A useful starting point, but how do people understand and implement these recommendations? It gets tricky...
Health and dietary messages do not fall on deaf ears.
The results of a recent qualitative study from the UK illustrate that people are cognizant of health “slogans,” but that they get augmented when being put into action.
The authors explored the affect of dietary recommendations on the awareness and action of mother’s of a low socio-economic status. It was a really fascinating study (with free full text) which provides evidence for something I have suspected for a long time:
People get the message. They’re familiar with the concept of eating plenty of fruits and vegetables, laying off the fast food and that a “poor diet” is a contributor to “poor health.” But there is something happening between hearing the message, and incorporating that into a pattern of their everyday life.
The authors commented:
“There are a number of reasons why people may not or cannot change their diet, including convenience, limited resources, and cooking skills. An alternative explanation for poor uptake of dietary advice is that individuals themselves do not perceive their diet to be particularly unhealthy or at odds with official advice and therefore do not consider changing their diet.”
This is the kicker, and something fascinating that emerged with this study. When mothers were interviewed, it became apparent that some of them did not see their (unhealthy) diet as “unhealthy,” something that was tied to their understanding of a “balanced diet”.
“This concept, according to official health promotion recommendations, involves a diet incorporating the major food groups and providing the body with the variety of nutrients needed for good health. Instead, the mothers’ interpretation incorporated the notion of balancing good food with bad food and was therefore very different from official definitions, although both definitions of balance (spread and equilibrium) could be valid.”
When asked what a good diet is, one subject replied:
“All the things that don’t taste so good, well, fresh things, fish, vegetables, fruit.”
Another went on:
“It’s a short life that we lead, and I think if you haven’t got a little of a vice in your life, it’s a bit boring, isn’t it? (Laughs) I mean, you know, you can’t be like, what’s the name, uhm, that woman on “You Are What You Eat” [a UK television program]. Blimey! I’d kill myself, I think, if I had to eat that diet all the time (laughs).”
I’m sure many of us can relate to this, but it really speaks to the challenge faced by health-care providers and dietitians. I have listened to a physician advise her patient to “eat well and get plenty of exercise.” The results from this study illustrate the futility of these simplistic recommendations.
How to effectively communicate the importance of a truly balanced diet is a trying task. It is not just ensuring that patients (and the public) are aware of recommendation “catch terms”, but also the deeper dimension as to how those same patients understand health recommendations and are applying them in their lives.
After that, it is important to provide clear, detailed and realistic advice on positive dietary modification.
References after the jump.
Dietary understanding paper (free full text):
Wood et al. A Question of Balance: A Qualitative Study of Mothers’ Interpretations of Dietary Recommendations. Ann Fam Med. 2010 Jan-Feb;8(1):51-7.
[...] I haven’t yet checked thoroughly to see if there is any relevant research on this, The Fodder File highlights a recent study (1) that should be considered here. Social factors and preexisting [...]
Food marketing drills people in the notion that certain foods are pleasant, a treat, and a way to escape the mundanity of life. Sophisticated people with refined pleasures don’t understand the mentality of someone who must settle for shoddy, coarse pleasures. George Orwell observed in The Road to Wigan Pier that the chattering classes who always chide the poor for wasting their money on vices fail to realise that the condition of poverty requires constant amelioration, compensation, comfort. That’s why there is a market for crystal meth.
When you have a boring job or a family to raise by yourself, and you live in squalid circumstances, half a kilo of chocolate is one of the safer forms of escapism that you have recourse to.
Although I disagree with the latter interviewee’s opinion on what foods are enjoyable, I do agree with her opinion of Gillian McKeith, the presenter of You Are What You Eat. Face like a camel chewing tobacco.