Introduction
Without good nutrition, one cannot lead a quality and healthy lifestyle. Quite a number of diseases and health conditions in America and in the rest of the world are caused by poor nutrition. These diseases are known as lifestyle diseases. Of course other factors such as hypertension, obesity, diabetes, heart disease, and reduced physical activity can also contribute to one acquiring a lifestyle disease, but the main cause is usually poor nutrition. Besides causing lifestyle diseases, a poor diet can also affect daily life in more ways than one. For example, poor nutrition can result in lower school performance, reduced productivity, and lower concentration. For young children, poor nutrition can also stunt growth and development. Unfortunately, it is the poor who are most affected by poor nutrition. It is they that have to bear the burden of lifestyle and chronic diseases brought about by poor nutrition. Besides the poor, research shows that even members of other socioeconomic classes are also affected albeit to a lesser extent. Some studies have pointed to rising insurance and health costs as evidence of this (Pothukuchi, 2004).
Nutrition has a close relationship with behavior. The relationship is often bi-directional. Evidence suggests that consuming certain foods/ nutrients can affect or trigger certain specific behaviors. Conversely, certain habits/ behaviors can influence what one decides to eat or reject. Furthermore, according to Hawkes (2013), several contextual factors often affect how, what, and when we eat.
Community thinking or behavior is also one of the most important factors in determining what people eat. Therefore, for any kind of significant change to diet to happen, there may be a need for community-wide engagement. There may be a need to talk to the rest of the community and involve them in helping people taking poor nutrition to get back on track and start accessing and consuming healthy food. Some of the discussions that should be had at the community-wide level include the evaluation of the local area food system to determine what is needed to bring about sustainable/ permanent change in the area. The discussions should result in resolutions and programs to bring about programs that are just the perfect size for easy and sustainable management and are good enough to bring about meaningful change in the local food system (Hawkes, 2013).
Misconceptions on Nutrition
People often adapt food related behaviors and attitudes from a very young age because of socioeconomic, psychosocial, and cultural factors. Moreover, many important elements of food selection, preparation, and style of consumption often have a cultural background and most people often participate subconsciously in the propagation of such cultural objects to maintain their cultural identity. Beliefs, attitudes, and behaviors about food cannot be accurately determined solely through the use of a survey. Therefore, it is important to design focus groups and other similar qualitative methods to paint the real picture and get valuable data to explain the observed phenomenon. The purpose of focus groups is often not just to get the big picture but to understand and engage the participants to find out their attitudes, opinions, experiences, explanations, and critiques regarding certain phenomena. Focus groups also allows respondents to clarify, qualify, and add to other respondents’ comments and responses so as to provide more expensive and in-depth data (James, 2004).
Nutrition scholars are nowadays utilizing theoretical frameworks and models to develop nutritional programs. However, even though nutritional and health theories and models can help to develop, execute, and assess nutritional programs, not many of them focus on culture and community as the principal reasons for nutritional choices and health behaviours (James, 2004). Another limitation in researching how nutrition and culture relate is optimistic bias. It has been suggested that most people have an optimistic bias because of their overwhelming lack of want to make nutritional changes since they think their risk of suffering the effects of poor nutrition is minimal compared to others. This sort of bias has been shown in many studies that have revealed how many persons believe that they are less likely to have a high fat diet compared to other persons, and in studies that show that individuals with low vegetable and fruit intake think they consume high amounts of the same (Pothukuchi, 2004).
Nutrition and Behaviour Concerns
The National Diet and Nutrition Survey of Young People between the ages of four and eighteen years revealed that school children were consuming more than the recommended daily intakes of sugars and saturated fat. Multiple studies have proven that high sugar intake in the form of sugary drinks between meals can result in dental carries and diabetes. The recommended alternatives are milk and water. These are the healthiest meals to take between meals yet studies show that children between eleven and fourteen years old and those between fifteen and eighteen years old take lower than the recommended daily intake levels of milk and water. This means that children in these age groups are missing out on iron and calcium. Low calcium levels are especially dangerous since the micronutrient is needed for bone development; meaning that those whose calcium levels is low risk developing osteoporosis at a later stage in their lives (Scott, 2007). High intake of saturated fat, on the other hand, increases the risk of young people developing heart diseases and related complications later in their lives. In conclusion, this study shows that many young people are not taking a balanced diet and their poor nutrition is exposing them to the possibility of developing lifestyle diseases later in life.
