Review: Determinants of Healthy Eating

The paper reviewed here is ‘Determinants of Healthy Eating: Motivation, Abilities and Environmental Opportunities’ by Johannes Brug and freely available here. I thought was a useful topic to examine as patterns of eating behaviour can influence outcomes in a wide-range of mental illnesses and are indeed used in the diagnostic criteria of a number of illnesses. So it seems reasonable to ask what models are there relating to eating behaviour. Brug presents a very broad psychosocial model and I was particularly interested in the intentionality aspect of the psychological component of this model. He outlines a structure proposed by M Rothschild in which motivation, ability and opportunity provide an explanatory framework. The article is relatively brief and consists of an overview of a model of healthy eating determinants together with a precis of some of Brug et al’s  systematic analyses of intervention or observational trials relating to eating and modifiers of eating behaviours. He cites a model in which four determinants of intention are outlined – these are

1. Attitudes. The evidence base here points to a weighing-up of short-term and long-term outcomes – benefits and risks. Short-term outcomes are prioritised. Thus for instance short-term factors such as a pleasant taste would outweigh long-term health risks.

2. Self-efficacy. The extent to which a person believes that they have control over their behaviours will influence these same behaviours.

3. Self-identity. Apparently there isn’t much evidence in this area.

4. Social influences. According to the ANGELO framework these are divided into Axis 1 and Axis 2. Axis 1 consists of micro-environments – immediate locations for food e.g shops and macro-environments which consists of informal infrastructures which influence eating behaviours. Axis 2 consists of physical, political, economic and socio-cultural factors.

In terms of the trials, Brug tells us that the data could be stronger but draws conclusions about the importance of parental influence, modelling and social support, accessibility and availability of healthy/unhealthy foods and socioeconomic factors. In summary Brug presents us with a simple model of determinants of eating behaviour but a knowledge of this model can be used to offer another perspective on relevant illnesses.

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