Question

Name three factors that discourage Americans from eating a healthy diet. How do these factors discourage Americans? Support your selections. Be Concise.

Answer 1

Environmental Factors:-
The environment of a person impacts an individual's diet in many forms. Food environments refer to homes, schools, stores, restaurants, food banks, soup kitchens and other physical settings where the cost and availability of foods influence people's diets. Accessibility to shops and the foods available in certain shops shape our eating choices. Those who live in cities and built up areas are more likely to have a variety of nutritious foods available to them compared to those who live in isolated and small communities. Residents who live in communities without access to affordable healthy food options generally have poorer diets. The transport links and geographical location of a person will influence their eating habits.

Majority of food intake consumed by an individual is eaten at home. For many, particularly youth, food that is readily available in their environment strongly affects their eating choices. Households that offer a large variety of fruits and vegetables encourage the people who live their to consume these foods. Compared to households that supply unhealthy food products such as crisps and soft drink where members are more likely to consume high amounts of fatty food and drink.

In today's culture food is always readily available and this has led people to eat without thinking about how hungry they actually are and how much they have already eaten. High availability of food in populated wealthy environments may be the reason for the increasing number of overweight citizens in society throughout many western cultures. Individuals who frequently eat at restaurants/fast food services tend to consume more fat and calories and less fruit, vegetables and fibre than those who eat home prepared meals. Fast food services and restaurants are abundant offering large portion meals leading people to purchase and eat more food than their bodies actually need.   

'Food deserts' are places that offer few or no shopping facilities generally throughout low income communities. People who live in these areas will have difficulty maintaining a balanced diet consisting of a variety of nutrients and foods. They may rely on the small supply of products that are offered in their local area or be forced to travel great distances in order to replenish food supplies. This is a great obstacle for many people living in food deserts because often the small stores that are sometimes available supply an overload on nutrient-poor snack choices such as cookies, chips and sodas which overwhelming the limited storage of fruits, vegetables and other healthy options.
Major determinants of food choice

The key driver for eating is of course hunger but what we choose to eat is not determined solely by physiological or nutritional needs. Some of the other factors that influence food choice include:

Biological determinants such as hunger, appetite, and taste Economic determinants such as cost, income, availabilityPhysical determinants such as access, education, skills (e.g. cooking) and timeSocial determinants such as culture, family, peers and meal patternsPsychological determinants such as mood, stress and guiltAttitudes, beliefs and knowledge about food

The complexity of food choice is obvious from the list above, which is in itself not exhaustive. Food choice factors also vary according to life stage and the power of one factor will vary from one individual or group of people to the next. Thus, one type of intervention to modify food choice behaviour will not suit all population groups. Rather, interventions need to be geared towards different groups of the population with consideration to the many factors influencing their decisions on food choice.

Biological determinants of food choice

Hunger and satiety

Our physiological needs provide the basic determinants of food choice. Humans need energy and nutrients in order to survive and will respond to the feelings of hunger and satiety (satisfaction of appetite, state of no hunger between two eating occasions). The central nervous system is involved in controlling the balance between hunger, appetite stimulation and food intake.

The macro-nutrients i.e. carbohydrates, proteins and fats generate satiety signals of varying strength. The balance of evidence suggests that fathas the lowest satiating power, carbohydrates have an intermediate effect and protein has been found to be the most satiating.

The energy density of diets has been shown to exert potent effects on satiety; low energy density diets generate greater satiety than high energy density diets. The high energy density of high-fat and/or high-sugar foods can also lead to ‘passive overconsumption’, where excess energy is ingested unintentionally and without the consumption of additional bulk.

An important satiety signal may be the volume of food or portion size consumed. Many people are unaware of what constitutes appropriate portion sizes and thus inadvertently consume excess energy.

Palatability

Palatability is proportional to the pleasure someone experiences when eating a particular food. It is dependent on the sensory properties of the food such as taste, smell, texture and appearance. Sweet and high-fat foods have an undeniable sensory appeal. It is not surprising then that food is not solely regarded as a source of nourishment but is often consumed for the pleasure value it imparts.

The influence of palatability on appetite and food intake in humans has been investigated in several studies. There is an increase in food intake as palatability increases, but the effect of palatability on appetite in the period following consumption is unclear. Increasing food variety can also increase food and energy intake and in the short term alter energy balance. However, effects on long-term energy regulation are unknown.

Sensory aspects

‘Taste’ is consistently reported as a major influence on food behaviour. In reality ‘taste’ is the sum of all sensory stimulation that is produced by the ingestion of a food. This includes not only taste per se but also smell, appearance and texture of food. These sensory aspects are thought to influence, in particular, spontaneous food choice.

From an early age, taste and familiarity influence behaviour towards food. A liking for sweetness and a dislike for bitterness are considered innate human traits, present from birth. Taste preferences and food aversions develop through experiences and are influenced by our attitudes, beliefs and expectations.

Economic and physical determinants of food choice

Cost and accessibility

There is no doubt that the cost of food is a primary determinant of food choice. Whether cost is prohibitive depends fundamentally on a person's income and socio-economic status. Low-income groups have a greater tendency to consume unbalanced diets and in particular have low intakes of fruit and vegetables. However, access to more money does not automatically equate to a better qualitydiet but the range of foods from which one can choose should increase.

