1. 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, availability
Physical determinants such as access, education, skills (e.g. cooking) and time
Social determinants such as culture, family, peers and meal patterns
Psychological determinants such as mood, stress and guilt
Attitudes, 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.
2. Eating disorders
Eating behaviour, unlike many other biological functions, is often subject to sophisticated cognitive control. One of the most widely practised forms of cognitive control over food intake is dieting.
Many individuals express a desire to lose weight or improve their body shape and thus engage in approaches to achieve their ideal body mass index. However, problems can arise when dieting and/or exercise are taken to extremes. The aetiology of eating disorders is usually a combination of factors including biological, psychological, familial and socio-cultural. The occurrence of eating disorders is often associated with a distorted self-image, low self-esteem, non-specific anxiety, obsession, stress and unhappiness36.
Treatment of an eating disorder generally requires weight stabilisation and one-to-one psychotherapy. Prevention is more difficult to define but suggestions include avoidance of child abuse; avoidance of magnifying diet and health issues; showing affection without over-controlling; not setting impossible standards; rewarding small attainments in the present; encouraging independence and sociability36.
3. Consumer attitudes, beliefs, knowledge and optimistic bias
Consumer attitudes and beliefs
In both the areas of food safety and nutrition, our understanding of consumers’ attitudes are poorly researched26. A better understanding of how the public perceive their diets would help in the design and implementation of healthy eating initiatives.
The Pan-European Survey of Consumer Attitudes to Food, Nutrition and Health found that the top five influences on food choice in 15 European member states are ‘quality/freshness’ (74%), ‘price’ (43%), ‘taste’ (38%), ‘trying to eat healthy’ (32%) and ‘what my family wants to eat’ (29%). These are average figures obtained by grouping 15 European member states results, which differed significantly from country to country. In the USA the following order of factors affecting food choices has been reported: taste, cost, nutrition, convenience and weight concerns27.
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.
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