Food and eating as social practice--understanding eating patterns as social phenomena and implications for public health

Beyond individual responsibility: Exploring lay understandings of the contribution of environments on personal trajectories of obesity

INTRODUCTION

Reversing the upward trajectory of obesity requires responding by including the multiple influences on weight control. Research has focused on individual behaviours, overlooking the environments where individuals spend their lives and shape lifestyles. Thus, there is a need for lay understandings of the impact of environments as a cause and solution to obesity. This research aimed to understand the influence of environments on the adoption of health practices in adults with obesity and to identify lay strategies with which to address environmental barriers to behaviour change.

METHODS

Nineteen adults with a history of obesity living in the United Kingdom were interviewed through video conferencing between May 2020 and March 2021. Semi-structured interviews and socio-demographic questionnaires were used, and data analysed through hermeneutic phenomenology informed reflexive thematic analysis.

RESULTS

Three main themes were created: living with convenience and normalcy: the increased accessibility of unhealthy food, people interacting with digital media for positive practice change, and the need to prioritise prevention in schools, the National Health Service and the food industry.

CONCLUSIONS

The food environment was the major barrier, while interactions with social media was the most important opportunity to adopt healthy practices. The National Health Service was considered an obesogenic environment, something relevant since it has been traditionally recognised as an obesity management system. The perceptions from individuals with a history of obesity provide new suggestions on the influence of previously overlooked environments to design more adequate and effective interventions and policies that consider, more than in the past, the environments where people spend their lives.

Higher Numbers of Family Meals and Social Eating Behavior Are Associated with Greater Self-Esteem among Adolescents: The EHDLA

BACKGROUND

the aim of this study was to assess the associations of family meals and social eating behavior with self-esteem levels among Spanish adolescents.

METHODS

This was a secondary cross-sectional study including 706 participants (aged 12 to 17 years; 56.1% girls) from the Eating Habits and Daily Life Activities (EHDLA) study. The evaluation of the frequency of family meals involved participants providing information in physical education classes on how frequently they, along with other members of their household, had shared meals in the previous week. Social eating behavior was assessed by three different statements: "I usually have dinner with others", "Having at least one meal a day with others (family or friends) is important to me", and "I enjoy sitting down with family or friends for a meal". To assess overall self-esteem, the Rosenberg Self-Esteem Scale was used.

RESULTS

In the adjusted models, a positive association was observed between the frequency of family meals and the self-esteem score (unstandardized beta coefficient [B] = 0.06, 95% confidence interval [CI] 0.003 to 0.12, p-adjusted = 0.040). Furthermore, the same positive association was also identified between social eating behavior and the self-esteem score (B = 0.23; 95% CI 0.07 to 0.40, p-adjusted = 0.005).

CONCLUSIONS

Although self-esteem is complex and can be influenced by numerous factors, both family meals and social eating behavior may exert a relevant role in adolescents. Encouraging consistent participation in family meals and promoting positive eating practices could be valuable approaches in public health actions targeting the enhancement of self-esteem levels in adolescents.

The difficult decision of buying food for others: Which puree will my baby like?

When selecting commercial baby food, parents make the initial decision, but the baby's approval ultimately determines the likelihood of repurchasing. However, discerning what babies prefer and enjoy can be challenging for food developers because babies cannot verbally express their preferences. To gain insight into the decision-making process of parents when selecting food for their infants, this study aims to examine: 1. the reasons behind choosing commercial baby food purees, 2. the sensory factors that influence baby acceptance, and 3. how accurately parents can predict baby acceptance. Two experiments were performed. The first investigated the purchasing decisions and underlying reasons of 100 parents, who evaluated 14 different commercial baby food purees. Second, a study was conducted involving 40 parents and their babies (8-30 months) who evaluated a set of 9 baby food purees in two different settings: 1. the parents tasted the puree, and 2. the babies ate the product at home. The results of the first experiment were analyzed using regression trees to uncover the hierarchy of factors that influenced parental decisions. Two negative factors, product unfamiliarity, and high price, were the most important factors leading to parental rejection. Healthiness, tastiness, satiety and good price were the reasons that contributed to a final positive purchasing decision. In the second experiment, the influence of the sensory attributes on babies' perception were determined through a PLS-regression model. The findings revealed that the chicken flavor and vegetable flavors, such as potato, onion, peas, and legumes, positively correlated with infants' liking, whereas fish, tomato, and acidic flavors had negative implications. The texture attributes of sandiness and stickiness had a positive effect on baby liking, whereas smoothness had a negative impact. The results of the regression model based on the predictions revealed that flavor attributes that drive liking and disliking for babies coincided with their parents. However, the texture attributes did not match. Parents considered texture attributes, specifically creaminess and smoothness, as relevant and positive. However, these texture attributes did not affect or slightly decrease babies' acceptance that was positively affected by sandiness and stickiness.

Relationships Between Three Eating Behaviors and Nine Motives for Food Choices Among Brazilian Adults: A Structural Equation Model

We examined the relationships between three eating behaviors and nine motives underlying food choices made by Brazilian adults. Using participant responses to the short version of the Three-Factor Eating Questionnaire and the Food Choice Questionnaire, we investigated eating behaviors (cognitive restriction, uncontrolled eating, and emotional eating) and motives for food choices (health, mood, convenience, sensory appeal, natural content, price, weight control, familiarity, and ethical concern). We used a structural equation model to test relationship pathways (β), with eating behaviors as independent variables and motives for food choices as dependent variables. Participants were 1297 individuals (69.5% female) with a mean age of 25.0 years (SD = 5.8). We confirmed the validity and reliability of the questionnaires in this sample. Restrictive eating behavior was significantly related to motives of health (β = .415), mood (β = .127), natural content (β = .364), weight control (β = .681), and ethical concern (β = .161). Emotional eating behavior was related to motives of mood (β = .277), health (β = -.137), and natural content (β = -.136). Uncontrolled eating behavior was related to motives of convenience (β = .226), sensory appeal (β = .121), price (β = .153), and familiarity (β = .090). We believe these findings can now help design future research and clinical interventions for managing people's risky eating behaviors and promoting beneficial food choices.

Considering the role of integration experiences in shaping immigrants' post-migration food choices and eating practices

This article draws on data collected from qualitative interviews with 38 recent immigrants in two Ontario cities to provide an overview of recent immigrants' general dietary acculturation experiences. With insights from both Cockerham's health lifestyle theory and Berry's acculturation model, this article explores how structural inequalities related to integration and settlement may shape recent immigrants' post-migration food choices and eating practices. The results of this study revealed that immigrants from non-Western countries experienced greater challenges in healthy eating. Findings are in line with Cockerham's health lifestyle theory: immigrants' post-migration food choices and dietary acculturation strategies were not only bounded by socioeconomic status and cultural differences but were also shaped by various structural inequalities, especially those related to systematic barriers during the integration and settlement process. Overall, this paper provides a more holistic understanding of the multifaceted nature of immigrants' dietary acculturation experiences.

