Question

Explain the connections between each of the factors of history, psychology, politics, economics, sociology, anthropology and science to each other such factor in terms of the ability and inability to meet the six dietary principles.

Answer 1

ANSWER:

Introduction

The term "diet" simply refers to what we eat. A good diet promotes positive change and helps us to incorporate sensible eating into our daily lifestyle. When designing a practical eating regimen, diet planners often recommend the ABCDMV method -- the six basic principles of adequacy, balance, calorie control, density, moderation and variety.

• Adequacy

An adequate diet provides the human body with energy and nutrients for optimal growth, maintenance and repair of tissue, cells and organs. Water, carbohydrates, fats, proteins, vitamins and some minerals comprise the six nutrient classes relied upon for performance of essential functions and activities. These nutrients must be replaced through diet to keep the body working efficiently. An adequate diet includes foods containing proper amounts of these nutrients to prevent deficiencies, anemia, headaches, fatigue and general weakness.

• Balance

A balanced diet includes foods containing sufficient amounts of each class of nutrients. For example, while milk is a good source of calcium and fish provides necessary iron and protein, the two are not enough alone. Other essential vitamins, carbohydrates and fats are found in whole grains, vegetables and fruits. The U.S. Department of Agriculture provides a great blueprint for a balanced diet with its five food groups -- grains, proteins, vegetables, fruit and dairy. Consuming the proper amount of servings from each category ensures a well-proportioned diet.

• Calorie Control

Once you know what to eat, the next factor is how much. It is possible to eat healthy foods and still overindulge. Therefore, a reasonable calorie allowance must be established. The amount of energy the body receives from incoming food needs to match the amount of energy needed for the body to sustain its biological and physiological activities. In other words, input needs to match output. An imbalance leads to weight loss or gain.

• Nutritional Density

Eating well without overeating is often challenging. You must select foods that pack the most nutrients into the least amount of calories. For example, 1 ounce of cheese and 1 cup of fat-free milk contain the same amount of calcium. While both foods are adequate sources of calcium, the milk is more calcium-dense than the cheese because you get the same amount of calcium with one-half the calories and no fat. In another example, calorie allowance is not a useful tool by number alone. Although a bowl of grapes and a can of soda contain roughly the same number of calories, the grapes contain far more nutrients than the cola. Designing a nutritionally sound diet requires proper "budgeting" of calories and nutrients so that you eat less while supporting good health.

• Moderation

Socrates once said "Everything in moderation; nothing in excess." Though over 2,500 years old, this adage still holds true. Those who place severe restrictions on what they can or cannot eat often find it difficult to stick to a pattern of sensible eating. Depriving yourself of foods rich in fat and sugar is not necessary. When eaten on occasion, these treats are not detrimental to your health and often provide enough enjoyment to keep one motivated to continue healthy eating practices.

• Variety

It's possible for a diet to have all the aforementioned characteristics, but still lack variety. While some people are creatures of habit and don't mind eating the same meals every day, most of us crave a wide array of choices and tastes. Good nutrition does not have to be boring. The USDA's food groups allow you to receive the proper nutrients while having a great selection of foods to pick and choose from. After all, variety is the spice of life.

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:

1. Science and Biological determinants such as hunger, appetite, and taste
2. History, Economic determinants such as cost, income, availability and Physical determinants such as access, education, skills (e.g. Cooking) and time
3. Politics and Social determinants such as culture, family, peers and meal patterns
4. Psychological determinants such as mood, stress and guilt
5. Anthropology and Attitudes, beliefs and knowledge about food

1. Science and Biological determinants such as hunger, appetite, and taste

• 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 fat has 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.

2. History, Economic determinants such as cost, income, availability and Physical determinants such as access, education, skills (e.g. Cooking) and time

• 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 quality diet 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, nutrition knowledge 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.

3.Politics and Social determinants such as culture, family, peers and meal patterns

• 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 particularrequirements, 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 patterns

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.

4. 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.

