What’s for Dinner? Factors That Influence Food Choices
By Mary Kaye Sawyer-Morse, PhD, RD
Today’s Dietitian
Vol. 7 No. 10 P. 68

Too many food choices—as well as personal, societal, and economic motivations—make choosing what you eat a complicated task.

I hate buffets. I am overwhelmed by the shear volume of choice; chicken prepared four ways, two different types of fish, 14 different toppings for the salad, and five different desserts. My taste buds go on overload contemplating the potential cornucopia. I walk out and find a cafe around the corner where I order a bowl of vegetable soup. Some days I prefer life—and my food choices—to be simple.

An Abundance of Choice
Americans enjoy one of the most plentiful and affordable food supplies in the world. With this abundance has come overconsumption—of calories, fat, sodium—and a host of related health concerns. The connection has not gone unnoticed. Indeed, Americans acknowledge that there is a relationship between diet and health. In fact, more than one-half of grocery shoppers report that they actively seek diet and nutrition information, and more than one-third report that they are doing all they can to eat healthfully.1,2 Though surveys suggest that Americans are moving toward healthier eating, there is still a long way to go and many obstacles remain. A reluctance to give up favorite foods and satisfaction with current diet, to minimal time available to prepare food and track diet and limited understanding of nutrition guidelines all stand in the way of healthier eating.2

Where do we go from here in our efforts to promote healthy eating?

A Look Back
Before we explore how to move forward, let’s first put the abundance of food choices of today into perspective by stepping back to the dinner table of the early 19th century. America’s food choices and eating habits have changed dramatically over the past 100 years. You sat down to dinner in 1900 and what did you see on your plate? Meat and potatoes. These two foods generally describe the American cuisine in the 19th century and the early years of the 20th.

Today, Americans have more choices than ever as they wander down the average grocery store aisle. Modern food production and processing allows us to have a wide variety of food items whenever and wherever they are desired. When food preparation doesn’t appeal, all that is necessary for dinner is a quick drive around the corner to the many beckoning fast food and family-style restaurants.

So how do we choose what’s for dinner?

Why We Eat What We Do
A number of factors influence our dietary choices. Factors include taste, cost, convenience, health concerns, and culture. Of these, taste plays a primary role. People will eat foods they evaluate as tasty. How a food tastes to us is affected by physiological and metabolic variables. Taste preferences are partly ‘hard-wired’ at birth like the preference for sweetness and are modified by gender, age, and food experiences. Some research suggests that early exposure (prior to the age of 4) to a variety of foods sets the stage for later food acceptance.3 The more foods children are exposed to in early childhood, the more likely they are to enjoy greater food variety as adults. It is interesting to note that the preference for fat is also learned in early childhood.4

Taste is the basic standard for food consumption. Indeed, concern about changes in the taste quality of food choices is one of the most often mentioned obstacles to adopting a reduced-fat and/or healthy diet. Consumers frequently have the perception that foods lower in fat don’t taste as good and consequently are averse to making dietary changes. However, people with a greater interest in health and weight are more likely to increase their fruit and vegetable consumption over fast food or high-fat snack food choices. For them, the gains of health-oriented dietary changes outweigh any perceived ‘losses’ from modifying their eating choices.

Cost and convenience of food are also significant concerns. Though the price of food is not as important to many people as it once was, it remains a consideration. Convenience, however, equals time savings and is a major factor for individuals and families with limited time for food preparation. The cost of convenience, value-added (precut, prewashed), and ready-made foods is secondary for the more than 60% of American women juggling both work and families and who desire to spend less than 15 minutes preparing a meal.5 What a difference a century makes.

The perceived health and nutritional value of a food is a major predictor of choice, though it is typically ranked behind taste, convenience, and cost. The demand for minimally processed, nutritious foods offering perceived greater health benefits has motivated the food industry to develop a variety of functional and fortified foods. Consumer demand for these foods is likely to increase in the future as the population develops an interest in self-healthcare.

Today Americans represent a broad cultural heritage. One in four has African, Asian, Hispanic, or American Indian ancestry.6 Our cultural heritage affects not only our taste preferences, but also our shopping habits, customs, and manners. Nevertheless, acculturation and the adoption of American eating habits alter cultural choices that often focus on whole grains, fruits, and vegetables to foods that are higher in fat and sugars.

It’s a Matter of Personal Choice
Food choices are also influenced by our attitudes and beliefs about food—think about how perceptions and beliefs about fat have shifted in recent years as a powerful example. Food habits offer a reflection of how we see ourselves—be it as a picky eater, food lover, healthy eater, or impulsive eater—and the value we place on our health.7 We bring personal identities to the food choices we make. Learning about the identities people bring to and derive from eating can help nutrition professionals think about food through the eyes of their clients. Information about identities can reveal what is of concern to clients, how clients organize food according to their own preferences, how they express themselves through food, and the ways in which they manage eating situations. By asking questions such as “Tell me how you manage food and eating for yourself” and “How would you describe the kind of eater you are?” or “What kind of eater would you like to be?” we begin to elicit a personal viewpoint about food and eating choices.

Food choices are also a social decision. We typically eat more in the company of others than we do when dining alone and in fact, the size of the meal often increases by the number of people present.8 Dining with health-conscious friends does make a difference.