Accessibility to shops is another important physical factor influencing food choice, which is dependent on resources such as transport and geographical location. Healthy food tends to be more expensive when available within towns and cities compared to supermarkets on the outskirts. However, improving access alone does not increase purchase of additional fruit and vegetables, which are still regarded as prohibitively expensive.

Education and Knowledge

Studies indicate that the level of education can influence dietary behaviour during adulthood. In contrast, nutritionknowledge and good dietary habits are not strongly correlated. This is because knowledge about health does not lead to direct action when individuals are unsure how to apply their knowledge. Furthermore, information disseminated on nutrition comes from a variety of sources and is viewed as conflicting or is mistrusted, which discourages motivation to change. Thus, it is important to convey accurate and consistent messages through various media, on food packages and of course via health professionals.

Social determinants of food choice

Influence of social class

What people eat is formed and constrained by circumstances that are essentially social and cultural. Population studies show there are clear differences in social classes with regard to food and nutrient intakes. Poor diets can result in under- (micronutrients deficiency) and over-nutrition (energy over consumption resulting in overweight and obesity); problems that face different sectors of society, requiring different levels of expertise and methods of intervention.

Cultural influences

Cultural influences lead to the difference in the habitual consumption of certain foods and in traditions of preparation, and in certain cases can lead to restrictions such as exclusion of meat and milk from the diet. Cultural influences are however amenable to change: when moving to a new country individuals often adopt particular food habits of the local culture.

Social context

Social influences on food intake refer to the impact that one or more persons have on the eating behaviour of others, either direct (buying food) or indirect (learn from peer's behaviour), either conscious (transfer of beliefs) or subconscious. Even when eating alone, food choice is influenced by social factors because attitudes and habits develop through the interaction with others. However, quantifying the social influences on food intake is difficult because the influences that people have on the eating behaviour of others are not limited to one type and people are not necessarily aware of the social influences that are exerted on their eating behaviour.

Social support can have a beneficial effect on food choices and healthful dietary change. Social support from within the household and from co-workers was positively associated with improvements in fruit and vegetable consumption and with the preparative stage of improving eating habits, respectively. Social support may enhance health promotion through fostering a sense of group belonging and helping people to be more competent and self-efficacious.

The family is widely recognised as being significant in food decisions. Research shows the shaping of food choices taking place in the home. Because family and friends can be a source of encouragement in making and sustaining dietary change, adopting dietary strategies which are acceptable to them may benefit the individual whilst also having an effect on the eating habits of others.

Social setting

Although the majority of food is eaten in the home, an increasing proportion is eaten outside the home, e.g. in schools, at work and in restaurants. The venue in which food is eaten can affect food choice, particularly in terms of what foods are on offer. The availability of healthy food at home and 'away from home' increases the consumption of such foods. However, access to healthy food options is limited in many work/school environments. This is particularly true for those with irregular hours or with particular requirements, e.g. vegetarian.
With the majority of adult women and men in employment, the influence of work on health behaviours such as food choices is an important area of investigation

Meal

People have many different eating occasions daily, the motivations for which will differ from one occasion to the next. Most studies investigate the factors that influence habitual food choice but it may be useful to investigate what influences food choice at different eating occasions.

The effects of snacking on health have been debated widely. Evidence shows that snacking can have effects on energy and nutrient intakes but not necessarily on body mass index. However, individuals with normal weight or overweight may differ in their coping strategies when snack foods are freely available and also in their compensatory mechanisms at subsequent meals. Moreover, snack composition may be an important aspect in the ability of individuals to adjust intake to meet energy needs.

Helping young adults to choose healthy snack choices poses a challenge to many health professionals. In the home, rather than forbidding unhealthy snacks, a more positive approach may be the introduction of healthy snack options over time. Moreover, healthy food choices outside the home also need to be made more readily available.

Psychological factors

Stress

Psychological stress is a common feature of modern life and can modify behaviours that affect health, such as physical activity, smoking or food choice.

The influence of stress on food choice is complex not least because of the various types of stress one can experience. The effect of stress on food intake depends on the individual, the stressor and the circumstances. In general, some people eat more and some eat less than normal when experiencing stress.

The proposed mechanisms for stress induced changes in eating and food choice are motivational differences (reduced concern about weight control), physiological (reduced appetite caused by the processes associated with stress) and practical changes in eating opportunities, food availability and meal preparation.

Studies also suggest that if work stress is prolonged or frequent, then adverse dietary changes could result, increasing the possibility of weight gain and consequently cardiovascular risk.

Mood

Hippocrates was the first to suggest the healing power of food, however, it was not until the middle ages that food was considered a tool to modify temperament and mood. Today it is recognised that food influences our mood and that mood has a strong influence over our choice of food.

Interestingly, it appears that the influence of food on mood is related in part to attitudes towards particular foods. The ambivalent relationship with food – wanting to enjoy it but conscious of weight gain is a struggle experienced by many. Dieters, people with high restraint and some women report feeling guilty because of not eating what they think they should. Moreover, attempts to restrict intake of certain foods can increase the desire for these particular foods, leading to what are described as food cravings.

Women more commonly report food cravings than do men. Depressed mood appears to influence the severity of these cravings. Reports of food cravings are also more common in the premenstrual phase, a time when total food intake increases and a parallel change in basal metabolic rate occurs.

Thus, mood and stress can influence food choice behaviour and possibly short and long term responses to dietary intervention.

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