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Nutrition Counseling

NC: Strategies (2007-2008)

BEHAVIOR CHANGE STRATEGIES USED IN NUTRITION COUNSELING 

Application of behavior change theories in nutrition practice has provided practitioners with a collection of evidence-based strategies to promote behavior change. Practitioners selectively apply strategies based upon patient/client goals and objectives, and their personal counseling philosophy and skill. 

Summary of the Evidence Related to Behavioral Strategies used in Nutrition Counseling

Grade I: Strong evidence, based upon randomized controlled trials, substantiates the effectiveness of self-monitoring and meal replacements or a structured meal plans as part of nutrition counseling. Four positive quality RCTs provide evidence that motivational interviewing is effective when added to CBT by significantly enhancing adherence to program recommendations and improving targeted diet-related outcomes.Strong evidence demonstrates that reward strategies are not effective.

Grade II: Randomized controlled trials indicate that problem-solving strategies are effective in promoting maintenance of weight loss and diet management, but the studies were small and included only women. One highly intense lifestyle change study found social support was helpful and four traditional lifestyle change programs did not find it helpful. The definition of social support has evolved to include multiple dimensions of social support which need further investigation as they relate to diet. Research validates the effectiveness of client self-selected behavioral goal setting and goal attainment intervention. 

Grade III: Little evidence was found to document the effectiveness of cognitive restructuring in clients without eating disorders.

Grade V: No evidence was found since 1986, which evaluated stress management and stimulus control strategies in the context of nutrition counseling.

View and download a copy of the Strategy Description and Application Guidance Table (PDF)