title: Interventions directed at eating habits and physical activity using the Transtheoretical Model: a systematic review.
abstract: BACKGROUND
  The multi-behavioral Transtheoretical Model (TTM) addresses multiple behaviors and it is a promising strategy to control multifactorial morbidities, such as chronic diseases. The results obtained using the TTM are positive, but are not consistently methodical.
  
  
  OBJECTIVE
  The aim of this study was to systematically review the effectiveness of the Transtheoretical Model in multi-behavioral interventions for changing eating habits and levels of physical activity.
  
  
  METHODS
  A search on PubMed and SciELO databases was performed with inclusion criteria set for intervention studies before 2016 using the Transtheoretical Model for more than one behavior, including eating habits and/or engaging in physical activity.
  
  
  CONCLUSIONS
  Eighteen studies were identified; there was a predominance of randomized clinical trials, studies conducted in the United States, and the use of the Internet and/or telephone. The selected studies were aimed at changing eating behaviors; five of the studies did not address physical activity. The main results were reduction of fat consumption, an increase in the consumption of fruit and vegetables, and increases in physical activity, which are progressions in the stages of change and weight loss identified by the Transtheoretical Model. However, the studies showed methodological weaknesses, including high participant loss and the omission of information about randomization and blinding.
authors.affiliation: Postgraduate Program in Nursing. Research Group in Nutrition Interventions of University of Minas Gerais. Universidade Federal de Minas Gerais. Minas Gerais. marysnut@gmail.com.
authors.forename: Mariana
authors.initials: M
authors.lastname: Carvalho de Menezes
authors.forename: Lydiane Bragunci
authors.initials: LB
authors.lastname: Bedeschi
authors.forename: Luana Caroline Dos
authors.initials: LC
authors.lastname: Santos
authors.forename: Aline Cristine Souza
authors.initials: AC
authors.lastname: Lopes
mesh_terms: D015444:Exercise; D005247:Feeding Behavior; D006293:Health Promotion / Q000706:statistics & numerical data*; D006801:Humans; D008962:Models, Theoretical; D016032:Randomized Controlled Trials as Topic
keywords: Theoretical models.  Food habits. Exercise.  Intervention studies.  Review.