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It Will Take More Than Information To Change Behaviour



Yesterday, I applauded the announcement by Canada’s leading beverage producers to clearly post calories on their products.

But I also warned that without educating Canadians on how to use this information, this ‘clarity on calories’ (as this initiative is called) may not quite produce the expected results.

So how effective are education campaigns on eating healthier and what are the key challenges in effecting actual behaviour change?

This question is addressed in a very readible treatise by Jeanne Goldberg and Sarah Sliwa from Tufts University, Boston, MA, published this month in the Proceedings of the Nutrition Society.

As the authors point out:

“Getting consumers to adopt a healthier diet has been a protracted undertaking with limited successes along the way. The obesity epidemic has added urgency to this discourse: not only do we need to eat better, but most of us also need to eat less.”

In this paper, the authors review some of the complex dynamics that have made the communication of accurate and actionable health behaviour information an ongoing challenge.

“The problem is that communication comes from multiple sources, often with different perspectives, different biases and different agendas. This communications web includes all levels of government, non-profit groups and advocacy organisations, the media, the food and beverage industries and consumers themselves. Each group has its own perspective on topics relevant to them.”

In fact, the complexity of providing actionable nutrition information is hampered by the interplay of four sets of factors:

  • the evolutionary nature of the science on which recommendations are based;
  • the many sources of communication about that science;
  • the agendas or motivations of each source;
  • the multifaceted nature of consumers, the recipients of these communications.

As the authors point out, communication alone has not been, and is unlikely to ever be, sufficient for consumers to adopt the behavioural changes endorsed by experts.

If we are to improve the diets of consumers, we will need to find creative ways to provide them with the intellectual tools they need to understand the most important elements of a healthful diet and the skills they need to purchase and prepare it. Communication alone will not affect behaviour change.

In addition, to effect behaviour change, efforts to help individuals hone their understanding of healthy nutrition and develop relevant skills need to be complemented by broad environmental interventions (clearly posting nutrition information on foods and beverages may be one example).

Thus, for e.g. educating consumers about the need to carefully household with their daily caloric allowance will only work if consumers can easily find and access this information. Conversely, simply providing nutrition information without also educating consumers on how to use this information to improve their diets will have little effect.

As I pointed out in yesterday’s post, “perhaps it is now time to launch a national campaign on caloric literacy“?

AMS
Freising, Germany

Goldberg JP, & Sliwa SA (2011). Communicating actionable nutrition messages: challenges and opportunities. The Proceedings of the Nutrition Society, 70 (1), 26-37 PMID: 21208498

7 Comments

  1. Hmmm Interesting point you did in those two posts.
    I think what you point it out is confrontation of [at least] two logic…
    A) market logic of “consumer sovereignty” over them choice
    VS
    B) public health logic who assumming an “rationale logic” of individuals gone act “well” [i.e. as recomended] by them “health desire”….
    Hummm :o) Thanks to bring this interisting topic to our attention…

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  2. Dr Sharma,
    In line with your suggestion of a “national campaign on caloric literacy” I believe that this initative needs to begin with an overhaul of our Health Education in schools. We should change the curriculum such that children come out of school with a indepth knowledge of calories and nutrition. Children are much smarter than given credit for and the concept of calories is not beyond their understanding. If a carfully thought our curriculum introduced calories gradually as they progressed though school they will have a much better grasp of the concept than the current generation of adults. I believe trying to introduce caloric literacy to an adult will be hit and miss, many may not bother to even care and ignore the message. The greatest benifit will be targeting the children. Not only will they grow up to have better caloric knowledge, often times children bring home what they learn and “teach” their parents. This would be a logical starting point to increasing Canada’s caloric literacy.

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  3. I came up with a somewhat tongue-in-cheek idea called the EZpoints system (http://weightmaven.org/2011/02/05/weight-mavens-ezpoints/). Rather than worrying about calories or macronutrients or micronutrients, my idea is that moving to a whole/real food diet would be beneficial in terms of weight loss and health compared to eating processed food.

    Not ideal, nor complete. But even in jest, it has the kernel of moving in the right direction IMO!

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  4. Information is definitely a necessary condition for behavior change, but it’s not a sufficient condition. The world is filled with people who know exactly what they should do, know exactly why they should do it, and who genuinely intend to do it BUT DON’T. I believe it’s a mistake to attribute all – or even most – follow through failures to insufficient education/information. A clinical psychologist, I’m convinced that the real problem is that the human mind is poorly designed for follow through! And until we accept that truth and get creative about how to work around it, I’m afraid we have little chance of making much progress.

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  5. I’m not a fan of counting calories and I’m not sure that it’s a way to take to promote better nutrition. I’m not sure that it will encourage better choices and that it will have an impact on the health of the population. I’m also afraid that it will take focus from something tasty and good to something low cal instead. I’m also afraid that it’s a good tool for chronic dieters. I prefer the HAES approach.

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  6. Dr Sharma, the title of your post motivated me to point out very interesting research by Canada’s leading health behavior change expert Dr Robert Reid from University Of Ottawa. Although not directly addressing the challenges “in communication of accurate and actionable health behavior information” but their findings might be helpful for Health Care Professionals in understanding why some people may be more successful than others at regulating their eating behaviors. In 3 studies, the authors examined how autonomous and controlled forms of motivation for the regulation of eating behaviors were related to successful and sustained eating behaviors change using their own developed and validated Regulation of Eating Behavior Scale (REBS).The dietary behavior measures were related to improvements in weight and blood lipid parameters (LDL-cholesterol.
    Finding form these studies [Motivation and Emotion (28), No. 3, 2004:245-277] suggest that “individuals are motivated to regulate their eating behaviors for different reasons, and that these reasons reflect different degrees of internalization of the regulatory processes of eating behaviors”. They evaluated predictors of “dysfunctional eating behaviors as well as sustained healthy eating behaviors” in one integrative model. Their findings suggest that “the more individuals display a self-determined regulatory style toward their eating behaviors, the more they have healthy eating behaviors.” Finally, their findings suggest that the regulatory processes underlying eating behaviors can have an impact on one’s global psychological adjustment.”
    I would like to add part of the conclusion as I find it very interesting:
    “Our results suggest that although people may be motivated to regulate their eating behaviors, successful regulation is less likely to occur if the motivation is non-self-determined. It is important for people to develop a genuine willingness for the activity so that they can personally endorse the regulation of the behavior. Therefore, health professionals’ effort should not be confined merely at encouraging people to regulate their eating behaviors but at promoting a self-determined regulatory style toward eating behaviors….. Globally, autonomy-supportive, informative, and caring contexts were found to affect the quality of the self-regulatory process. Thus, having a partner who displays a caring attitude and who provides information about the regulation of healthy eating by supporting one’s autonomy and competence may help the person develop a self-determined style of regulation. Although, contemporary research has acknowledged the negative impact of pressures (sociocultural influences, partner, friends, and families’ pressures) on eating behaviors, it has neglected to examine how positive interpersonal behaviors (e.g., autonomy support, competence support, and caring) could facilitate the adoption of a self-determined regulatory style toward eating, which in turn could lead to positive eating behaviors”.

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  7. You can educate people all you want, but if they can’t afford to buy the foods you recommend- all the teaching & preaching won’t help-

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