Journal of Isfahan Medical School

Journal of Isfahan Medical School

Operational Strategies for Stage-Based Interventions in Promoting Nutritional Health Among Middle-Aged Adults

Document Type : policy brief

Authors
Sahebjan Torkian 1
Zahra Heidari 2
Fereshteh Zamani-Alavijeh 3
1 Student Research Committee, Nutrition and Food Security Research Center, Department of Health Education and Health Promotion, Isfahan University of Medical Sciences, Isfahan, Iran
2 Social Determinants of Health Research Centre, Department of Health Education and Health Promotion, Isfahan University of Medical Sciences, Isfahan, Iran
3 Department of Biostatistics and Epidemiology, Applied Physiology Research Center, Cardiovascular Research Institute, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
10.48305/jims.v44.i871.1322
Abstract
Healthy dietary behaviors are among the key components of preventing noncommunicable diseases and promoting public health. However, evidence from a cross-sectional study showed that individuals’ readiness to change behavior is not uniform and is influenced by personal and contextual characteristics. Accordingly, designing identical and generalized interventions for all individuals cannot address differences in readiness for change. This policy brief emphasizes the need to adopt stage-based, targeted, and tailored interventions appropriate to each individual’s condition. The findings indicate that variables such as age, sex, education, employment status, marital status, tobacco use, sleep duration, and anthropometric indicators including BMI and waist circumference are associated with stages of change in dietary behaviors, and this can serve as a basis for identifying groups in need of intervention. In such a context, the health system should adopt personalized interventions and incorporate readiness to change assessment into primary care. Implementing this approach requires staff training; simultaneous intervention on high-risk behaviors such as diet, sleep, and tobacco use; systematic recording of assessment results in health records; and a focus on high-risk groups, including individuals with higher BMI, smokers, and those with insufficient sleep. Overall, this policy brief suggests that health policymakers should prioritize stage-based educational interventions and the use of screening data to create conditions for improving healthy dietary behaviors among middle-aged adults.

Highlights

Sahebjan Torkian: Google Scholar

Keywords
Middle-Aged Adults
Nutrition
Prevention
Health Promotion
Transtheoretical Model
Policy Brief
Subjects
1.     Khoshkchali A, Torkian S, Ahmadi H, Manochehri MJ. Change of the pattern of red and white meat consumption among households during the COVID-19 lockdown in Isfahan Province, Iran, in 2021: A cross-sectional study [in Persian]. J Health Syst Res 2026; 21(4): 437-44.
2.     Sameh Salari S. The role of nutrition in human biological and cultural evolution [in Persian]. Iranian Archaeological Research 2025.
3.     Nebot-Valenzuela E, Aparicio VA, Morán LJ, Flor-Alemany M, Fernández-Bergés D, Nestares T, Felix-Redondo FJ. Food group intake and Mediterranean Diet adherence among a representative sample of Spanish middle-aged and older adults. Are we still on track? The HERMEX study. Nutr Metab Cardiovasc Dis 2026; 36(5): 104415.
4.     Seago ER, Rego ML, Davy BM, Katz B. Differential association of ultraprocessed food categories with risk of developing cognitive impairment in middle-aged and older adults in a longitudinal panel study. Am J Clin Nutr 2025; 121(5): 965-71.
5.     Torkian S, Zamani F, Heidari Z. Assessment of nutrition and health behavior changes in middle-aged adults: A cross-sectional study based on new technologies at different stages of SOC change. [Thesis]. Isfahan University of Medical Sciences; 2026. [in Persian]
6.     Heidarpoor P, Saeedi F. Effect of a foot care program based on the transtheoretical model on improving foot care behaviors and self-efficacy in adults with type 2 diabetes [in Persian]. Iran J Health Educ Health Promot 2025; 13(3): 64-76.
7.     Ebrahimi S, Salehnezhad AS, Peyman N. Application of health education models and theories to promote physical activity in Iran: A systematic review [in Persian]. J Health Syst Res 2025; 21(3): 269-84.
8.     Asadolahi A, Sajjadi SH, Nikaeen Z, Zarei A. Designing a model of physical activity for middle-aged Iranian women [in Persian]. Sport Physiology & Management Investigations 2022; 14(3): 185-202.
Namazi N, Naini A, Mostafavidarani F, Boroumandfar Z. Investigation of stage of change and behavior and cognitive behavioral processes (transitional model) in the use of nutrients in overweight middle-aged women [in Persian]. J Sch Public Health Inst Public Health Res 2019; 17(2): 145-60
1.     Khoshkchali A, Torkian S, Ahmadi H, Manochehri MJ. Change of the pattern of red and white meat consumption among households during the COVID-19 lockdown in Isfahan Province, Iran, in 2021: A cross-sectional study [in Persian]. J Health Syst Res 2026; 21(4): 437-44.
2.     Sameh Salari S. The role of nutrition in human biological and cultural evolution [in Persian]. Iranian Archaeological Research 2025.
3.     Nebot-Valenzuela E, Aparicio VA, Morán LJ, Flor-Alemany M, Fernández-Bergés D, Nestares T, Felix-Redondo FJ. Food group intake and Mediterranean Diet adherence among a representative sample of Spanish middle-aged and older adults. Are we still on track? The HERMEX study. Nutr Metab Cardiovasc Dis 2026; 36(5): 104415.
4.     Seago ER, Rego ML, Davy BM, Katz B. Differential association of ultraprocessed food categories with risk of developing cognitive impairment in middle-aged and older adults in a longitudinal panel study. Am J Clin Nutr 2025; 121(5): 965-71.
5.     Torkian S, Zamani F, Heidari Z. Assessment of nutrition and health behavior changes in middle-aged adults: A cross-sectional study based on new technologies at different stages of SOC change. [Thesis]. Isfahan University of Medical Sciences; 2026. [in Persian]
6.     Heidarpoor P, Saeedi F. Effect of a foot care program based on the transtheoretical model on improving foot care behaviors and self-efficacy in adults with type 2 diabetes [in Persian]. Iran J Health Educ Health Promot 2025; 13(3): 64-76.
7.     Ebrahimi S, Salehnezhad AS, Peyman N. Application of health education models and theories to promote physical activity in Iran: A systematic review [in Persian]. J Health Syst Res 2025; 21(3): 269-84.
8.     Asadolahi A, Sajjadi SH, Nikaeen Z, Zarei A. Designing a model of physical activity for middle-aged Iranian women [in Persian]. Sport Physiology & Management Investigations 2022; 14(3): 185-202.
9.   Namazi N, Naini A, Mostafavidarani F, Boroumandfar Z. Investigation of stage of change and behavior and cognitive behavioral processes (transitional model) in the use of nutrients in overweight middle-aged women [in Persian]. J Sch Public Health Inst Public Health Res 2019; 17(2): 145-60
Journal of Isfahan Medical School
Volume 44, Issue 871
3rd Week,September (Policy Brief)
September and October 2026
Pages 1322-1326

  • Receive Date 16 April 2026
  • Accept Date 20 April 2026