Racialized Perceptions of Vegetarianism: Stereotypical Associations That Undermine Inclusion in Eating Behaviors

Shifting societal eating patterns toward a vegetarian diet offers promise for improving public health and environmental sustainability. Yet concerns exist about racial disparities in inclusion, as some sentiments suggest that vegetarianism is stereotypically associated with Whiteness. Through four studies (total N = 3,234), we investigated associations U.S. adults hold between race and vegetarianism, along with implications for behavior change and belongingness among Black individuals. Participants, across racial backgrounds, strongly associated vegetarianism with Whiteness, both explicitly and implicitly. A race prime led Black participants to report lower interest in becoming a vegetarian, whereas a prime of race-vegetarianism associations decreased Black participants' feelings of belongingness in the vegetarian community. Exposure to racially inclusive messaging about vegetarianism, meanwhile, increased belongingness among Black participants. These findings provide the first quantitative insights into racial stereotypes about vegetarianism and pose future directions for theory, research, and practice at the intersections of race and eating behavior.

Food, health and sustainability

This review makes a case for taking an integrated 'food systems' approach to explore the links between health and sustainability rather than treating them as separate topics. Unlike more linear 'farm-to-fork' conceptions, a systems approach emphasises the links between domains and sectors, helping avoid perverse effects where an intervention at one point in the system can have unanticipated consequences at other points. Adopting this approach, the review argues that food security and sustainability are as much a socio-cultural as a technical challenge requiring the combined forces of researchers from the natural and social sciences together with a range of stakeholders from government, business and civil society. Meeting the twin challenges of health and sustainability will require changes to intensive food production systems, dietary change and reductions in current levels of food waste. The review explores why dietary practices are so resistant to change seeking alternatives to the deficit thinking that pervades much advice on 'healthy eating'. It explores the locus of responsibility for food system change, emphasising the asymmetrical power relations that shape contemporary dietary choices. The review includes an example of food system research, the H3 project (healthy soil, healthy food, healthy people), which seeks to transform UK food systems 'from the ground up', adopting the principles outlined in the body of the review.

Fathers' experiences of childcare and feeding: A photo-elicitation study in a low resource setting in urban Addis Ababa, Ethiopia

Children's health and wellbeing studies focus mainly on mothers' roles while very little is known about the experiences/challenges that fathers face in fulfilling their responsibilities. Therefore, this study aims to explore the fathers' lived experiences of childcare and feeding in an urban low-income setting. This qualitative study was conducted in Addis Ababa, Ethiopia. Photo-elicitation was used to facilitate the in-depth interviews with fathers of children below the age of five years. All interviews were audio-recorded, transcribed and translated verbatim, followed by a thematic analysis approach. The overarching theme of this study was "Fatherhood as an enduring identity", which comprised of three sub-themes: 1) Blessings of fatherhood, 2) Adjusting to fathering roles, and 3) Struggles/demands of fatherhood in a low-resource setting. Fathers expressed that having children or becoming parents was a blessing. They expressed their love, devotion, and attachment to their children. Some used the term "my second chance in life" underscoring the importance. Although fathers strived relentlessly to spend time and care for their children, they faced challenges such as internal struggles adjusting to and fatherhood whilst maintaining a sense of their former self. As well, providing for their families amidst added pressures imposed by the external environment, such as poor housing conditions, a lack of employment opportunities, the then COVID-19 pandemic, further increased their stressors. Most fathers were engaged in child care and feeding, suggesting that like mothers, fathers should be viewed as potential agents for implementing nutrition interventions in this setting. However, if interventions are to be successful, they need to incorporate components that boost fathers' livelihoods and general wellbeing.

Examining Nutrition Knowledge, Skills, and Eating Behaviours in People with Severe Mental Illness: A Cross-Sectional Comparison among Psychiatric Inpatients, Outpatients, and Healthy Adults

Compared to the general population, people with severe mental illness (SMI) have an increased risk of weight gain and metabolic syndrome, but also of malnutrition, in part due to unhealthy lifestyle behaviours. The aim of this cross-sectional study was to identify barriers to healthy eating, including nutrition knowledge and skills in people with SMI. For this purpose, we compared the means of anthropometric data such as body mass index, waist-to-hip ratio, and interview data on nutrition knowledge and skills, health-related variables, eating behaviours, personality, motivation, and attitudes in 65 inpatients and 67 outpatients of the Psychiatric Hospital of the University of Zurich and 64 healthy adults using ANOVA and chi-squared tests. The results showed that patients with SMI had worse nutritional status and lifestyle compared to the healthy controls, including disordered (e.g., night eating) and unhealthy (e.g., high intake of sugary foods) eating habits. However, levels of nutrition knowledge, cooking and food skills, and motivation to eat healthily were not significantly lower in the psychiatric patients than in the healthy adults and were not associated with weight change. Based on our findings, nutritional support for people with SMI is urgently needed and should include not only educational but also behavioural and long-term approaches.

Food practices adaptation: Exploring the coping strategies of low-socioeconomic status families in times of disruption

COVID-19 impact on global and national food systems, along with associated physical restrictions, lockdowns, and school closures, have led to dramatic changes in families' everyday food practices. Our research explored the way food practices adapted and emerged, allowing families to cope with the disruption caused by COVID-19. We recruited 18 low socio-economic status families with primary school children across the United Kingdom and New Zealand to partake in two interviews, a survey, and the use of an ethnographic app. Analysis illuminates that this disruption triggered the emergence of three practices that were necessary to carry on and mitigate the impact of disrupted food practices; 'asking for help', 'planning' and 'research and experimentation'. As a way to deal with disruption to their food practices, many participants called on the support of the community, including the use of food banks and the sharing of food. Participants discussed the way they had to plan their food, which often involved the expansion of practices formerly enacted to a small degree, such as curation of online shopping lists and stockpiling. Food research and experimentation also emerged as largely new practices, such as freezing foods, learning new recipes online (YouTube), experimenting with new ingredients and recipes. As such, for some participants, experimentation and research transformed cooking practices into leisure practices. The findings have practical implications for policy makers and non-governmental organisations, such as providing formal support that is accessible while reducing any associated stigma. Designing interventions that integrate planning routines within food practices can help build skills (e.g., bulk cooking and freezing) which can be vital during disruptions, aiding families to cope with the difficulties and aftermath of sudden and large-scale disruption, such as a pandemic.

