Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Oct 29;15(10):e107435.
doi: 10.1136/bmjopen-2025-107435.

Development, content and planned evaluation of a behavioural support intervention to reduce ultraprocessed food intake and increase physical activity in UK healthcare workers: UPDATE trial stage 2 study protocol

Gabriella Niamh Heuchan  1 , Caroline Buck  2 , Rana Conway  2 , Samuel Dicken  2   3   4 , Adrian Carl Brown  3   4   5 , Friedrich C Jassil  3   4   5   6 , Janine Makaronidis  3   4 , Chris Van Tulleken  7 , Claudia Angela Gandini Wheeler-Kingshott  8   9   10 , Rachel Batterham  3   4   5 , Abigail Fisher  2
Affiliations

Development, content and planned evaluation of a behavioural support intervention to reduce ultraprocessed food intake and increase physical activity in UK healthcare workers: UPDATE trial stage 2 study protocol

Gabriella Niamh Heuchan et al. BMJ Open. .

Abstract

Introduction: Diets high in ultraprocessed food (UPF) are associated with poor health outcomes and weight gain. Healthcare workers are particularly at risk of consuming diets high in UPF due to erratic work patterns, high stress and limited access to fresh food at work. Despite this, no interventions to date have specifically targeted a reduction in UPF intake in healthcare workers.

Methods and analysis: This article describes the development and content of a 6-month behavioural support intervention targeting a reduction in UPF intake in UK healthcare workers. The intervention was offered to all participants who took part in the UltraProcessed versus minimally processed Diets following UK dietAry guidance on healTh outcomEs trial-a two-stage study in which Stage 1 was a controlled-feeding crossover randomised controlled trial of provided UPF versus minimally processed food (MPF) diets (published previously) and was completed before the start of Stage 2. Stage 2, reported here, aimed to support participants to reduce their UPF consumption, increase MPF and increase physical activity in real-world settings. The intervention was developed using the behaviour change wheel framework, which systematically links behavioural diagnoses to intervention functions, incorporating the capability, opportunity and motivation model for behaviour change. It included tailored one-to-one and group support sessions, bespoke digital and print resources and a mobile-optimised website. The detailed description is intended to support future replication and adaptation. The acceptability and feasibility of the intervention will be assessed using quantitative and qualitative data in a future paper.

Ethics and dissemination: Sheffield Research Ethics Committee approved the trial (22/YH/0281). Findings will be disseminated through peer-reviewed publications, conference presentations and summaries shared with participants and stakeholders.

Trial registration number: NCT05627570.

Keywords: Behavior; NUTRITION & DIETETICS; Obesity; Psychosocial Intervention.

PubMed Disclaimer

Conflict of interest statement

Competing interests: SD receives royalties from Amazon for a self-published book that mentions UPF, payments from Red Pen Reviews as a contributor and consultancy work for Consensus and Androlabs. RB from May 2023 is an employee and shareholder of Eli Lilly and Company. ACB declares researcher-led grants from the National Institute for Health Research, Rosetrees Trust, MRC, INNOVATE UK, British Dietetic Association, British Association of Parenteral and Enteral Nutrition, BBRSC, the Office of Health Improvement and Disparities and Novo Nordisk. ACB reports honouraria from Novo Nordisk, Lilly, Office of Health Improvement and Disparity, Johnson and Johnson and Obesity UK outside the submitted work and is on the Medical Advisory Board and shareholder of Reset Health Clinics Ltd. CAGW-K is a shareholder in Queen Square Analytics. JM reports institutional funding from Novo Nordisk, Rhythm Pharmaceuticals and Innovate UK outside the submitted work. CVT receives royalties for a book on UPF and has been paid for other broadcasting on this subject (podcast and BBC documentaries). CB, GNH, RC, FCJ and AF report no conflicts of interest.

Figures

Figure 1
Figure 1. Exemplar graphical representation of a participant’s scores across various barriers and facilitators to reducing their UPF intake according to their responses to a capability, opportunity and motivation questionnaire. Responses are plotted against a possible maximum score for each domain. UPF, ultraprocessed food.
See this image and copyright information in PMC

References

    1. Stiebahl S. Obesity statistics. 2025. https://researchbriefings.files.parliament.uk/documents/SN03336/SN03336.pdf Available.
    1. Di Angelantonio E, Bhupathiraju S, et al. Global BMI Mortality Collaboration Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet. 2016;388:776–86. doi: 10.1016/S0140-6736(16)30175-1. - DOI - PMC - PubMed
    1. Griffith R. The Costs of Obesity. 2023. [30-Dec-2024]. https://ifs.org.uk/sites/default/files/2023-07/The-costs-of-obesity-fina... Available. Accessed.
    1. Bradshaw A, Dace H. Unhealthy numbers: the rising cost of obesity in the UK. 2023. [20-May-2025]. https://institute.global/insights/public-services/unhealthy-numbers-the-... Available. Accessed.
    1. Kyle RG, Wills J, Mahoney C, et al. Obesity prevalence among healthcare professionals in England: a cross-sectional study using the Health Survey for England. BMJ Open . 2017;7:e018498. doi: 10.1136/bmjopen-2017-018498. - DOI - PMC - PubMed

Publication types

Associated data