The use of psychological methodologies in cardiovascular disease interventions promoting a Mediterranean style diet: A systematic review

To evaluate theory-based psychological approaches that have been effective in promoting behavior change in interventions promoting a Mediterranean style diet (MD) for the reduction of cardiovascular disease (CVD) risk. A systematic review of primary research articles using PRISMA recommendations was conducted. References were retrieved using keyword searches from MEDLINE via PUBMED and included studies targeted participants at high risk for CVD. Two hundred and ninety one studies were reviewed; however, only six met the inclusionary criteria. Three articles describe the same intervention; therefore, only four were included. Included studies incorporated social cognitive theory, social learning theory, goal-system theory, social ecological theory, selfdetermination theory, and the transtheoretical model of behavior change. Overall, studies were nutrition interventions in clinical settings with participants at high risk for or with CVD. Results from use of the social cognitive theory and self-determination theory in increasing MD adherence for the reduction of CVD risk and events are encouraging. However, we encourage future long-term interventions focusing on dietary behavior change to provide not only an in-depth description of the psychological methodologies used but also how these methodologies were implemented in order ascertain the most effective theory for promoting dietary behavior change towards patterns of a MD. •Limited data exists on theories in CVD studies promoting a Mediterranean diet (MD).•The self-determination theory (SDT) is beneficial in MD adherence in males.•Social cognitive theory (SCT) creates sense of community in a technological world.