Exploring everyday life dynamics in meat reduction - A cluster analysis of flexitarians in Denmark

Exploring everyday life dynamics in meat reduction - a cluster analysis of flexitarians in Denmark. Flexitarians are attracting increasing attention in the research on meat reduction. But there has been limited focus on comprehensive understandings of a broader range of dynamics that can work as barriers and facilitators for meat reduction. In this article, we use social practice theory (SPT) as a comprehensive approach to barriers and facilitators in meat reduction in everyday life. We present an analysis of data from a representative Danish cross-sectional survey. We show, first, that Danish flexitarians can be divided into four distinct clusters (what we will refer to as classes) in accordance with combinations of everyday facilitators and barriers. Second, we show that the prevalence of these classes varies considerably depending on how long people have been flexitarians. We argue that the patterns in this variation indicate that over time people transition to other classes where barriers to plant-rich eating become less significant, and routinization emerges in different ways. Finally, third, we show that flexitarians do report eating less meat than consumers who label themselves as eating meat with no restrictions. But we also highlight that the difference is relatively modest. Indeed, meat intake is still quite common even in classes where routinization is highest. Throughout the paper, we discuss similarities and differences between the SPT framework and another recent framework, the COM-B model, that also provides a comprehensive approach to the understanding of behavioural change.

Understanding health inequalities through a practice-oriented 'capabilities' perspective. Motherhood and leisure time physical activity

In this article, we explore how a capabilities perspective can advance practice theoretic conceptualisations of persistent health inequalities. Specifically, we seek to understand the capabilities necessary for recruitment to leisure time physical activity (LTPA) practices by low SES mothers, a group traditionally excluded from LTPA. Our study illuminates that mothers living a life of social disadvantage face difficulties in becoming recruited to LTPA practices despite, in many cases, the availability of elements required for performance. We identify that temporal, support and energy capabilities are necessary for low SES mothers to become recruitable to LTPA. The dispossession of these capabilities signals inequalities in the constellation of practices that configure this group's lived experiences, in turn giving rise to practice absence and further consolidating patterns of inequality. We offer a framework of practice capabilities and health inequalities to guide future practice-oriented scholarship in the sociology of illness and health, which signals how capabilities may enable or constrain recruitment to health-promoting practices, give rise to inequalities and condition the possibility of practice absence.

Motivations for nutrition information-seeking behavior among Belgian adults: a qualitative study

BACKGROUND

Nutrition information-seeking behavior is highly prevalent even though it can be challenging to find reliable nutrition information in the current media landscape. Previous quantitative research has identified which population segments use which sources, yet little is known about motivations underpinning nutrition information-seeking behavior. Understanding motivations for seeking nutrition information can increase the efficacy of future nutrition education efforts. The present study aims to identify motivations for nutrition information-seeking behavior among Belgian adults.

METHODS

In-depth qualitative interviews were conducted with 20 adults (n women = 15, n men = 4, n other = 1). Audio-recorded interviews were transcribed verbatim and analyzed in NVivo 12 using inductive thematic analysis. The coding process involved open and axial coding combined with constant comparison to identify themes.

RESULTS

The interviews revealed a diverse spectrum of motivations for nutrition information-seeking behavior. Five categories of motivations centered on health management, cognitive needs, affective needs, social integrative needs, and personal identity. Participants indicated seeking nutrition information to regain a sense of control over their health and it also helped them express their autonomy. Additionally, participants sought nutrition information out of curiosity or out of a long-standing interest. Nutrition information-seeking was also used as a form of emotion regulation with participants actively engaging in seeking behavior to pursue enjoyment, diversion, confirmation, inspiration, and even relaxation. Furthermore, nutrition information-seeking enabled participants to meet social integrative needs by helping them connect to others, gather social support, help others, and sometimes convince others. Lastly, participants indicated a need for nutrition information to express or defend their identity.

CONCLUSIONS

Our results indicate that beneath the surface of a more apparent need for nutrition information lies a range of motivations demonstrating that nutrition information serves more complex needs than simply information needs. To improve the efficacy of future nutrition education efforts, communication strategies must be tailored to a diverse range of motivations.

Social and economic factors influencing intrahousehold food allocation and egg consumption of children in Kaduna State, Nigeria

Adequate intake of high-quality nutritious foods during infancy and early childhood is critical to achieving optimal growth, cognitive and behavioural development, and economic productivity later in life. Integrating high-quality and nutrient-dense animal source foods (ASFs), a major source of protein and micronutrients, into children's diets is increasingly considered essential to reducing the global burden of malnutrition in low- and middle-income countries. While eggs are an ASF that shows promise for mitigating child undernutrition, interventions promoting egg consumption among children have had mixed results in improving egg intake and child growth outcomes. As part of an evaluation of a demand creation campaign promoting egg consumption, qualitative research was carried out in September 2019 to assess sociocultural and household factors affecting egg intake among young children living in Kaduna State, Nigeria, where a thriving egg industry and childhood stunting rates of 50% exist. Methods included freelisting exercises (11), key informant interviews (11), in-depth interviews (25) and FGDs (4). Results illuminated cultural rules that restrict egg consumption among children living in low-income households. These rules and norms reflect social and economic valuations that foster male dominance in household decision-making and guide food purchasing and intrahousehold food allocation that allow men to consume eggs more regularly. Study results highlight sociocultural considerations when selecting food interventions to address child malnutrition in low-income contexts. Interventions encouraging increased consumption of ASFs, and specifically eggs in young children, should be informed by formative research to understand sociocultural norms and beliefs guiding egg consumption.

Loving lunch in junior high: Lunchtime activities and a sense of belonging in school

We explore student lunchtime experiences as they relate to student sense of belonging. We use SPSS Two-Step cluster analysis and logistic regression of data from a schoolwide survey (n = 830) in the United States. Stepwise modeling is used to determine the importance of clusters representing lunchtime activity preferences and love of lunch on belonging scores. Loving lunch significantly positively affects school belonging. Students naturally group into five distinct different activity profiles based on lunchtime preferences. These profiles are significantly related to a sense of belonging. Being active with peers during lunch was most strongly correlated with sense of belonging. Lunchtime warrants more attention for fostering a sense of belonging in the school community. Broadening lunchtime activity options, especially in schools where there are few available ways for socializing and being active, has the potential to support the diverse needs of students and increase belonging.

