April 28, 2006

The increase in the amount of food prepared and eaten outside of home has been linked to obesity in popular media and by consumers.  Although the out of home food and beverage industry contributes significantly to the ease and convenience of life, consumers throughout the world are torn between the attraction of freeing up valuable personal time from cooking and washing up and their suspicions that out of home eating may not be as healthful as home prepared food. Furthermore, it is clear that consumers are often confused about how to manage their weight and long term health prospects effectively.             

A global qualitative study on habits and heuristics in out of home food and beverage consumption may contribute to public health understanding of the rise in obesity and overweight:  

Two clear findings emerge from an international qualitative study involving around 330 consumers from 21 markets, conducted by AC Nielsen about how out of home eating and drinking patterns become established. Firstly, the study illustrated how understanding the decision making process of consumers in food choices may be more useful than understanding their motives in addressing the rise in obesity and overweight prevalence. Secondly, there were substantial disparities between the personal tactics that consumers reported they adopted to manage their body weight, and the best methods indicated by current scientific evidence and understanding.  

Habit and Decision Making

The AC Nielsen study which used focus groups taking part in three hour discussions was conducted in North America, North Asia, Southeast Asia, Europe and the Middle East. The focus of the groups was to explore the needs of the consumer based on the rationale that the better the needs of consumers are satisfied, the more likely they will be to choose a particular product. However, the study revealed that consumers may not be assessing their needs when it comes to food choices, rather, they are often simply following established routines, i.e. a fixed pattern of doing things that have worked for them in the past. 

The choice process is determined using simple rules of thumb and over time, this process becomes established as a habit. Once this happens, the original choice dynamics remain the same unless something disrupts the decision making process and stimulates an individual to try something new. 

The following diagram shows the life stages and the corresponding characteristics that determine habits in diet and nutrition of typical consumers.   

Habits are generally established based on life stage needs and evolve over time

Source: Habits and Heuristics in out of home food and beverage consumption and the obesity epidemic – study by AC Nielsen

Inevitably, disruptions to established decision making do occur, and can lead to changes in habits. These disruptions can be created in many ways such as through social interactions, product innovations or inbuilt mechanisms which stimulates changes within us. Thus, by understanding the process of habit establishment, and disruption, it is possible to understand how and when communications can have best effect for positive changes to diet and weight management.   

Weight Management - Consumer Understanding Versus Scientific Evidence

The study also revealed that there are substantial disparities between consumer understanding of effective weight management and established scientific evidence on which public health advice is generally based. Research showed that while there was knowledge of increased disease incidence arising from increased weight, people believed this to be more a concern in extreme cases of obesity which they tended to believe

they were unlikely to suffer from. At the same time, their understanding of obesity and in some cases, their tolerance and acceptance of overweight indicated a distinct gap between scientific knowledge and common perception.   

There was a wide variety of cultural responses:  In Japan, respondents reported they do not want to stand out, so have a very limited tolerance of variance in weight. In some markets such as Hong Kong, the United Arab Emirates and China, which have experienced substantial income growth over one or two generations the study found a cultural acceptance of being overweight, and obesity was generally unrecognised, even if obesity levels were high. In New Zealand, there was a resistance to the assertion that being overweight is always undesirable. In other countries such as the Philippines and Australia, the study found that people developed their own informal classifications of degrees of overweight and obesity, distinguishing between 'good fat' and 'bad fat'. The implications of the study findings therefore, were that in some cultures, overweight is perceived as "normal" and the health risks of being overweight were at best  unrecognized and at worst actually refuted.

The study respondents were found to associate rapid and unhealthy weight gain with Western fast food and soft drinks more than with other kinds of foods and drinks such as Asian and other ethic foods which were perceived as less likely to lead to obesity. As a consequence, when they were shown the calorie values of some local and western food, their response was often one of surprise, because of a tendency to under-estimate the energy content of national dishes such as fried noodles, nasi lemak, and other traditional favourites.   

Survey respondents also had differing interpretations of 'healthy eating'. Amongst Indonesian study participants, for example, "healthy food" was associated with hygiene and presentation while in New Zealand; "healthy food" was linked to healthy weight maintenance and eating 'good food'.   

Regarding weight management strategies, the most common response to perceptions that certain food will cause weight gain was to reduce the frequency of eating it. However the efficacy of this was somewhat undermined by misperceptions of which foods were high in energy. Many respondents reported a belief in a 'balanced eating' approach. In China, for example, a common misperception was that drinking hot tea with the meal could reduce the greasiness of food consumed. Also there was a common view that it was possible to balance one day of heavy eating with another day of light eating. However more often than not, the estimation of energy value was inaccurate and therefore, less effective as a strategy in weight management.     

Another common strategy cited, was giving up 'western' fast foods and soft drinks which were believed by many people to be among the easier weight loss strategies to implement. Many respondents also reported their belief that skipping meals was an effective weight loss method, contrary to advice of health professionals. 

"Understanding habit establishment and reinforcement is vital in influencing food choices. Old habits die hard as the saying goes, so it difficult, but not impossible to change habits. Most habits will change if something else comes along and circumstances are ripe. Understanding this can allow the food industry and public health educators to think of ways to influence and perhaps, drive improved decision making by larger numbers of people on more frequent occasions to reduce or halt obesity." Says Fiona Cameron, Research and Development Director for Asia Pacific, AC Nielsen. 

The Implications of the Findings

From the study, three potential action points for the food and beverage industry and public health educators alike in the prevention of weight management become apparent: Firstly, there is a need to identify and dispel common myths about effective weight management. Secondly, targeting such information at consumers during those life cycle periods when they are most receptive to changing their habits, may be particularly effective. Thirdly, practical advice on healthful eating which recognizes and addresses common behaviours and decision making methods as an alternative to generic public health approaches may offer new opportunities to encourage behaviour change. 

Identifying and Dispelling Myths of Weight Management

The first step is to ensure that people understand what exactly obesity and being overweight means. Definitions of healthy weight, over weight and obesity need to be clarified and communicated so that there is a common understanding of what healthful weight is and when overweight becomes a health risk. People also need factual information on effective and scientifically evaluated methods of weight management to better manage their own body weight.  

Target Consumers During Certain Periods of Time to Change Habits 

Consumers' habits are more amenable to change during certain periods of their life.  There is greater potential to influence consumers when they are in their early working lives when they are establishing their eating habits for example. Similarly, consumers with young families may be more receptive, as they start to take interest in the dietary well-being of their families. Women in particular are very open to, and motivated to by information about eating and drinking to maintain a healthy weight. Reaching out to these groups can be done through media and other channels to drive important messages through. 

Practical Advice on Healthy Eating                                                           

People are often advised to eat a balanced and healthy diet and many believe they do. Advice on healthy eating needs to demonstrate clearly what this means in terms of proportions, nutritional value and calorie content, so that understanding is enhanced and support for those who are receptive is as focused as possible.