Undernutrition and Food Insufficiency
Statistics from WHO (the World Health Organization) have revealed that of the 57,000,000 people who lost their lives in the year 2008, 63 percent of the deaths were caused by NCDs (Non-communicable diseases). The NCDs that caused the most deaths are chronic respiratory illnesses, cancers, diabetes, and cardiovascular conditions. About 80 percent of the deaths occurred in poor countries and middle income countries. The health organization estimates that the fraction of deaths caused by NCDs is likely to increase across the world especially in underdeveloped and developing countries. According to the organization, poor nutrition is going to be one of the main drivers of this increase (National Research Council, 2010). The poor nutrition in poor countries is because of food insufficiency, which means that this needs to be addressed if any progress is to be made in adopting health food choices in such countries.
Researchers from across the globe have consistently found that low intake of vegetables and fruits increases the risk of one developing cancers and cardiovascular diseases. They have also found that high salt intake also increase the risk of stomach cancer, the risk of developing cardiovascular complications, and the risk of developing hypertension. Moreover, researchers have also conclusively determined that high intake of trans-fatty acids and saturated fats is one of the leading causes of cardiovascular issues and complications. Scholars have pointed out that a high intake of processed sugar is one of the leading causes of diabetes. Furthermore, recent studies have shown that excessive intake of red meat can cause cancer, while the exercise take of carbohydrates can cause obesity and overweightness. The World Health Organization approximate that about 2,800,000 persons die annually because of obesity and overweightness. Most of these deaths occur in high income countries and generally developed countries. However, the cases of obesity and overweightness are increasing rapidly even in developing and under developing countries and therefore it is something that needs to be looked at (National Research Council, 2010). What is clear from this is that poor nutrition and undernutrition are heavily linked with many diseases and that something needs to be done to turn the situation around and save lives.
Determinants of food choice
1. Hunger and satiety
Hunger is the primary determinant of food choice. Whenever people feel hungry they want to eat and they will probably eat until they are satisfied (satiety). The control of hunger and satiety is mental through the central nervous system. The feeling of satisfaction after eating is generated by taking the likes fats, proteins, and carbohydrates (European Food Information Council, 2006).
2. Palatability
Palatability is the amount of pleasure one derives from taking a specific meal. Palatability affects appetite and the amount of food one is willing to eat. The higher the palatability of a certain meal, the more likely one is to take a certain food (European Food Information Council, 2006).
3. Sensory aspects
Just like hunger, taste is also one of the primary determinants of food choice. Taste is defined as the total of all stimulations triggered by taking a certain food. It is closely related to palatability. People usually develop taste towards certain foods from a very young age. Taste is thought to be inborn. However, cultural influences, beliefs, attitudes, and expectations are also thought to influence taste as one grows up (European Food Information Council, 2006).
4. Cost and availability
People cannot buy and eat food that they cannot afford no matter how nutritious or tasty it is. Therefore, the food people consume is often a reflection of their socioeconomic level. This is why you families from low socioeconomic levels usually have poor diets because they cannot afford to diversify their meals. Improving access to foods including fruits and vegetables and making them affordable is therefore certainly one of the solutions to helping people adopt health food choices (European Food Information Council, 2006).
5. Education and knowledge
Education and knowledge are some of the biggest influences of dietary choices for adults. Some people are not aware that the foods they are eating are harmful to them. Some are not aware of basic nutritional health concepts such as a balanced diet. There is a need to help those who are unaware of such basic nutritional concepts to get awareness from public sources and media so that they can start eating right (European Food Information Council, 2006).
6. Culture
People are usually brought up eating certain unique meals to their cultures. Others are brought avoiding certain foods such as meats and eggs. It is usually very difficult to change cultural food preferences unless one moves to a completely new location where the food habits and choices are different (Brent, 2019).
7. Social influence and marketing
Sometimes people eat food because their friends or people they adore eat those foods. This is usually a subconscious influence. Nevertheless, food choices and habits caused by social influence are usually not very permanent. They change when the social influencer is removed. Marketing and advertisement also has the same influence as social influence. When people see good food being advertised they usually want to eat it the moment they are in a similar situation to that which was in the advertisement (European Food Information Council, 2006). For instance, when people are out and about they may subconsciously remember an advertisement about tasty fried chicken or a thirst-killing soda and find themselves in a fast food restaurant in no time (Brent, 2019).