Identity processes and food choice: predictors of dietary lapses among ethical and health vegans

An interesting finding in the literature on vegetarianism and veganism finds that vegetarians and vegans often report that they deviate from their diets from time to time. Work examining this phenomenon finds that these dietary lapses relate to many factors; however, little research examines how these factors collectively influence dietary lapses while also controlling for the relationships that may exist among factors. Here, I fill this gap by drawing from the unified model of vegetarian identity (UMVI) and identity theory (IT) to propose an inclusive model of dietary lapses. Structural equation model results from a sample of 488 vegans reveal differences in how identity and interactional processes relate to dietary lapses across ethical and health motivations. This work is important because it highlights how identities relate to dietary behaviors differently for ethical and health vegans; it also provides fruitful avenues for future work in this area.

From healthy food environments to healthy wellbeing environments: Policy insights from a focused ethnography with low-income parents' in England

Overweight and obesity continue to increase globally. In England, as in many other countries, this disproportionately affects people who experience socioeconomic deprivation. One factor blamed for inequalities in obesity is unhealthy food provisioning environments (FPEs), leading to a focus on policies and interventions to change FPEs. This paper aims to provide insights into how FPE policies could more effectively tackle inequalities in obesity by addressing a key research gap: how the structural contexts in which people live their lives influence their interaction with their FPEs. It aims to understand how low-income families engage with FPEs through in-depth focused ethnographic research with 60 parents across three locations in England: Great Yarmouth, Stoke-on-Trent, and the London Borough of Lewisham. Analysis was guided by sociological perspectives. FPEs simultaneously push low-income families towards unhealthy products while supporting multiple other family needs, such as social wellbeing. FPE policies and interventions to address obesity must acknowledge this challenge and consider not just the makeup of FPEs themselves but how various structural contexts shape how people come to use them.

Consumer Behaviour and Food Waste: Understanding and Mitigating Waste with a Technology Probe

Globally, nearly one third of food produced for human consumption is lost or wasted. This equals a total of 1.3. billion tonnes per year, which is a large, unnecessary burden for the environment and the economy. Research and development have delivered a wealth of resources for understanding food waste, yet little is known about where food wasting occurs in the home. The study begins with a literature review of articles that deal with food waste and consumer behaviour, reflecting on their definition of ‘waste’, approach, findings and recommendations. Having noticed a lack of convergence in the literature, and an absence of research into digital technologies for the study of food waste, the potential for incorporating novel technology probe methodologies is explored. Building on the proliferation of internet of things devices, the ‘smart bin’ is introduced as an effective intervention for making visible routine household food wasting practices. These data were then triangulated with user interviews, leading to an enriched qualitative discussion and revealing drivers and mitigators of waste. This paper concludes with some reflections on the smart bin as a domestic product and how it might synthesise previous understandings of consumer behaviour, leading to better informed food waste policies and initiatives.

Exploring the environmental determinants of food choice among Haudenosaunee female youth

Background

Research on Indigenous food literacy within Canada has been focused on northern and remote communities despite the fact there are considerable and unique barriers to food access, availability, and utilization in southern Indigenous communities. Food insecurity is also a prevalent issue among Indigenous Peoples living in these more populous regions. Study objectives included investigating the determinants of food choice among youth, along with perceived opportunities that would improve food environments individually and at the community level.

Methods

This community-based study used Photovoice to explore the perceptions and experiences of traditional foods and the determinants of food choice among youth in the community of Six Nations of the Grand River. Participants took photos of their local food environments, including where foods were acquired, consumed, prepared, or shared, and participated in semi-structured interviews to share the stories behind these images. Thematic analysis was used to identify patterns in participants’ photos and interview content.

Results

Environmental factors were found to influence participants’ traditional and everyday food choices. Built, social, economic and ecological environments were described by the youth as distinct yet inter-related determinants that converge to influence individual food choice. Built environments had a notable impact on food choice, most notably at home and in school settings. Home and family were found to be facilitators of meal consistency and healthy food choices across participants. The social environment including participants’ relationships with their peers and community friends was often a barrier to healthy food choices. Eating at fast food outlets was a common social activity. The economic environment included cost deterrents associated with food choices and regular meals. The ecological environment was less of an influence and impacted the seasonal consumption of traditional and other locally harvested foods.

Conclusions

Overall, the study findings have generated important knowledge regarding food environments and literacy and serves as a unique example of how to explore the traditional and everyday food experiences of Indigenous youth. Recommendations will inform the development of new as well as existing initiatives and resources to enhance the holistic wellbeing of youth and the broader community.

Exploring drivers of food choice among PLHIV and their families in a peri-urban Dar es Salaam, Tanzania

Background

A nutritious diet is critical to minimizing disease progression of human immunodeficiency virus (HIV) and maximizing treatment efficacy. In low resource settings, meeting the food preference needs of people living with the HIV (PLHIV) can be achieved with a supportive food environment when HIV status is disclosed. However, less is known about family-level strategies related to building a supportive food environment. The Diet, Environment, and Choices of positive living (DECIDE), a mixed-methods observational study conducted in peri-urban Dar es Salaam, Tanzania, explored food preferences as influenced by the personal, family, and external food domains.

Methods

We completed a qualitative analysis of data generated from 40 interviews (n = 20 PLHIV and n = 20 family members) aimed at exploring the dynamics of food choice for using a family perspective. We expanded on Turner’s food environment framework and drew on Giddens’ structuration theory to guide our data collection and analysis. Interviews were audio recorded, transcribed, translated from Kiswahili to English, coded, and organized into themes.

Results

We found PLHIV personal food preferences were influenced by organoleptic properties, medications, disease stage, and gender norms. Family members were knowledgeable about the importance of nutritious food for HIV treatment and prioritized these needs to avoid HIV-related stigma and fulfill family obligations. With high prices of nutritious foods (animal source foods, fruits), family members strategized to secure preferred foods for the PLHIV by, 1) forgoing their own food preferences; 2) reallocating food within the household; 3)making food substitutions; and 4) leveraging external networks. These strategies were increasingly employed as the disease progressed.

Conclusion

The use of this expanded framework that included a family perspective on PLHIV food choice illuminated the various households decision-making dynamics that took place in this low resource community. Family members of PLHIV tried to buffer the limitations imposed by the external food environment, especially as the disease progressed. In the context of HIV status disclosure, integrating a family perspective into HIV nutrition interventions and programs has the potential to influence health outcomes and slow disease progression.

