Journal Screenshot

International Journal of Academic Research in Business and Social Sciences

Open Access Journal

ISSN: 2222-6990

Integrating Health Belief Model in Nutrition Education for Individuals with Cardiometabolic Risk: The State-Of-The-Art

Wan Ling Chiang, Barakatun Nisak Mohd Yusof, Azrina Azlan

http://dx.doi.org/10.6007/IJARBSS/v11-i19/11743

Open access

While nutrition education modifies dietary habits, the impact is not sustainable over time. Integrating Health Belief Model (HBM) in nutrition education may aid in sustaining the improvement. This article determines the impact of integrating the HBM in nutrition education for individuals with cardiometabolic risk (CMR) to improve CMR markers, knowledge and dietary habits, especially regarding calories and nutrients of concern. We conducted a comprehensive search using online databases (Ovid LWW, PubMed, and Scopus (Elsevier)) for full-text articles published in the English language for the past ten years from January 2011 until August 2021. The included studies used controlled intervention among individuals with CMR defined using 'Harmonised' definitions by the International Diabetes Federation Task Force. The Quality Assessment Tool for Controlled Intervention Studies assessed the study quality. Seven studies, mainly from Iran, Iraq, Qatar and Greece, were included in this review, involving 1055 participants with CMR. Study quality ranged from fair to good. Most of the intervention studies did not blind the participants, providers and outcome assessors to group assignments. Integrating HBM in nutrition education with study duration between three to 12 months effectively improved some dietary habits, physical activity levels, knowledge, health belief, anthropometric and CMR factors. Integrating HBM in nutrition education positively impacted the outcome measures in individuals with CMR. The need for HBM is evident in improving dietary habits, particularly the calories intake and the nutrient of concern, including carbohydrates, fats, and dietary sugar. Modifying to a better quality of nutrients, such as antioxidants warrant further investigation.

