Comparison of the effects of a plastic-free diet program, interactive education and providing exposure feedback on Bisfenol-A levels in adolescents with high packaged product use

Objective: This study was conducted to compare the effects of a plastic-free diet program, plastic-free diet education program and BPA exposure feedback on Bisphenol A levels in adolescents with high use of packaged products. Method: The first phase of the two-phase study is descriptive, the second phase is a single-center, three-parallel group, single-blind, pretest-posttest design, three-arm non-randomized experimental design. The study was conducted in the 2022-2023 academic year, and in the first stage, adolescents with high use of plastic packaged products and low attitudes towards healthy nutrition were identified. In the second stage, participants were assigned to the intervention1 (n=36), intervention2 (n=36) and intervention3 (n=36) groups by simple random sampling method from the sample population. An eight-week plastic-free diet program was applied to the intervention group, plastic-free diet education program and BPA exposure feedback was given to the comparison group, and only BPA exposure feedback was given to the two comparison groups. Participant information form, Plastic Packaged Product Usage Survey, Feelings Towards Nutrition and Malnutrition sub-dimensions of the Attitude Scale towards Healthy Nutrition, and spot urine samples were used to collect data. Results: It was found that 2% of adolescents used low plastic packaging, 34% medium, 57% high, and 7% very high. Pretest-posttest urine BPA levels ng/ml (µg/g creatinine) were 1.98 (2.54), 1.43 (1.51) in the intervention1 group, respectively; 1.91 (2.35), 1.43 (1.47) in the intervention2 group; It was found to be 1.97 (2.49) and 1.49 (1.66) in the intervention3 group. The effect sizes of pretest-posttest BPA/creatinine values were calculated as 1.38, 1.13 and 1.09 in intervention1-2-3 groups, respectively. Conclusion: Dietary behaviors that lead to BPA exposure are common among adolescents. All three interventions (plastic-free diet program, plastic-free diet education program and BPA exposure feedback) were effective in reducing urinary BPA levels, reducing plastic-packaged product use levels, and increasing attitudes towards healthy eating. Keywords: Urinary Bisphenol A, diet and education intervention, exposure feedback, adolescents, nurse.