The Association of COVID-19 Stressors and Family Health on Overeating before and during the COVID-19 Pandemic

Prior studies have examined how stress and the family environment affect overeating, but less is known about how COVID-19 stressors and family health may affect overeating during the COVID-19 pandemic. The research questions included: (1) Did COVID-19-related stressors increase the risk for overeating among adults in the United States? (2) Did family health protect against overeating during a pandemic? The sample included 443 participants aged 18 years and older living in the United States who were recruited via Amazon Mechanical Turk. Stata version 16 was used to analyze the data using multiple linear regression. The results indicate that one year into the pandemic, COVID-19 stressors were associated with increased overeating, even after adjusting for overeating before the pandemic. More family health resources were associated with less overeating. These results indicate that although COVID-19 stressors were associated with overeating, greater family health resources helped prevent overeating. Interventions and policies that aim to increase health resources for families may be particularly beneficial at preventing overeating and obesity in the face of long- and short-term stress.

Where do Dutch adults obtain their snack foods? Cross-sectional exploration of individuals' interactions with the food environment

We investigated frequency of consumption and location of obtaining snack foods and sociodemographic differences therein. Data: cross-sectional survey data (N = 1784 Dutch adults 18-65 years) on the frequency of consumption of 10 snack foods and where they obtained them. Adjusted logistic regression analyses revealed notable differences in the frequency of snack food consumption between younger and older adults and between those with low vs. high socioeconomic position (SEP). The location of obtaining snack foods also differed between sociodemographic groups with supermarkets forming an important point-of-purchase for snack foods, especially for those with low SEP and with children in their household.

The reflective eater: Socializing French children to eating fruits and vegetables

Studies often suggest that the family meal is the locus for the acquisition of healthy eating habits. However, these studies rarely offer a deeper understanding of what it is about eating together as a family that increases the intake of healthy foods, such as fruits and vegetables. This ethnographic study examines dinners in French households, whose children have shown to habitually consume fruits and vegetables, analyzing talk around the dinner table. Our analysis shows that naturally occurring exchanges between parents and children socialize children to experiencing eating in culturally informed ways that promote attending to the prized characteristics, such as origin, quality, taste, and preparation of food items that intrinsically elevates their value and leads to their consumption. These communicative patterns also encourage reflection and openness to foods, which, we posit, constitute ways of 'doing being French'. Ultimately, we argue that French children's readiness to eat fruits and vegetables is not linked to them being healthy, but rather is derived from the cultural significance of experiencing sensory pleasure from food and from being able to talk about and share these experiences with others, that is being reflective eaters.

Life-course perspectives of milk consumption among young Norwegian women and their knowledge of milk as a source of iodine: a qualitative study

Mild to moderate iodine deficiency has been found among young Norwegian women of reproductive age. In Norway, cow’s milk is the main source of iodine; however, milk consumption is decreasing, particularly among young women. This study aimed to investigate milk consumption practices in young Norwegian women and their attitudes toward milk consumption from childhood to young adulthood in a life-course perspective and their knowledge of milk as a source of iodine. Convenience sampling was used to recruit 30 bachelor students (women, 18–25 years old) from five different study programs. Interpretative phenomenological analysis (IPA) was used to interpret milk consumption practices from a life-course perspective. Five focus group interviews were conducted using a semistructured interview guide. The transcribed interviews were coded according to emerging themes related to milk consumption practices and turning points. Milk consumption practices were dynamic and changed over time and were influenced by several factors: family traditions, school milk subscription, friends and social media, social acceptance, availability, price, and attitudes toward health and the environment. Young women tend to be in a phase of life in which milk is not part of their food practices. Most of the women were not aware of the consequences of omitting milk from their diet and had limited knowledge of iodine and how to secure adequate dietary iodine intake. Awareness of possible consequences of omitting milk from the diet should be promoted along with information on how to secure adequate iodine intake.

Weighing the importance of animal body size in traditional food systems

Traditional food systems based on harvest from the local environment are fundamental to the well-being of many communities, but their security is challenged by rapid socio-ecological change. We synthesized literature and data describing how a fundamental form of biodiversity, animal body size, contributes to the security of traditional food systems through relationships with species availability, accessibility, adequacy, and use. We found larger vertebrate species were more available, accessible, and used on a per kilogram basis, particularly for mammals. Conversely, larger species were no more or less adequate from a combined nutritional, health, and cultural perspective. Larger species represented more biomass, and this biomass required less time to harvest, with greater but more variable mean caloric returns over time. Smaller species provided more consistent caloric returns and were harvested during documented shortages of prey. This reliance on species with a range of body sizes is consistent with optimal foraging theory and the evolutionary value of flexibility, and highlights the importance of a biodiverse pool of species for traditional food security in times of change. Our synthesis of published literature and data highlights the many socio-ecological correlates of species size and how these relate to the security of traditional food systems.

How (not) to feed young children: A class-cultural analysis of food parenting practices

This study unpacks how class processes shape understandings and practices of "good feeding" in families with young children. It brings a Bourdieusian class consumption focus together with food parenting studies and approaches feeding as encompassing a wide range of processes including cooking, shopping, and planning. To capture the lived experience of feeding work, the study draws on a longitudinal and ethnographic study conducted in the south-east of England over the course of two years. The analysis suggests that, regardless of their resources, parents tend to internalize the dominant discourse on "healthy" and "varied" feeding. However, closer inspection of day-to-day practices reveals a nuanced class-cultural patterning in how these terms are defined and achieved. Moreover, it reveals how different interpretations of key notions such as homemade, nutritious, and balanced generate practices that contribute to the cultivation of distinctively classed culinary agencies in children. This study also questions what potential role these understandings can play in reproducing taste hierarchies and maintaining symbolic boundaries from very early ages.

The foodscapes of children and adolescents attending schools in Lima, Peru

Foodscapes are the sum of all places where food and eating are actualized, as well as the institutional arrangements, discourses, cultural practices, trends and meanings that shape the relationship between individuals and food. However, limited research is available on how the different elements of foodscapes (physical, social, institutional) interact to influence children's and adolescents' eating behaviors. The aim of this study was to identify and characterize the factors influencing Peruvian children's and adolescents' practices around food, focusing on the systemic and complex nature of eating. We conducted non-participant observations inside and around two schools-one public and one private-located in Lima, Peru, for an entire school-week, and interviewed 44 parents/caregivers of children and adolescents, ages 6-16. Qualitative content analysis was developed, as its iterative and reflective nature allowed for evolving understandings of the data. Results showed that individual attributes (SES, age and gender) interact with individual agency, the physical environment, parental and peer influence, to determine differentiated food-related outcomes of children and adolescents. Moreover, the state-wide law aiming to protect children's and adolescents' health and nutrition seemed to partially influence the eating practices of parents and children at school and at home. This study is unique in its kind, as existent research has mainly focused on the effects of foodscapes on children and adolescents in Western countries, while research in the Global South, such as Peru, remains mostly underdeveloped. Moreover, this study, unlike previous ones, intends to systematically understand how foodscapes shape children's and adolescents' eating practices.