Abdulah, D. M., Hassan, A. B., Saadi, F. S., & Mohammed, A. H. (2018). Impacts of self-management education on glycaemic control in patients with type 2 diabetes mellitus. Diabetes and Metabolic Syndrome: Clinical Research and Reviews, 12(6).
https://doi.org/10.1016/j.dsx.2018.06.007
Agyei-Mensah, S., & De-Graft Aikins, A. (2010). Epidemiological transition and the double burden of disease in Accra, Ghana. Journal of Urban Health, 87(5), 879–897.
https://doi.org/10.1007/s11524-010-9492-y
Alberti, K. G. M. M., Eckel, R. H., Grundy, S. M., Zimmet, P. Z., Cleeman, J. I., Donato, K. A., Fruchart, J. C., James, W. P. T., Loria, C. M., & Smith, S. C. (2009). Harmonising the metabolic syndrome: A joint interim statement of the international diabetes federation task force on epidemiology and prevention; National heart, lung, and blood institute; American heart association; World heart federation; International. In Circulation.
https://doi.org/10.1161/CIRCULATIONAHA.109.192644
Alidosti, M., Sharifirad, G. R., Golshiri, P., Azadbakht, L., Hasanzadeh, A., & Hemati, Z. (2012). An investigation on the effect of gastric cancer education based on Health Belief Model on knowledge, attitude and nutritional practice of housewives. Iranian Journal of Nursing and Midwifery Research, 17(4).
Baghianimoghadam, M. H., Hadavandkhani, M., Mohammadi, M., Fallahzade, H., & Baghianimoghadam, B. (2012). Current education versus peer-education on walking in type 2 diabetic patients based on Health Belief Model: a randomised control trial study. Romanian Journal of Internal Medicine = Revue Roumaine de Médecine Interne, 50(2).
Baghianimoghadam, M. H., Shogafard, G., Sanati, H. R., Baghianimoghadam, B., Mazloomy, S. S., & Askarshahi, M. (2013). Application of the health belief model in promotion of self-care in heart failure patients. Acta Medica Iranica, 51(1).
Bayat, F., Shojaeezadeh, D. S. M., Heshmat, R., Baikpour, M., & Hosseini, M. (2013). The effects of education based on extended health belief model in type 2 diabetic patients: A randomised controlled trial. Journal of Diabetes and Metabolic Disorders, 12(1).
https://doi.org/10.1186/2251-6581-12-45
Bellastella, G., Bizzarro, A., Aitella, E., Barrasso, M., Cozzolino, D., di Martino, S., Esposito, K., & de Bellis, A. (2015). Pregnancy may favour the development of severe autoimmune central diabetes insipidus in women with vasopressin cell antibodies: Description of two cases. European Journal of Endocrinology, 172(3). https://doi.org/10.1530/EJE-14-0762
Choo, J., Yoon, S. J., Ryu, H., Park, M. S., Lee, H. S., Park, Y. M., & Lim, D. S. (2016). The Seoul metropolitan lifestyle intervention program and metabolic syndrome risk: A retrospective database study. International Journal of Environmental Research and Public Health, 13(7). https://doi.org/10.3390/ijerph13070667
De la Iglesia, R., Loria-Kohen, V., Zulet, M. A., Martinez, J. A., Reglero, G., & de Molina, A. R. (2016). Dietary strategies implicated in the prevention and treatment of metabolic syndrome. In International Journal of Molecular Sciences, 17(11).
https://doi.org/10.3390/ijms17111877
Emiral, G. O., Tozun, M., Atalay, B. I., Goktas, S., Dagtekin, G., Aygar, H., Arslantas, D., Unsal, A., Babaoglu, A. B., & Tirpan, K. (2021). Assessment of knowledge of metabolic syndrome and health literacy level among adults in Western Turkey. Nigerian Journal of Clinical Practice, 24(1). https://doi.org/10.4103/njcp.njcp_88_18
Equator. (2020). The EQUATOR Network | Enhancing the QUAlity and Transparency Of Health Research. In Equator Resource Centre.
Farhadi, Z., Roshanaei, G., Bashirian, S., & Rezapur-Shahkolai, F. (2014). The Effect of an Educational Program on School Injury Prevention in Junior High School Students of Famenin Based on the Health Belief Model. Journal of Education and Community Health, 1(3). https://doi.org/10.20286/jech-010371
Fathi, A., Sharifirad, G., Gharlipour, Z., Hakimelahi, J., & Mohebi, S. (2017). Effects of a nutrition education intervention designed based on the health belief model (HBM) on reducing the consumption of unhealthy snacks in the sixth grade primary school girls. International Journal of Pediatrics, 5(2). https://doi.org/10.22038/ijp.2016.7567
Fechner, E., Smeets, E. T. H. C., Schrauwen, P., & Mensink, R. P. (2020). The effects of different degrees of carbohydrate restriction and carbohydrate replacement on cardiometabolic risk markers in humans—a systematic review and meta-analysis. In Nutrients, 12(4). https://doi.org/10.3390/nu12040991
Ghavami, M., Harandy, F. T., & Kabir, K. (2016). The Effect of Educational Intervention in Promoting Safe Behaviours in a Sample of Iranian Primary School Students: An Application of the Health Belief Model. Global Journal of Health Science, 8(11). https://doi.org/10.5539/gjhs.v8n11p242
