The road to not-so-wellville: paved with good intentions and misperceptions - diet choices

Choices: The Magazine of Food, Farm and Resource Issues, Fall, 2002 by Lisa Mancino, Jean Kinsey

What we know about the importance of eating well should increase our intentions to follow a healthy diet. Unfortunately, intentions can be thwarted by circumstances, such as hunger, a hectic schedule, and where we choose to obtain our food (Figure 1). This article illustrates the way these factors tend to thwart good intentions. Making specific reference to these situations, and suggesting ways to mitigate their effects, should enhance the usefulness of educational campaigns designed to improve diet quality.

The public policy approach to improving Americans' diet and health centers on telling consumers how and why to eat well. National campaigns have aimed at educating Americans about the importance of a healthful diet: Consume "Five a Day" for fruits and vegetables. Follow the food guide pyramid. Limit calories from fat. These campaigns contribute to the growing number of shoppers who say that their grocery purchases are affected by health concerns, and who believe that eating well is more effective than medication in health care management.

Meanwhile, the rising number of dual-income and single-parent families means that more shoppers are pressed for time and willing to pay for the convenience of eating out, buying ready-to-eat meals, or dining on fast foods. Unfortunately, Americans demonstrate little knowledge about the nutrient content--especially fat and calories--of food prepared away from home (Kennedy et al.). While information about their nutritional value is almost always unavailable, these foods tend to be both higher in fat and calories than home-prepared meals(Figure 2). An individual who eats a Big Mac, a medium order of French fries, and a medium Coke for lunch consumes 1,250 calories and 54 grams of fat. This meal accounts for almost 63 percent of the daily calories and 83 percent of the recommended far intake for someone on a 2,000 calorie-per-day diet.

Americans claim to better understand the relationship between diet and health, but they are increasing their risk of suffering from diet-related illnesses. The cause is unclear; it may be that Americans just eat too much of everything, or there may be a clear division between the people who eat poorly and those who eat healthfully. Alternatively, it may be that individuals try to incorporate their beliefs about healthy eating into their food choices, but because of time constraints and the desire for convenience--situational factors--they sacrifice good intentions for immediate gratification.

The difference between what an individual chooses to do, and what she believes she should do, is an example of a time-inconsistent choice. An individual makes a choice, perhaps under pressure or in haste. The individual might nor have made the same choice in a more objective situation. For example, an individual may claim that for tomorrow's dinner, she would prefer a broiled chicken breast at 6:30PM over a hamburger at 5:35PM. However, when making this same decision for tonight's dinner (while hungry and pressed for time), this same person may decide that a hamburger now is preferred to broiled chicken in one hour. Although the one-hour delay between alternatives has not changed, eliminating the 24-hour planning horizon causes the ranking of alternatives to switch.

Such inconsistencies are well documented in the literature on behavioral economics, where both human and animal subjects have switched their choices when the time delay is shortened. Despite these findings, traditional economic studies of consumer behavior have relied primarily on prices, income, and information to explain food choices. Advances in behavioral economics suggest that understanding consumers motivations can be improved by incorporating the effects of situational factors such as time delays on the link between intentions and actual behavior.

Paved with Choices

For example, suppose 100 individuals were surveyed about what they ate for lunch and about their corresponding knowledge of health and nutrition, revealing a positive relationship between diet quality and information about nutrition. Knowing how hungry the individuals were when they decided what to have for lunch could reveal a relationship between degree of hunger and nutritional knowledge in food selection. In this case, increasing hunger leads to greater sensitivity to delayed outcomes (eat now, regardless of the nutritional implications). Thus, there are two distinct relationships between nutritional knowledge and diet quality: one where diet quality is highly correlated with nutritional information, and one where food choices tend to be less nutritionally based, regardless of knowledge.

What's The Point?

If some food choices show inconsistencies related to specific situational factors, then our educational efforts regarding the relationship between health knowledge and diet quality can be improved by acknowledging situations in which individuals are prone to make inconsistent choices and suggesting ways to minimize the effects. To do this, we first need to establish that short-term situational factors, such as hunger and time constraints, do indeed affect our eating decisions. We also need to determine how these factors interact with health objectives when making eating decisions (Figure 1). This will identify the situations in which intentions about a healthy diet give way to one's demand for convenience and immediate gratification.