruits and vegetables and excessive consumption of take-out meals. Theory-based interventions are suggested to promote dietary change. The transtheoretical model is an example that stages an individual’s readiness to change behaviours as precontemplation, contemplation, preparation, action and maintenance, and includes a series of processes that help people move between stages. The purpose of this study is to investigate whether self-reported usual dietary intakes of fruits and vegetables and take-out foods differ by reported stage-of-change.

Cross-sectional data from 250 overweight young adults, aged 18-35 years, who enrolled in a lifestyle intervention to prevent weight gain are analysed. Participant’s stage-of-change for increasing fruit and vegetable intakes and reducing take-out foods is determined using staging algorithms. This is compared with self-reported dietary intakes over the past month using a food frequency questionnaire. Differences in intakes and variety by stage-of-change are compared for fruits, vegetables and take-out foods.

Take-out foods differed between stages (p < 0.0001), with lower weekly intakes in action (309 g) and maintenance (316 g) compared with preparation (573 g). Daily fruit intakes and variety scores varied by stage-of-change (p < 0.0001), being highest for action and maintenance (261 g and 263 g, respectively, and variety scores of 1 and 2) compared with precontemplation, contemplation and preparation (all = 100 g and 0 for variety). Daily vegetable consumption and variety scores differed by stage (p = 0.009 and p = 0.025, respectively) being highest for action/maintenance (204 g and 2 for variety) versus precontemplation and preparation (<110 g daily and Variety 1).

The finding of no differences in intakes between precontemplation, contemplation or preparation stages implies that the adoption of the dietary behaviours is not a continuum but a move from pre-action to actioning the target intakes. This means that for planning health promotion and dietary counselling, assigning people to the three different pre-action stages may be unnecessary.

This study is the first to examine the congruence of self-reported readiness to change behaviour with dietary intakes of take-out foods as well as variety of fruit and vegetables in overweight young adults.

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system that causes debilitating symptoms. Currently, there is insufficient evidence to recommend a special diet for people with MS to slow disease progression and reduce symptoms. Little is known about the dietary choices made by people with MS. This study aimed to explore the interpretations of healthy eating in people recently diagnosed with MS. Objectives were to investigate the types of changes in food choices and to describe the impact of making these changes.

A social constructionist approach applying qualitative secondary analysis of semi-structured interviews was conducted (n = 11). Interviews were transcribed, coded and analysed using a deductive approach.

Participants were mostly female (82%), mean age 47 years and mean time since diagnosis eight months. Four themes emerged from the data: (1) moving in the direction of the dietary guidelines, (2) modifying intake of dietary fat, (3) requiring mental effort and (4) needing input from a dietitian.

The directions of food choices and the absence of dietetic input highlighted in this study suggest the need for evidence-based nutrition education that enables people with MS to tailor dietary guidelines according to their preferences.

How people interpret healthy eating advice and the impact on making food choice changes is useful for explaining dietary changes in MS. Special diets promoted for MS provide conflicting advice, and the lack of access to dietitians means that additional mental effort is required when interpreting healthy eating messages and diets.

The purpose of this paper is to evaluate the effectiveness of the Eatwell for Life (EWL) programme, with a particular focus on longer term effectiveness in terms of dietary behaviour and the wider impact. EWL is a six-week community-based dietary intervention which aims to increase nutritional knowledge, cooking confidence and provide the necessary skills to support behavioural change in relation to eating a balanced diet. There have been many evaluations of community-based dietary interventions, but most focus on brief measures and changes examined at the end of each course.

A mixed method evaluation was conducted using a self-reported questionnaire, focus groups and semi-structured telephone interviews. A follow-up evaluation was conducted at 3, 6 and 12 months with a purposive sample of EWL participants.

A total of 66 participants completed both pre- and post-intervention questionnaires. A total of 22 participants took part in the qualitative follow-up evaluation. The mixed method evaluation demonstrates improvements in participants’ fruit and vegetable consumption and a reduction in participants’ sugar consumption. Qualitative data highlight key themes such as “cooking from basic ingredients”, “knowledge of key healthy eating messages”, “changes in eating, cooking and shopping habits” and “wider influences on family and friends’ diets”.

This paper is useful to public health nutritionists and other practitioners delivering community-based dietary and cooking skills programmes and those commissioning such provision. It contributes to existing evidence of sustained change over time targeting those in areas of high deprivation.

The present exploratory study aimed (1) to explore the traditional dietary habits of local communities, (2) to analyze the shift in traditional eating practices and (3) to examine the changes observed in socio-cultural beliefs system due to climate change.

A cross-sectional study was conducted with purposive sampling of 210 households in the select ten villages of the western Himalayan region. Open-ended interview questionnaires and a close-ended survey on a 5-point Likert scale are used. Statistical Package for the Social Sciences (SPSS) version 24 is used for the exploratory factor analysis. Further, Atlas-ti version 8 is also employed for thematic analysis.

The exploratory and thematic analysis illustrated that socio-ecological beliefs are crucial in food choices, but cultural beliefs are also changing due to climate change. Thus, the shift in socio-cultural beliefs can significantly affect the nutritional security of the indigenous societies during climate-induced emergencies in the mountain regions.

Therefore, the findings of the study are significant for a comprehensive understanding of the traditional dietary practice of the indigenous community for an evidence-based inclusive food security and climate change adaptation policy.

The inclusion of cultural practices is evident for ensuring the nutritional security. But, the magnitude of the climate-induced impacts on customary societies is not yet fully understood. Thus, the current study was conducted.