8. Psychological factors
Stress and depression are known to force people to eat more. When one is happy he or she is less likely to eat more and is more likely to make healthy food choices (European Food Information Council, 2006).
Models for Changing Behaviour
1. Health Behavioural Models
It is crucial to understand how individuals think about their health so as to effectively plan how to help them. Social psychology theories are useful in understanding how people think and make health decisions. This is because they explain human thinking and behaviour. They can also be utilized to predict how likely one will change his diet habits (European Food Information Council, 2006). This section looks at some of the common social psychology based behavioural models.
2. The Health Belief Model and the Protection Motivation Theory
Rosenstock is the author of the Health Belief Model. His model was further developed by Becker and is now commonly utilized to predict how people make health choices including whether or not they will listen to health advice, they will go for screening, or take healthy foods. The theory suggests that individuals usually opt to alter their behaviours when they feel threatened by a condition or illness. The fear usually drives them to do a CBA (cost-benefit analysis) and that the need to protect themselves is usually what forces them to make the right health decisions in the end (European Food Information Council, 2006).
3. The Theory of Reasoned Action and the Theory of Planned Behaviour
The Theory of Reason Action has been utilized in the past to elucidate and estimate the intentions of people acting in a certain way. The theory is based on the idea that the best estimator or predictor of behaviour is the intention behind it. The reasoning behind the theory is that intention is often the result of one of three elements including perception of control or lack of it over a behaviour, the social pressure to change or stick to a behaviour, and attitudes. Dietary studies have proven that examining these elements can help people to change their behaviours and adapt healthy food choices. The Theory of Reasoned Action, on the other hand, explains how people decide about food choices such as whether or not to take milk, salt and fat and in what quantities (European Food Information Council, 2006).
4. Stage classification for health-related behaviour
According to the model of Stages of Change created by Prochaska and colleagues, health associated behavioral change ensues via five different separate phases. These phases are pre-contemplation, contemplation, preparation, action and finally maintenance. The Stages of Change model presumes that if changes at different phases are influenced different aspects, then an individual ought to respond best to any interventions adapted to match their phase of transition (Keane & Willetts, 1994).
Unlike other models that have been discussed, the model of Stages of Change has been found to be more commonly used in changing behavior instead of applying it in clarifying existing behavior. This is likely due to the fact that the model provides hands-on intervention guidance, which can be imparted to physicians. Moreover, huge random samples can be analyzed with messages that have been adapted to the individual’s readiness stage to change (Keane & Willetts, 1994).
Future Recommendations for a Lifestyle Change
Control of dietary habits is one of the recommendations for lifestyle changes in order to improve the quality of life in a community. The suggested interventions should be aimed at improving the general health of obese as well as overweight persons in the society, and assist them in adopting healthy lifestyles that can improve their quality of life. Apart from a healthy diet, a healthy lifestyle can also be encouraged through exercising regularly and staying away from dangerous habits like alcohol consumption and smoking (Bashan et al., 2018).
Majority of obese or overweight kids find lifestyle behaviour change to be the most appropriate approach as it encourages small but manageable changes to physical activity and diet. Nonetheless, programs that have the entire family involved are the most effective. Kids should not shed a lot of weight but instead maintain their weight as they grow. According to Scott (2007), the younger the kid, the more years he/she has to outgrow the obesity.
Simultaneously dealing with several nutritional factors, like minimizing dietary fat while increasing vegetables and fruits, has proven to be useful in the primary care setting. Nutritional counselling accompanied by behavioural counselling appears to be most effective in similar settings though the financial implications of coaching primary care specialists in behavioural counselling is still unclear. Behavioural and educational tactics have also been implemented in community/ public health settings that have been proven to increase vegetable and fruit consumption (Valdez et al., 2016).
Another obvious intervention setting is schools given that they can reach the school personnel, students and their parents. The intake of vegetables and fruits has been increased via the use of canteens, the internet and children partaking in the cultivation, preparation and cooking of the food they consume. Additionally, hidden alterations to dishes to reduce sodium, energy and fat content significantly enhanced the dietary profile of school dinners whilst maintain student involvement in the school lunch program (Valdez et al., 2016).