It is a tall order. Given all the complexities of food choice, how do we develop educational programs and messages that promote healthy eating?

A Look at Successful Messages
We develop successful messages and interventions through understanding consumer behavior and the factors that influence food choice. Public and private nutrition and health education efforts help consumers understand the importance of healthy food choices and making associated changes. Effective communication campaigns are key. Communication efforts that utilize a theory or model are more powerful and successful.

Why?

Using a theory or model helps us better understand human behavior and how it works. Theory explains “how” and “why” things happen the way they do. Let’s take the airplane as an example. We know that an airplane flies. Do we know how or what makes this possible? Most of us have little real knowledge in this area and so would find it difficult to repair an airplane if it breaks.

Let’s compare the airplane to human behavior. We know certain individuals have been able to modify their lifestyles. Do we know why these individuals are different from those who have not been able to change their behavior? What were the reasons behind their success? How were they able to do it? If we do not understand the principles behind behavior change (what is it, what defines it, what affects it, etc), how are we going to be able to explain and affect it? Theories and models help us accomplish this.

Eating is a complex behavior closely tied to personal, social, and economic motivations. As such, a comprehensive model such as the Stages of Change/Transtheoretical Model is useful.

Stages of Change
The Stages of Change model describes individuals in terms of progress through a series of behavioral stages or stages of change. The model includes related dimensions, such as self-efficacy and decisional balance (pros/cons), that are taken into account when tailoring educational messages to the target audience’s needs and readiness for change. As an example, learners who are in the precontemplation stage are not “ready” to adopt a behavior such as reducing dietary fat. The educational message for them would be to emphasize the benefits of making a change rather than an action-oriented, how-to message.9,10

The recipe for creating successful health and nutrition messages is taking shape: We take what we know and understand about consumer food choice behavior, mix in an appropriate theory or model to help craft more effective messages, and finally—we bind it together through the principles of social marketing.

Social Marketing
Social marketing is a program planning process that adapts commercial marketing technologies to promote the voluntary behavior of target audiences to improve well-being. Programs built on social marketing principles seek to influence behavior by emphasizing benefits and reducing barriers that would otherwise discourage engagement in the behavior. It is a powerful combination; we use a variety of theoretical concepts to develop effective interventions and messages, and social marketing to design the media or marketing campaign. An example would be the “5 A Day for Better Health” campaign; one of the first major health initiatives to follow the principles of social marketing.12

Putting It All Together
Food choice, like any complex human behavior, is influenced by many interrelated factors. These factors need to be taken into account when considering nutrition and health interventions. Nutrition and health interventions must focus on positive “gain” messages—increased energy, better health—while minimizing perception of “loss”—avoidance of favorite foods, decrease of preferred tastes or flavor. Thus, intervention messages need to convince people that changes in food choices will provide substantially higher gains than losses. Effective programs must also consider specific lifestyle factors and food choices and offer behaviorally focused action messages. By tailoring messages through the application of appropriate theories and models, we build effective programs and campaigns to promote healthy, pleasurable eating.

— Mary Kaye Sawyer-Morse, PhD, RD, is a professional speaker, author, and wellness expert. She is owner and education director of The Center for Success, a Texas-based company that provides keynotes, in-service training, and seminars to diverse industries.

References
1. A Look at the Self-Care Movement. Food Marketing Institute and Prevention Magazine; 1998.

2. Nutrition and You: Trends 2000. Chicago, Ill: American Dietetic Association; 2000.

3. Nicklaus S, Boggio NS, Chabanet C, et al. A prospective study of food variety seeking in childhood, adolescence, and early adult life. Appetite. 2005;44(3):289-297.

4. Nestle M, Wing R, Birch L, et al. Behavior and social influences on food choice. Nutr Rev. 1998;56(5S):S50-S74.

5. Trends in the United States. Consumer Attitudes & the Supermarket, 1999. Washington, D.C.: Food marketing Institute.

6. Dyson LK. American Cuisine in the 20th Century. Food Rev. 2000;23(1):2-7.

7. Blake C, Bisogni CA. Personal and family food choice schemas of rural women in upstate New York. J Nutr Educ Behav. 2003;35(6):282-293.

8. deCastro JM. Socio-cultural determinants of meal size and frequency. Br J Nutr. 1997;77(S1):S39-S55.

9. Greene GW, Rossi SR, Rossi JS, et al. Dietary applications of the Stages of Change Model. J Am Diet Assoc. 1999;99:673-678.

10. Shepherd R. Resistance to changes in diet. Proc Nutr Soc. 2002;61(2):267-272.

11. Balch GI, Loughrey KA, Weinberg L, et al. Probing consumer benefits and barriers for the national 5 A Day campaign: Focus group findings. J Nutr Educ. 1997;29:178-183.

Resources
Prochaska J. Changing For Good. New York: William Morrow and Company, Inc.; 1994.

This book includes a great review of the Stages of Change model and its application in a variety of settings.

Glanz K, Rimer BK, Lewis FM (Eds.). Health Behavior and Health Education: Theory, Research, and Practice. Indianapolis: Jossey-Bass; 2002.

Karen Glanz and the other editors offer a comprehensive look at the primary health education and health behavior theories utilized in today’s practice, including Social Marketing.