This study aims to investigate whether epistemological assessment is a suitable approach to evaluate students’ learning of dietary knowledge via the use of an augmented reality (AR) information system. Students’ perceived dietary knowledge was compared before and after learning with the AR system. Two major questions were addressed: Did students improve their understanding of dietary knowledge after the use of AR information system? Did students gain more appropriate understanding of dietary knowledge after the use of AR information system?

A mixed-methods approach was used in the study. The mobile AR system was used among 65 volunteered non-nutrition-major college students recruited in campus. For promoting epistemological development of personal dietary knowledge, students practiced with life experiences to access daily dietary information. Pre- and post-tests of students’ understanding of dietary knowledge were compared. Interviews with 20 students were used for gathering in-depth research data to analyse students’ epistemological understanding of dietary knowledge.

The epistemological assessment indicated an improvement in learning after the use of the AR system. Students gradually gained awareness of dietary knowledge and changed their perceptions of their dietary behaviours. Epistemological approaches to the analysis of students’ conceptual change in dietary knowledge revealed a significant increase in the mean nutritional concepts (p < 0.01) and a decrease in their mean misconceptions (p < 0.001) after learning via the mobile nutrition monitoring system. Learning assessment of 65 students also indicated a significant increase from the post-test after learning with the system (p < 0.0001).

This study might have its limitations, as it only assessed learning using a pretest-posttest design for a specific learning context over a short period of learning time. The use of interviews based on the epistemological approach might have its limitations in the interpretations of the phenomenon. Future implementations can also be extended to different populations to promote self-monitoring dietary behaviours.

The findings of this study will contribute to the application of AR in learning about dietary knowledge. The research involving in-depth observation of students’ learning relevant to personal nutritional information needs via mobile AR might provide potential contributions to dietitian professionals and health education.

The purpose of this paper is to explore the use of qualitative approaches to add depth and insight to understanding concerning the issues involved when consumers try to make changes in their behaviour. The context of this study is people trying to make and sustain changes to their dietary behaviour. Taking Prochaska and Di Clemente's Stages of Change model as the starting point, this paper marks a departure from other work in the behavioural change area in so far as a qualitative approach is adopted rather than a quantitative perspective.

This study was longitudinal in design and the data presented concern groups of people who were categorized as belonging to stages of change and who followed a similar stage of change pattern over a period of 18 months (according to the Stage of Change algorithm described by Curry et al.).

By examining peoples' behaviour changes in depth, the similarities and differences in their attitudes and motivations are revealed in terms of their dietary behaviour change and maintenance of change. This provides a more refined understanding of how people make changes and maintain them over time.

While focusing only on a small number of people, the weaknesses of the Stages of Change model is demonstrated and how qualitative research approaches can be used to add depth and meaning to quantitative methodologies popular in the social marketing domain.

This paper demonstrates that the Stages of Change model has value in categorizing people into stages of change and measuring these changes over time but is limited in its ability to develop understanding of the lived experience of trying to change behaviour.

The purpose of this paper is to assess the effectiveness of cooking skill interventions (CSIs) targeting adults to improve dietary intakes in public health nutrition settings.

A scoping review of the literature was used to identify and assess the quality and effectiveness of Australian single-strategy CSIs and multi-strategy programmes that included cooking for independent healthy people older than 16 years from 1992 to 2015.

There were only 15 interventions (n=15) identified for review and included CSIs as single strategies (n=8) or as part of multi-strategy programmes (n=7) over 23 years. The majority of the interventions were rated as weak in quality (66 per cent) due to their study design, lack of control groups, lack of validated evaluation measures and small sample sizes. Just over half (53 per cent) of the CSIs reviewed described some measurement related to improved dietary behaviours.

There is inconclusive evidence that CSIs are effective in changing dietary behaviours in Australia. However, they are valued by policymakers and practitioners and used in public health nutrition programmes, particularly for indigenous groups.

This is the first time that CSIs have been reviewed in an Australian context and they provide evidence of the critical need to improve the quality CSIs to positively influence dietary behaviour change in Australia.

Randomised controlled trials identify causal links between variables but not why an outcome has occurred. This analysis sought to determine how psychological factors assessed at baseline influenced response to personalised nutrition.

Web-based, randomised, controlled trial (RCT) was conducted across seven European countries. Volunteers, both male and female, aged over 18 years were randomised to either a non-personalised (control) or a personalised (treatment) dietary advice condition. Linear mixed model analysis with fixed effects was used to compare associations between internal and external health locus of control (HLoC), nutrition self-efficacy (NS-E) and self-report habit index (S-RHI) at baseline (N = 1444), with healthy eating index (HEI) and Mediterranean diet index (MDI) scores between conditions post-intervention (N = 763).

An increase in MDI scores was observed between baseline and six months in the treatment group which was associated with higher NS-E (p < 0.001), S-RHI (p < 0.001) and external HLoC (p < 0.001). Increase in HEI between baseline and six months in the treatment group was associated with higher NS-E (p < 0.001) and external HLoC (p = 0.009). Interaction between time and condition indicated increased HEI scores (p < 0.001), which were associated with higher S-RHI scores in the treatment than control group (p = 0.032). Internal HLoC had no effect on MDI or HEI.

Psychological factors associated with behaviour change need consideration when tailoring dietary advice. Those with weaker habit strength will require communication focussed upon establishing dietary habits and support in integrating advised changes into daily routine. Information on habit strength can also be used to inform how progress towards dietary goals is monitored and fed back to the individual. Those with stronger habit strength are more likely to benefit from personalised nutrition.