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Kothe - International Society of Nutritional Psychiatry - 2014

Do good intentions lead to healthy food choices?

Background: Emerging research shows a clear link between dietary choice and physical and mental health outcomes. As such, there is a need for interventions to improve the dietary choices of individuals. However, interventions will only be successful if they address the psychosocial factors that are responsible for poor dietary choices. This research considered the extent to which individuals who intend to engage in healthy food choices are able to translate that intention into action.
Method: Three studies considered the extent to which individuals’ were able to translate dietary intentions into action across a range of contexts including: adherence to dietary guidelines among pregnant women (Study 1), gluten-free diet adherence among individuals with coeliac disease (Study 2), and young adults’ consumption of breakfast (Study 3). In each study individuals indicated their intention to engage in the relevant dietary behaviour and reported their corresponding dietary behaviour at the same (Study 2) or subsequent time-points (Study 1 & 3).
Results: Intention to engage in healthy dietary choices was very high across all samples. However, data from all three studies showed that highly motivated people often failed to translate good dietary intentions into healthy food choices. This “intention-behaviour gap” was seen across a range of contexts.
Conclusion: Difficulty in achieving healthy diet cannot be accounted for by a lack of motivation within these samples. It appears that intention may be a necessary but not sufficient determinant of healthy diet. These findings suggest that interventions that attempt to change dietary behaviour by increasing motivation will have limited impact. There is a clear need to consider potential moderators of the intention-behaviour relationship in order to achieve desired changes in dietary behaviour.

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Kothe - International Society of Nutritional Psychiatry - 2014