Monitoring a meat-free pledge with smartphones: An experimental study

Pledges are a popular strategy to encourage meat reduction, though experimental studies of their efficacy are lacking. Three-hundred and twenty-five participants from three different countries (UK, Germany, Australia) were randomly assigned to pledge 28 days meat-free or not, and their behavior was tracked via smartphones. Participants answered daily surveys regarding their eating behavior, meat cravings, and shared photos of their meals. Baseline data was collected prior to the pledge, after the 28 days, and one-month post-intervention. Participants assigned to the pledge condition ate less meat across the 28 days, compared to control participants. Meat reductions, observed at outtake, did not endure one-month post-intervention. Overall, German participants ate the least amount of meat, and showed the sharpest decrease in consumption when pledging. Meat cravings tended to increase among pledgers, relative to control participants. Pledgers who reported high starting intentions and conflict about meat tended to eat less meat and reported fewer cravings. All participants reported reduced meat-eating justifications one-month post-intervention. These findings provide experimental evidence that pledges can encourage meat consumers to reduce their intake, though additional mechanisms are needed to sustain commitments.

Residents' Insights on Their Local Food Environment and Dietary Behaviors: A Cross-City Comparison Using Photovoice in Spain

Perceptions of local food environments and the ability of citizens to engage in participatory research may vary, even if participants share similar cultural and socioeconomic contexts. In this study, we aimed to describe participants’ narratives about their local food environment in two cities in Spain. We used the participatory methodology of Photovoice to engage participants in Madrid (n = 24) and Bilbao (n = 17) who took and discussed photographs about their local food environment (Madrid; n = 163 and Bilbao; n = 70). Common themes emerged across both cities (food insecurity, poverty, use of public spaces for eating and social gathering, cultural diversity and overconsumption of unhealthy foods); however, in Bilbao citizens perceived that there was sufficient availability of healthy foods despite that living in impoverished communities. Photovoice was a useful tool to engage participating citizens to improve their local food environments in both cities. This new approach allowed for a photovoice cross-city comparison that could be useful to fully understand the complexity and diversity of residents’ perceptions regardless of their place of residence.

Adaptation and reliability of 'Nutrition Screening Tool for Every Preschooler' (NutriSTEP) for use as a parent administered questionnaire in New Zealand

AIM

To adapt the validated Canadian Nutrition Screening Tool for Every Pre-schooler (NutriSTEP), for use in New Zealand and test its reliability to identify nutrition risk in pre-school children aged 2-5 years, as a parent administered questionnaire.

METHODS

Adaptations to the Canadian NutriSTEP were undertaken by three registered dietitians (expert review), followed by intercept interviews with pre-schooler parents (n = 26). A second expert review was conducted to finalise the adaptions for online reliability testing. A further 79 pre-schooler parents completed online administrations of the Canadian and adapted NutriSTEP tools, 4 weeks apart in a blinded manner. Intraclass correlation coefficients (ICCs) were used to verify test-retest reliability between the administrations. Individual questionnaire items were verified for reliability between administrations through Cohen's κ statistic (κ), Pearson's χ² value and Fisher's exact test.

RESULTS

Online administrations of the Canadian and adapted NutriSTEP tools were determined to be reliable (ICC = 0.91; P < 0.001). Between NutriSTEP administrations, 13 out of 17 questionnaire items had adequate (κ > 0.5) agreement, one item had excellent agreement (κ > 0.75) with a significant relationship (P < 0.05) between all items. Sensitivity for the adapted NutriSTEP was higher for pre-schoolers at nutrition risk (31.6%) versus the Canadian version (20.3%). Risk items were highest for low intake of breads and cereals (58.2%), milk and milk products (51.9%), meat and meat alternatives (40.5%), child controlling the amount consumed (35.4%) and vegetable intake (34.2%).

CONCLUSION

The Canadian NutriSTEP and the adapted NutriSTEP were reliable between online administrations when completed by parents in the community. The adapted NutriSTEP identified an additional nine preschoolers at increased nutrition risk, demonstrating increased sensitivity in comparison to the Canadian NutriSTEP. Nutrition risk can be identified in early childhood to prevent the development of chronic disease. The adapted NutriSTEP should be considered for future use to identify preschoolers at increased nutrition risk and guide appropriate nutrition intervention.

"We used to get food from the garden." Understanding changing practices of local food production and consumption in small island states

Many Small Island Developing States (SIDS) lead global rates in obesity and non-communicable chronic diseases (NCDs). Drivers for this are complex and include lack of food sovereignty, evidenced by an increasing reliance on cheap nutrient-poor food imports and a focus on export orientated cash crop production for much local agriculture. To better inform SIDS' policy goals of improving nutrition through increased local food production, we explored in two SIDS current practices of food production and consumption. Teams of researchers from the two main regional universities conducted 28 focus groups in Fiji in the Pacific and Saint Vincent and the Grenadines in the Caribbean with rural and urban communities of different socio-economic or land-owning status. In both countries home gardens were still common, valued as providing staple foods to households and contributing to health and livelihoods. Yet social changes had been experienced over the life course and across generations, such as increased purchase of foods, consumption of processed and often imported foods, and fast foods. While participants associated local foods with better nutrition and health outcomes than imported foods, some local foods were also acknowledged as unhealthy (e.g. locally produced tinned products, pesticide contaminated fresh produce). Finally, as food and related health advice moves globally, crossing national boundaries, and through formal and informal channels, local experiences can be confusing and contested. We suggest the need to understand temporal and spatial aspects of social practices, as social practices and their meaning change over time, travel globally and are experienced locally. To enhance and support re-localising food to counteract unhealthy consumption of ultra-processed, shop-bought, often imported foods, it is vital to understand these lived experiences of changes and resulting uncertainties, and to explicitly build on the longstanding positive relationships that people continue to express about home gardens and local food.

Decoding the Role of Gut-Microbiome in the Food Addiction Paradigm

Eating behaviour is characterised by a solid balance between homeostatic and hedonic regulatory mechanisms at the central level and highly influenced by peripheral signals. Among these signals, those generated by the gut microbiota have achieved relevance in recent years. Despite this complex regulation, under certain circumstances eating behaviour can be deregulated becoming addictive. Although there is still an ongoing debate about the food addiction concept, studies agree that patients with eating addictive behaviour present similar symptoms to those experienced by drug addicts, by affecting central areas involved in the control of motivated behaviour. In this context, this review tries to summarise the main data regarding the role of the gut microbiome in eating behaviour and how a gut dysbiosis can be responsible for a maladaptive behaviour such as “food addiction”.