Giugliano, D., Ceriello, A., & Esposito, K. (2008). Are there specific treatments for the metabolic syndrome? In American Journal of Clinical Nutrition, 87(1). https://doi.org/10.1093/ajcn/87.1.8
Glanz, K., Rimer, B. K., & Viswanath, K. (2008). Theory, research and practice in health behaviour and health education. In Health Education.
Goldenberg, J. Z., Day, A., Brinkworth, G. D., Sato, J., Yamada, S., Jönsson, T., Beardsley, J., Johnson, J. A., Thabane, L., & Johnston, B. C. (2021). Efficacy and safety of low and very low carbohydrate diets for type 2 diabetes remission: systematic review and meta-analysis of published and unpublished randomised trial data. BMJ (Clinical Research Ed.), 372. https://doi.org/10.1136/bmj.m4743
Hallberg, S. J., Gershuni, V. M., & Athinarayanan, S. J. (2019). Reversing type 2 diabetes: A narrative review of the evidence. Nutrients, 11(4).
https://doi.org/10.3390/nu11040766
Hammer, S., Snel, M., Lamb, H. J., Jazet, I. M., van der Meer, R. W., Pijl, H., Meinders, E. A., Romijn, J. A., de Roos, A., & Smit, J. W. A. (2008). Prolonged Caloric Restriction in Obese Patients With Type 2 Diabetes Mellitus Decreases Myocardial Triglyceride Content and Improves Myocardial Function. Journal of the American College of Cardiology, 52(12). https://doi.org/10.1016/j.jacc.2008.04.068
Jalilian, F., Motlagh, F. Z., Solhi, M., & Gharibnavaz, H. (2014). Effectiveness of self-management promotion educational program among diabetic patients based on health belief model. Journal of Education and Health Promotion, 3(1).
https://doi.org/10.4103/2277-9531.127580
Janz, N. K., & Becker, M. H. (1984). The Health Belief Model: A Decade Later. Health Education & Behaviour, 11(1), 1–47. https://doi.org/10.1177/109019818401100101
Jeihooni, A. K., Hidarnia, A., Kaveh, M. H., & Hajizadeh, E. (2015). The effect of a prevention program based on health belief model on osteoporosis. Journal of Research in Health Sciences, 15. https://doi.org/10.34172/jrhs151803
Mahmoud, M. H., Sayed, S. H., Ibrahim, H. A.-F., & Abd-Elhakam, E. M. (2018). Effect of Health Belief Model-Based Educational Intervention About Breast Cancer on Nursing Students' Knowledge, Health Beliefs and Breast Self-Examination Practice. International Journal of Studies in Nursing, 3(3). https://doi.org/10.20849/ijsn.v3i3.503
Mohamed, H., Al-Lenjawi, B., Amuna, P., Zotor, F., & Elmahdi, H. (2013). Culturally sensitive patient-centred educational programme for self-management of type 2 diabetes: A randomised controlled trial. Primary Care Diabetes, 7(3).
https://doi.org/10.1016/j.pcd.2013.05.002
Mohammadi, S., Karim, N. A., Talib, R. A., & Amani, R. (2018). The impact of self-efficacy education based on the health belief model in Iranian patients with type 2 diabetes: A randomised controlled intervention study. Asia Pacific Journal of Clinical Nutrition, 27(3). https://doi.org/10.6133/apjcn.072017.07
National Heart Lung and Blood Institute. (2014). Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Bethesda, MD: National Institutes of Health, Department of Health and Human Services.
Neter, J. E., Stam, B. E., Kok, F. J., Grobbee, D. E., & Geleijnse, J. M. (2003). Influence of Weight Reduction on Blood Pressure: A Meta-Analysis of Randomised Controlled Trials. Hypertension, 42(5). https://doi.org/10.1161/01.HYP.0000094221.86888.AE
Olatona, F. A., Onabanjo, O. O., Ugbaja, R. N., Nnoaham, K. E., & Adelekan, D. A. (2018). Dietary habits and metabolic risk factors for non-communicable diseases in a university undergraduate population. Journal of Health, Population and Nutrition, 37(1). https://doi.org/10.1186/s41043-018-0152-2
Paisey, R. B., Harvey, P., Rice, S., Belka, I., Bower, L., Dunn, M., Taylor, P., Paisey, R. M., Frost, J., & Ash, I. (1998). An intensive weight loss programme in established type 2 diabetes and controls: Effects on weight and atherosclerosis risk factors at 1 year. Diabetic Medicine, 15(1).
https://doi.org/10.1002/(SICI)1096-9136(199801)15:1<73::AID-DIA516>3.0.CO;2-F
Petersen, J. M., Prichard, I., Kemps, E., & Tiggemann, M. (2019). The effect of snack consumption on physical activity: A test of the Compensatory Health Beliefs Model. Appetite, 141. https://doi.org/10.1016/j.appet.2019.104342
Petrogianni, M., Kanellakis, S., Kallianioti, K., Argyropoulou, D., Pitsavos, C., & Manios, Y. (2013). A multicomponent lifestyle intervention produces favourable changes in diet quality and cardiometabolic risk indices in hypercholesterolaemic adults. Journal of Human Nutrition and Dietetics, 26(6). https://doi.org/10.1111/jhn.12041
