Most of us have a good idea of what a healthy diet is. We may be short on a few particulars, but in general, we know that eating fruits and vegetables are good for us, along with certain dairy, fish and meats. Conversely we know that processed and packaged foods are not so great, and their intake should be limited.
Despite this knowledge, adherence to a healthy diet is hard and many people fall short of eating healthy foods. For example, in the US, 12% of adults meet the recommended amounts of daily fruit and vegetables, while 30% of Canadians do (this large difference may be due to variations in country-specific guidelines, which are generally around 5 to 10 servings per day).
It’s not that people don’t want to eat healthy, people do want to eat healthier, or at least recognize they could eat better. It’s no different from the person who wants to exercise and doesn’t, or the smoker who knows that smoking is bad for him/her. So for most of us, the knowledge, or the what of a diet is not the problem. It’s more of the how; How do I get my fruits and vegetables servings each day? How can I purchase healthy foods? One survey reported that people found it easier to do their taxes than eat healthy. Knowing how hard taxes are (I pay an accountant to do mine), this is a disheartening barrier.
So why is it that people don’t eat as healthy as they want to? A lot of it has to do with the challenges of making a change, which I explored more deeply in previous blogs. Change is hard and there is a fear of the unknown and a fear of failure. But this just covers one aspect of change when it comes to eating differently. While individual responsibility has a key role, unless we can grow all of the food we need ourselves in our own backyard, our access to food depends on a lot of circumstances beyond our control.
Much to the chagrin of my exercise colleagues, I have been known to say that changing eating habits is a lot harder than starting an exercise program. Maybe I’m being simplistic, but to exercise, you can just go outside to walk, run or bike, plus you either are, or are not exercising, and it’s essentially free. With eating, it’s far more complex; you need to eat to live, you need money to buy food, time to buy it, store it and prepare it. This complexity is reflected by the main reasons why people eat what they do: taste, cost and convenience. Add on the fact that food for many people has a place in their culture and it is more than just something that provides sustenance.
When it comes to deciding what food to eat, we can only make choices based on the options in front of us. Let’s say you’re buying a car, if it only comes in blue or red, chances are you’ll end up owning either a blue or red car. In doing so, you’ve made an individual choice but only within the options of the colours the factory has decided to make; the choice of colours available was out of your control.
The same thing happens when it comes to food. If we don’t have access to healthy foods, we’re unlikely to buy and eat them. And when I say access, I mean convenient and affordable access. The foods we eat are likely to parallel the foods available in our neighbourhood, and why shouldn’t they; we spend a lot of time in and around were we live.
Not surprisingly fast food consumption is greater in areas where there are more fast food restaurants. Similarly, living in an area where there is limited access to affordable healthy foods, a so-called food desert, is associated with higher levels of risk factors for heart disease such as high blood pressure, high blood sugar and more obesity.
Conversely, being close to a supermarket may not matter as much in terms of risk factors. This may be because many people drive to supermarkets and are therefore willing to travel further distances. Indeed, we found that over 50% of people surveyed travelled more than 1 km to get to their regular supermarket.
It’s not just having the stores nearby that plays a role in what we buy, and therefore what we eat. How the store is set up also influences us. In the world of marketing, it has long been known that where items are situated on a shelf can influence what gets sold. In general, the more shelf space an item is given, the more it sells. In addition, items at eye level and at the end of aisles often sell better. And those sugary snacks and tabloid magazines at the check-out counter are there to entice you to buy them too.
Of course price is also important when buying food. We were surprised to learn that shoppers at supermarkets with lower prices had a greater risk for obesity compared to supermarkets with higher prices. This has been confirmed in other studies as well. This isn’t to suggest that we should raise prices to help curb obesity, but it may reflect that at the lower priced supermarkets, we tend to buy more food and once in our house, we might be tempted to eat it more quickly.
It’s only in the last decade or so that the health field has started to realize what impact the food environment has on what we eat and the role in long-term health. Given what we know, it can definitely be challenging to eat healthy (and I didn’t even touch on the advertisements we’re exposed to in various forms of media). But having this knowledge has also helped to shape our neighbourhoods so that access to healthy foods can improve. As an individual, understanding how our environment influences our eating habits can empower us to make more informed choices on where we buy our foods and exert pressure so that the healthy food choices become the easier food choices.
In upcoming blogs I’ll discuss tips for eating healthy.