Do dietary patterns and morbidities have a relationship with primary infertility among women? A study from NFHS-4 (2015-16), India

This study assessed the rate of primary infertility and its associated factors among 402,807 currently married women aged 20-49 years in India using National Family Health Survey-4 data collected in 2015-2016. Dietary patterns and selected morbidities were included as independent variables, and socioeconomic variables were considered as covariates. Bivariate and multivariate analyses were done to estimate the prevalence of primary infertility and assess its association with the selected variables, respectively. The rate of primary infertility among currently married women in India in 2015-16 was 1.9% and this was significantly associated with younger age (<35 years), higher age at marriage (≥18 years), urban residence, higher secondary or above education and poverty. The consumption of dairy products (OR = 0.79, CI = 0.73-0.86), dark green leafy vegetables (OR = 0.57, CI = 0.39-0.81) and fruit (OR = 0.88, CI = 0.77-1.01) significantly reduced the odds of primary infertility. Daily consumption of fish and aerated drinks was related to 1.06-1.21 times higher odds of primary infertility. Overweight/obesity, high blood pressure and high blood glucose levels were associated with 1.08-1.21 times elevated odds of primary infertility. Thyroid disorder (OR = 1.38, CI = 1.21-1.60), heart disease (OR = 1.17, CI = 1.16-1.19) and severe anaemia (OR = 1.24, CI = 1.00-1.53) were associated with an increased likelihood of primary infertility among women (OR 1.17-1.39, CI 1.00-1.60). The findings provide compelling evidence that primary infertility among women is related to dietary patterns and morbidities. Interventions and programmes targeting the promotion of healthy diets and lifestyles could be beneficial in addressing the issue of primary infertility among women.

"We're just stuck in a daily routine": Implications of the temporal dimensions, demands and dispositions of mothering for leisure time physical activity

The reduced physical activity of women when they become mothers is a public health priority. Existing studies show that mothers have little time for leisure, or time that is fragmented and requiring negotiation with others. However, the temporal features of mothering are undertheorised and qualitative studies tend to focus on how mothers can skilfully construct physically active identities and balance societal expectations about being a "good mother". In line with other research that focuses on the configuration of everyday practices that condition the "possibilities" for health-related practices like physical activity, we shift our focus away from the resisting capacities of mothers to the temporal features of mothering practices. We interrogate the lived experiences of 15 mothers of preschool children in deprived urban areas and illuminate the inherent temporal dimensions, demands and dispositions of mothering practices that condition the possibility of leisure time physical activity being undertaken. Together, these temporal features mean mothering practices can readily work against leisure time physical activity. The focus on the mothering practices rather than mothers brings a novel perspective for developing public health policy designed to support mothers into regular leisure time physical activity.

Dyadic Interviews versus In-Depth Individual Interviews in Exploring Food Choices of Norwegian Older Adults: A Comparison of Two Qualitative Methods

The term “dyadic interview” refers to interviewing two participants together. Although there has been an increase in the use of dyadic interviews as a data collection method in qualitative studies, the literature on the use of this method with older adults is limited. This study was designed to explore the suitability of dyadic interviews as a method of data collection among older adults living at home. The study involved a direct comparison of the data obtained from dyadic interviews and in-depth individual interviews concerning older adults’ food choices. The study sample consisted of eight dyads for the dyadic interviews and six participants for the in-depth individual interviews. The dyads were composed of pairs who share a pre-existing relationship as well as pairs of strangers. We also discussed the role of participant selection and pairing in dyadic interviewing and how the interactions between the dyads may affect the result. Our results indicated that dyadic interviews can be used as an important data collection tool for home-living older adults, particularly when exploring a topic that often involves a dyadic decision. Our findings can be useful for researchers to make a more informed choice when choosing qualitative data collection methods, particularly when interviewing older people.

Obese societies: Reconceptualising the challenge for public health

The prevalence of obesity and related health problems has increased sharply in recent decades. Dominant medical, economic, psychological, and especially epidemiological accounts conceptualise these trends as outcomes of individuals' lifestyles - whether freely chosen or determined by an array of obesogenic factors. As such, they rest on forms of methodological individualism, causal narratives, and a logic of substitution in which people are encouraged to set currently unhealthy ways of life aside. This article takes a different approach, viewing trends in obesity as consequences of the dynamic organisation of social practices across space and time. By combining theories of practice with emerging accounts of epigenetics, we explain how changing constellations of practices leave their marks on the body. We extend the concept of biohabitus to show how differences in health, well-being, and body shape are passed on as relations between practices are reproduced and transformed over time. In the final section, we take stock of the practical implications of these ideas and conclude by making the case for extended forms of enquiry and policy intervention that put the organisation of practices front and centre.

Feeding the Australian family: challenges for mothers, nutrition and equity

Australian women shoulder the bulk of household duties including family food provisioning, despite increasing participation in the workforce. This research aimed to understand employed mothers' daily-lived experience of family food provisioning, in particular, the intersection between family food provisioning, gender inequality and nutritional guidelines as they impact women's time and health. Semi-structured interviews were conducted with 22 employed mothers in South Australia. Participants had at least one child aged less than 13 years. Qualitative data was analysed using a thematic content approach. Time-scarcity was common and associated with stress in relation to family food provisioning; this relationship was particularly apparent among employed mothers who were also studying. Most mothers valued nutrition and strove to provide nutritious meals, although they tended to work from their own nutritional understandings, not the national nutrition guidelines; they saw the nutrition guidelines as unhelpful because of the time demands that were implied. The study invites policy makers, practitioners and researchers to consider time for family food provisioning as a social determinant of family as well as women's health, and structural strategies to address this health inequity for women.

Individual responsibilities, collective issues: The framing of dietary practices in Latvian media

Topics concerning food and diets have gained prominence in academic writing, policy debates and media coverage, not least due to public health problems, sedentary lifestyles, and concerns regarding dietary habits and the impact of food production on climate change. The purpose of this paper is to reveal the ways dietary practices have been framed in the media through an analysis of Latvian print and digital media articles. A selection of 192 media articles published between 2014 and 2019 were analysed through the perspective of framing. The analysis identifies three prominent frames found in Latvian media: (i) a biomedical frame, (ii) a psychological frame, and (iii) a social practice frame. The frames are connected by several cross-cutting themes: individualisation, self-disciplining, gendering, and medicalisation. The results suggest that the media portray unhealthy dietary as the responsibility of individuals, whilst ignoring, with some exceptions, the impact of broader societal and food system processes. These results call for more attention to be paid by media content creators to the diversity of actors involved in food production, consumption and distribution and their inter-connections, as well as the impact that food systems have on economic, social, and ecological sustainability.