• 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.

5.Anthropology and Attitudes, beliefs and knowledge about food

• Consumer attitudes and beliefs

In both the areas of food safety and nutrition, our understandings of consumers’ attitudes are poorly researched. A better understanding of how the public perceive their diets would help in the design and implementation of healthy eating initiatives.In the Pan-European study, females, older subjects, and more educated subjects considered ‘health aspects’ to be particularly important. Males more frequently selected 'taste' and 'habit' as main determinants of their food choice. ‘Price’ seemed to be most important in unemployed and retired subjects. Interventions targeted at these groups should consider their perceived determinants of food choice.Attitudes and beliefs can and do change; our attitude to dietary fat has changed in the last 50 years with a corresponding decrease in the absolute amount of fat eaten and a change in the ratio of saturated to unsaturated fat.

• Optimistic bias

There is a low level of perceived need among European populations to alter their eating habits for health reasons, 71% surveyed believing that their diets are already adequately healthy. The lack of need to make dietary changes, suggest a high level of optimistic bias, which is a phenomenon where people believe that they are at less risk from a hazard compared to others. This false optimism is also reflected in studies showing how people underestimate their likelihood of having a high fat diet relative to others and how some consumers with low fruit and vegetable intakes regard themselves as ‘high consumers’.

If people believe that their diets are already healthy it may be unreasonable to expect them to alter their diets, or to consider nutrition/healthy eating as a highly important factor when choosing their food. Although these consumers have a higher probability of having a healthier diet than those who recognise their diet is in need of improvement, they are still far short of the generally accepted public health nutrition goals. It is also unlikely that these groups will be motivated further by dietary recommendations. Hence, future interventions may need to increase awareness among the general population that their own diet is not wholly adequate in terms of, for example fat, or fruit and vegetable consumption. For those who believe their diets to be healthy it has been suggested that if their beliefs about outcomes of dietary change can be altered, their attitudes may become more favourable and they therefore may be more likely to alter their diets. Thus, a perceived need to undertake change is a fundamental requirement for initiating dietary change.

Dietary and lifestyle change

• Focus on cost

Household income and the cost of food is an important factor influencing food choice, especially for low-income consumers. The potential for food wastage leads to reluctance to try ‘new’ foods for fear the family will reject them. In addition, a lack of knowledge and the loss of cooking skills can also inhibit buying and preparing meals from basic ingredients.Education on how to increase fruit and vegetable consumption in an affordable way such that no further expense, in money or effort, is incurred has been proposed as a solution. Efforts of governments, public health authorities, producers and retailers to promote fruit and vegetable dishes as value for money could also make a positive contribution to dietary change.

• Time constraints

Lack of time is frequently mentioned for not following nutritional advice, particularly by the young and well educated. People living alone or cooking for one seek out convenience foods rather than cooking from basic ingredients. This need has been met with a shift in the fruit and vegetables market from loose to prepacked, prepared and ready-to-cook products. These products are more expensive than loose products but people are willing to pay the extra cost because of the convenience they bring. Developing a greater range of tasty, convenient foods with good nutritional profiles offers a route to improving the diet quality of these groups.

Conclusion

Dietary change is not easy because it requires alterations in habits that have been built up over a life-time. Various settings such as schools, workplaces, supermarkets, primary care and community based studies have been used in order to identify what works for particular groups of people. Although results from such trials are difficult to extrapolate to other settings or the general public, such targeted interventions have been reasonably successful, illustrating that different approaches are required for different groups of people or different aspects of the diet.There are many influences on food choice which provide a whole set of means to intervene into and improve people's food choices. There are also a number of barriers to dietary and lifestyle change, which vary depending on life stages and the individual or group of people in question.It is a major challenge both to health professionals and to the public themselves to effect dietary change. Different strategies are required to trigger a change in behaviour in groups with different priorities. Campaigns that incorporate tailored advice that include practical solutions as well as environmental change are likely to succeed in facilitating dietary change.