Effectiveness of tableware to improve eating behavior and cardiometabolic health: A systematic review and meta-analysis

Abstract

Introduction

This study determined whether tableware-based intervention promotes healthy eating behavior and address cardiometabolic risk factors.

Methods

PubMed, Web of Science, Scopus, Embase, ClinicalTrials.gov, and ICTRP were searched from the earliest date available to July 2024. Data were pooled to calculate mean differences and 95% confidence intervals using a random or fixed effect model. This study was registered with PROSPERO (CRD42024573343).

Results

Twenty-seven publications with 5319 participants were included in this review. The effectiveness of tableware was mostly evaluated through plate models, followed by lunchboxes, forks, spoons, placemats, and take-out containers. Tableware significantly reduced bite rate (d = –1.04 bites per minute), protein intake (d = –14.13 g), and starch intake (d = –26.27 g), body weight (d = –1.24 kg), body mass index (d = –0.41 kg/m²), waist circumference (d = –1.24 cm), HbA1c (d = –0.41%), 2-hour postprandial glucose (d = –2.47 mmol/L), and high-density lipoprotein cholesterol (d = –1.61 mg/dL). Tableware significantly increased the proportion of vegetables taken (d = 5%), with a positive trend for increasing meal duration and fruit intakes. Tableware had no significant effect on blood pressure, total cholesterol, triglycerides, low-density lipoprotein, and fasting blood glucose (unless 12 months duration).

Conclusions

Tableware might be a practical tool to promote healthy food choices and weight loss, address fast eating, and improve cardiometabolic health across populations of various age groups.