Planting seeds of change: reconceptualizing what people eat as eating practices and patterns

Language focused on individual dietary behaviors, or alternatively, lifestyle choices or decisions, suggests that what people eat and drink is primarily a choice that comes down to free will. Referring to and intervening upon food consumption as though it were a freely chosen behavior has an inherently logical appeal due to its simplicity and easily defined targets of intervention. However, despite decades of behavioral interventions, population-level patterns of food consumption remain suboptimal. This debate paper interrogates the manner in which language frames how problems related to poor diet quality are understood and addressed within society. We argue that referring to food consumption as a behavior conveys the idea that it is primarily a freely chosen act that can be ameliorated through imploring and educating individuals to make better selections. Leveraging practice theory, we subsequently propose that using the alternative language of eating practices and patterns better conveys the socially situated nature of food consumption. This language may therefore point to novel avenues for intervention beyond educating and motivating individuals to eat more healthfully, to instead focus on creating supportive contexts that enable sustained positive dietary change. Clearly, shifting discourse will not on its own transform the science and practice of nutrition. Nevertheless, the seeds of change may lie in aligning our terminology, and thus, our framing, with desired solutions.

Linking socioeconomic disadvantage to healthiness of food practices: Can a practice-theoretical perspective sharpen everyday life analysis?

Food is one of the key themes in public health policy and debates over inequalities in health. In this article, we argue that more research is needed to understand how socioeconomic disadvantage is translated into low degrees of healthiness. We suggest that everyday life analysis may be sharpened by way of drawing upon a practice-theoretical perspective on the mundane processes involved in this translation. We base our suggestion on a small review of three strands in the literature on social inequality, food and health, namely public health research, lifestyle analysis and everyday life studies, and we take our analytical starting point in the latter. In the article, we argue that a practice-theoretical perspective may enable research in social disadvantage and healthiness of food that describes and interprets variants in the conditioned agency, which cuts cross the multiplicity of different practices that make-up people's daily lives. Finally, we suggest that a stronger focus on social interaction and social hierarchy would adapt a practice-theoretical perspective further to empirical analysis in the field of food, health and socioeconomic disadvantage.

Promoting healthy eating in the community sport setting: a scoping review

Community sport organizations promote beneficial health outcomes such as social connection and physical activity, yet they can also facilitate the consumption of unhealthy food and beverages. To provide a foundation for future research and to inform intervention efforts in this context, this scoping review summarizes existing knowledge of the factors that contribute to unhealthy food and beverage consumption in the community sport setting and explores the interventions to promote healthier choices. Using a qualitative process aligned with the nature of our aims, 228 articles were initially identified and subjected to a systemized appraisal, resulting in 45 articles pertinent to the review. The findings identify that the two key factors contributing to unhealthy food choices are the limited availability of healthy options within the sport setting and the presence of unhealthy food and beverage sponsorship. These factors contribute to the normalization of unhealthy eating in this context and health promotion interventions have had limited success. Barriers to change primarily stem from the revenue implications of removing unhealthy food sponsors, lack of organizational capabilities and resources, and consumer preference for unhealthy options. Public health practitioners seeking to intervene in this setting should consider adopting practices used in other settings outside of the sport environment, including the use of technology, the role of peers and mentors and the co-production of impactful material. Community sport plays a vital role in delivering health benefits but must do more to stem its facilitation of a potentially unhealthy consumptive environment.

The social gradient in smoking: individual behaviour, norms and nicotine dependence in the later stages of the cigarette epidemic

The cigarette epidemic tends to develop in a similar pattern across diverse populations in different parts of the world. First, the prevalence of smoking increases, then it plateaus and finally it declines. The decline in smoking prevalence tends to be more pronounced in higher social strata. The later stages of the cigarette epidemic are characterized by emerging and persisting socioeconomic gradients in smoking. Due to its detrimental health consequences, smoking has been the subject of extensive research in a broad range of academic disciplines. I draw on literature from both the social and medical sciences in order to develop a model in which physiological nicotine dependence, individual smoking behaviour and norms surrounding smoking in the immediate social environment are related through reflexive processes. I argue that the emergence and persistence of social gradients in smoking at the later stages of the cigarette epidemic can be attributed to a combination of the pharmacological properties of nicotine, network homophily and the unequal distribution of material and non-material resources across social strata.

Acting against obesity: a cross-cultural analysis of prevention models in Spain, Argentina and Brazil

This article analyses and compares preventive models for obesity in Spain, Argentina and Brazil through an examination of the respective measures adopted to counter it in those countries. Based on a qualitative study of the main actions carried out since 2004, the aim is to delineate the conceptual framework and reflect on the reasons for their relative effectiveness. The results show that in contexts where prevalence has increased rapidly, sociocultural causes acquire greater explanatory power as opposed to biological and/or behavioral factors. These models premise worsening diets and sedentary lifestyles as being the main culprits, and assume that contemporary societies generate obesogenic and toxic environments. The international health bodies have developed specific strategies to control and prevent obesity based on this diagnosis, and these have been supported by member states such as Spain, Argentina and Brazil. Although the measures reflect certain particularities, they conform to a common pattern organized from platforms promoting so-called "healthy lifestyles" and articulated mainly around the twin axes of a balanced diet and regular physical exercise. The discussion suggests that the excessive emphasis on individual responsibility and the underplaying of the role of food as a complex practice, as well as changing structural factors and the differential distribution of this disease, might largely explain the limited impact of these strategies.

Time Course and Determinants of Individual Motivation among Women Enrolled in a Diet and Physical Activity Primary Prevention Trial

We studied the determinants of motivation among post-menopausal women enrolled in a two-year diet and physical activity primary prevention randomized trial. Participants were requested to grade the importance attached to changing their lifestyle, their confidence about being able to implement the change, and their willingness to be involved in studies focusing on lifestyle. We used multi-adjusted regression to investigate the association between individual characteristics, study arm, and individual motivation at study entry and end. Participants (n = 234) were highly motivated both at entry and throughout the study. Women with pre-existing healthier eating habits and lifestyles (e.g., high consumption of fruit and vegetables, low red meat consumption, and physically active) were more motivated at entry and over the course of the study. Women assigned to any intervention arm were more motivated than those in the control arm. These findings may help enhance adherence to recommendations and improve effectiveness of community-based health promotion campaigns.