  1. 1. Do good intentions lead to healthy food choices? Emily Kothe School of Psychology, Deakin University @emilyandthelime
  2. 2. People consistently fail to translate good intentions into good behaviour Inclined abstainers Inclined actors Disinclined abstainers Disinclined actors
  3. 3. People consistently fail to translate good intentions into good behaviour Inclined abstainers Inclined actors Disinclined abstainers Disinclined actors
  4. 4. People consistently fail to translate good intentions into good behaviour Across behaviours, median proportion of people who intend to act and then fail to do so is 47% (Sheeran, 2002) 57% of women who indicate they intend to undergo cervical cancer screening fail to do so within 1 year (Orbell & Sheeran, 1998) 46% of people who intend to exercise, do not (Rhodes & de Bruijn, 2013) The extent to which intention to engage in dietary behaviours translates to adherence to dietary behaviours has not been systematically investigated.
  5. 5. Inclined abstention within dietary behaviour Study 1: adherence to dietary guidelines among pregnant women Study 2: gluten-free diet adherence among individuals with coeliac disease Study 3: young adults’ consumption of breakfast
  6. 6. Motivated abstention in pregnant women 250 pregnant women reported motivation to engage in a healthy diet (18 weeks) and adherence to dietary guidelines (32 weeks). Motivation was operationalized as scoring above neutral on measures of importance, confidence, and readiness. Adherence to dietary guidelines was assessed using a FFQ. Consumption of mostly reduced fat dairy Consumption of 2+ serves of dairy each day Consumption of 2+ serves of fruit each day Consumption of 4+ serves of vegetables each day*
  7. 7. Motivated abstention in pregnant women 78% of the pregnant women meet the criteria of “motivated” 90% of motivated women failed to adhere to at least one dietary guideline
  8. 8. Inclined abstention in gluten-free diet 105 individuals with biopsy confirmed coeliac disease reported intention to strictly adhere to the gluten free diet and adherence to the diet at a single timepoint. Intention was measured using a single item from the Biagi coeliac adherence measure Gluten free diet adherence was measured using the Coeliac Dietary Adherence Test (CDAT)
  9. 9. Inclined abstention in gluten-free diet Participants were classified as according to status Inclined abstainers Reported never intentionally consuming gluten Less than strict adherence according to the CDAT Inclined actors Reported never intentionally consuming gluten Strict adherence according to the CDAT Disinclined abstainers Reported intentionally consuming gluten Less than strict adherence according to the CDAT Disinclined actors Reported intentionally consuming gluten Strict adherence according to the CDAT
  10. 10. Inclined abstention in gluten free diet 30% of adults with biopsy confirmed coeliac disease who intended to always follow the diet failed to do so Inclined abstainers accounted for 90% of inadequate adherence
  11. 11. Inclined abstention in breakfast consumption 349 university students reported intention to eat breakfast (Time 1) and actual breakfast consumption (Time 2). Intention was measured on a 7 point scale where higher scores indicated stronger intention. Breakfast consumption individuals indicated the number of days in the previous week they had consumed breakfast on a self-report questionnaire Kothe, E. J., Mullan, B. A., & Amaratunga, R. (2011). Randomised controlled trial of a brief theory-based intervention promoting breakfast consumption. Appetite, 56(1), 148-155.
  12. 12. Inclined abstention in breakfast consumption Participants were classified as according to status Inclined abstainers Scored 5 or above in intention at Time 1 Skipped breakfast 3 or more times a week at Time 2 Inclined actors Scored 5 or above in intention at Time 1 Ate breakfast 5 or more times a week at Time 2 Disinclined abstainers Scored 5 or above in intention at Time 1 Skipped breakfast 3 or more times a week at Time 2 Disinclined actors Scored 3 or below in intention at Time 1 Ate breakfast 5 or more times a week at Time 2 Kothe, E. J., Mullan, B. A., & Amaratunga, R. (2011). Randomised controlled trial of a brief theory-based intervention promoting breakfast consumption. Appetite, 56(1), 148-155.
  13. 13. Inclined abstention in breakfast consumption 63% of young adults who intended to regularly consume breakfast failed to do so. Inclined abstainers made up 77% of all breakfast skippers Kothe, E. J., Mullan, B. A., & Amaratunga, R. (2011). Randomised controlled trial of a brief theory-based intervention promoting breakfast consumption. Appetite, 56(1), 148-155.
  14. 14. Summary of results Intention to engage in healthy dietary choices was very high across all samples. However, all three studies showed that highly motivated people often failed to translate good dietary intentions into healthy food choices. Inclined abstention accounted for the majority of poor adherence to healthy dietary patterns across all contexts.
  15. 15. Implications Difficulty in achieving healthy diet cannot be accounted for by a lack of motivation. It appears that intention may be a necessary but not sufficient determinant of healthy diet. Interventions that attempt to change dietary behaviour by increasing motivation will have limited impact.
  16. 16. My collaborators Study 1 A/Prof Helen Skouteris (Deakin University) Dr Matthew Fuller-Tyszkiewicz (Deakin University) Dr Skye McPhie (Deakin University) Briony Hill (Deakin University) Study 2 A/Prof Barbara Mullan (Curtin University) Lauren Smith (University of Sydney) Study 3 A/Prof Barbara Mullan (Curtin University)

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  • bradatslice

    Apr. 4, 2014

Do good intentions lead to healthy food choices? Background: Emerging research shows a clear link between dietary choice and physical and mental health outcomes. As such, there is a need for interventions to improve the dietary choices of individuals. However, interventions will only be successful if they address the psychosocial factors that are responsible for poor dietary choices. This research considered the extent to which individuals who intend to engage in healthy food choices are able to translate that intention into action. Method: Three studies considered the extent to which individuals’ were able to translate dietary intentions into action across a range of contexts including: adherence to dietary guidelines among pregnant women (Study 1), gluten-free diet adherence among individuals with coeliac disease (Study 2), and young adults’ consumption of breakfast (Study 3). In each study individuals indicated their intention to engage in the relevant dietary behaviour and reported their corresponding dietary behaviour at the same (Study 2) or subsequent time-points (Study 1 & 3). Results: Intention to engage in healthy dietary choices was very high across all samples. However, data from all three studies showed that highly motivated people often failed to translate good dietary intentions into healthy food choices. This “intention-behaviour gap” was seen across a range of contexts. Conclusion: Difficulty in achieving healthy diet cannot be accounted for by a lack of motivation within these samples. It appears that intention may be a necessary but not sufficient determinant of healthy diet. These findings suggest that interventions that attempt to change dietary behaviour by increasing motivation will have limited impact. There is a clear need to consider potential moderators of the intention-behaviour relationship in order to achieve desired changes in dietary behaviour.

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