Media could be used as a crucial element to promote nutritional awareness. Individuals can get to learn more about healthy habits, portion size awareness, nutrition-poor dishes, and weight control. Radio advertising, high-frequency TV and signage might encourage attitude improvements towards a healthy diet. Media approaches might even cause communities to change their nutrition habits. Based on the campaign objectives and available resources, adoption of both national and local message campaigns might be helpful. With regards to the focus of the report on changes that can be made by the local governments to enhance the nutrition as well as physical activity of kids, it is necessary to emphasize that social marketing and media campaigns are capable of improving these local surroundings. This can be achieved through emphasising the reasons for enhancing kids’ nutrition and physical activity surroundings, and involving the community in making use of the new resources in their surroundings such as grocery stores and farmer’s markets (Valdez et al., 2016).
The local governments have a part to play in minimizing accessing to foods considered unhealthy and increasing access to healthier options. Currently, and is shown in this reports, there exists more access-improving schemes compared to those that may minimize access to these unhealthy dishes. Local governments need to concentrate on tactics that minimize access to the unhealthy foods, as such approaches might be quite effective in dealing with obesity (National Research Council, 2010).
Limiting access to sugar-sweetened drinks in community programs and colleges might, for instance, be more effective in reducing weight gain among the youth through the intake of excess calories than starting a community garden. Lastly, even though some interventions might have a direct or immediate influence on healthy eating habits, they might reinforce ties amongst important different community stakeholders. Organizational strengths or broad-based coalitions created via such activities might encourage effective funding for ensuing initiatives that bare more influence but are more challenging to execute (National Research Council, 2010).
Conclusion
Quality of life can be described as a general improving parameter of a patient’s comfort level. It is simply a multi-factor notion created by the individual’s view of psychological, social, and physical functioning, and its measurement is becoming more and more valuable in most fields of health research (Basin et al., 2018). Health issues that are nutrition-related, such as obesity, greatly affect the quality of life both directly and indirectly. In order to improve and maintain the quality of life, the dietary intake ought to be balanced and enough. Similar to malnutrition-related illnesses, obesity and its related issues that are as a result of overfeeding and an unbalanced diet negatively affect the quality of life.
References
Bashan, I., Bakman, M., Uysal, Y., & Mert, E. (2018). Regulation of Dietary Habits: The effect of losing weight on quality of life. Pakistan Journal of Medical Sciences, 34(5), 1253–1256. https://doi.org/10.12669/pjms.345.15667
Brent, M. (2019, January 23). 6 Factors That Influence Our Food Choices. Retrieved February 27, 2019, from https://www.leaf.tv/articles/6-factors-that-influence-our-food-choices/
European Food Information Council. (2006, June 06). The determinants of food choice. Retrieved February 27, 2019, from https://www.eufic.org/en/healthy-living/article/the-determinants-of-food-choice
Hawkes, C. (2013). Promoting healthy diets through nutrition education and changes in the food environment: an international review of actions and their effectiveness. Nutrition Education and Consumer Awareness Group, Rome: FAO. Available at: www. fao. org/ag/humannutrition/nutritioneducation/69725/en.
James, D. (2004). Factors Influencing Food Choices, Dietary Intake, and Nutrition-Related Attitudes among African Americans: Application of a Culturally Sensitive Model. Ethnicity and Health, 9(4), 349-367. https://doi.org/10.1080/1355785042000285375
Keane, A., & Willetts, A. (1994). Factors that affect food choice. Nutrition & Food Science, 94(4), 15-17.
MacDonald, C., Genat, B., Thorpe, S., & Browne, J. (2016). Establishing health-promoting workplaces in Aboriginal community organisations: healthy eating policies. Australian Journal of Primary Health, 22(3), 239–243. https://doi.org/10.1071/PY14144
National Research Council. (2010). Local government actions to prevent childhood obesity. National Academies Press.
Pothukuchi, K. (2004). Community food assessment: A first step in planning for community food security. Journal of Planning Education and Research, 23(4), 356-377.
Scott, J. (2007). Food for life: healthy choices for children. (Cover story). Primary Health Care, 17(3), 14–16. https://doi.org/10.7748/phc2007.04.17.3.14.c4396
Valdez, A. C., Ziefle, M., Verbert, K., Felfernig, A., & Holzinger, A. (2016). Recommender systems for health informatics: state-of-the-art and future perspectives. In Machine Learning for Health Informatics (pp. 391-414). Springer, Cham.
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