Phillips, K. M., Carlsen, M. H., & Blomhoff, R. (2009). Total Antioxidant Content of Alternatives to Refined Sugar. Journal of the American Dietetic Association, 109(1), 64–71. https://doi.org/10.1016/j.jada.2008.10.014
Saboya, P. P., Bodanese, L. C., Zimmermann, P. R., Gustavo, A. Da S., Assumpção, C. M., & Londero, F. (2016). Metabolic syndrome and quality of life: a systematic review. Revista Latino-Americana de Enfermagem, 24(0).
https://doi.org/10.1590/1518-8345.1573.2848
Shahnazi, H., Sabooteh, S., Sharifirad, G., Mirkarimi, K., & Hassanzadeh, A. (2015). The impact of education intervention on the Health Belief Model constructs regarding anxiety of nulliparous pregnant women. Journal of Education and Health Promotion, 4(1). https://doi.org/10.4103/2277-9531.154120
Shamsi, M., Sharifirad, G., Kachoyee, A., & Hassanzadeh, A. (2010). The effect of educational program walking based on health belief model on control suger in woman by type 2 diabetics. Iranian Journal of Endocrinology and Metabolism, 11(5).
Siddiqui, F., Kurbasic, A., Lindblad, U., Nilsson, P. M., & Bennet, L. (2017). Effects of a culturally adapted lifestyle intervention on cardio-metabolic outcomes: a randomised controlled trial in Iraqi immigrants to Sweden at high risk for Type 2 diabetes. Metabolism: Clinical and Experimental, 66. https://doi.org/10.1016/j.metabol.2016.10.001
Singh, A., Lal, U. R., Mukhtar, H. M., Singh, P. S., Shah, G., & Dhawan, R. K. (2015). Phytochemical profile of sugarcane and its potential health aspects. In Pharmacognosy Reviews, 9(17). https://doi.org/10.4103/0973-7847.156340
Snel, M., Jonker, J. T., Hammer, S., Kerpershoek, G., Lamb, H. J., Edo Meinders, A., Pijl, H., de Roos, A., Romijn, J. A., Smit, J. W. A., & Jazet, I. M. (2012). Long-term beneficial effect of a 16-week very low calorie diet on pericardial fat in obese type 2 diabetes mellitus patients. Obesity, 20(8). https://doi.org/10.1038/oby.2011.390
Staessen, J., Fagard, R., & Amery, A. (1988). The relationship between body weight and blood pressure. In Journal of Human Hypertension, 2(4).
te Morenga, L. A., Howatson, A. J., Jones, R. M., & Mann, J. (2014). Dietary sugars and cardiometabolic risk: Systematic review and meta-analyses of randomised controlled trials of the effects on blood pressure and lipids. In American Journal of Clinical Nutrition, 100(1). https://doi.org/10.3945/ajcn.113.081521
te Morenga, L. A., Mallard, S., & Mann, J. (2013). Dietary sugars and body weight: Systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ (Online). https://doi.org/10.1136/bmj.e7492
Timóteo, A. T. (2018). Diet in patients with metabolic syndrome: What is the ideal macronutrient composition? In Revista Portuguesa de Cardiologia, 37(12). https://doi.org/10.1016/j.repc.2017.11.013
Tougas, M. E., Hayden, J. A., McGrath, P. J., Huguet, A., & Rozario, S. (2015). A systematic review exploring the social cognitive theory of self-regulation as a framework for chronic health condition interventions. In PLoS ONE.
https://doi.org/10.1371/journal.pone.0134977
Van der Heijden, M. M. P., Pouwer, F., Romeijnders, A. C., & Pop, V. J. M. (2012). Testing the effectiveness of a self-efficacy based exercise intervention for inactive people with type 2 diabetes mellitus: Design of a controlled clinical trial. BMC Public Health, 12(1). https://doi.org/10.1186/1471-2458-12-331
Wing, R. R., Blair, E., Marcus, M., Epstein, L. H., & Harvey, J. (1994). Year-long weight loss treatment for obese patients with type II diabetes: Does including an intermittent very-low-calorie diet improve outcome?. The American Journal of Medicine, 97(4). https://doi.org/10.1016/0002-9343(94)90302-6
World Health Organization. (2015). WHO Guideline: Sugars intake for adults and children. In WHO Library Cataloguing-in-Publication Data.
Yokokawa, H., Fukuda, H., Yuasa, M., Sanada, H., Hisaoka, T., & Naito, T. (2016). Association between health literacy and metabolic syndrome or healthy lifestyle characteristics among community-dwelling Japanese people. Diabetology and Metabolic Syndrome, 8(1). https://doi.org/10.1186/s13098-016-0142-8
Zareban, I., Karimy, M., Niknami, S., Haidarnia, A., & Rakhshani, F. (2014). The effect of self-care education program on reducing HbA1c levels in patients with type 2 diabetes. Journal of Education and Health Promotion, 3(123).

In-Text Citation: (Chiang et al., 2021)
To Cite this Article: Chiang, W. L., Yusof, B. N. M., & Azlan, A. (2021). Integrating Health Belief Model in Nutrition Education for Individuals with Cardiometabolic Risk: The State-Of-The-Art. International Journal of Academic Research in Business and Social Sciences, 11(19), 381–403.