Stages of change and factors associated with misperceived eating behavior in obese individuals

Abstract

Objective: To evaluate the stages of behavior change related to fat and fruit/vegetable intakes and the factors associated with misperceived eating behavior (pseudo-maintenance). Methods: This cross-sectional study collected sociodemographic, socioeconomic, health, and food intake data from obese individuals (n=103) aged ≥20 years. Stages of behavior change according to the Transtheoretical Model were measured for fat and fruit/vegetable intakes. The pseudo-maintenance stage was reclassified in subjects in the action/maintenance stage who had inappropriate food habits. Multiple logistic regression models were proposed to assess the factors associated with misperceptions. Results: The prevalences of pseudo-maintenance for fat and fruit/vegetable intakes were 23.3 and 19.4%, respectively. The factors associated with misperceived fat intake were overconsumption of saturated fatty acids (OR=3.84; 1.18-12.56) and age (OR=1.06; 1.02-1.11), and with fruit and vegetable intake, income (OR=0.99; 0.98-0.99). Conclusion: The results reveal that perceived eating behavior and actual food intake diverge from anthropometric and health data, signaling the need of different intervention strategies to raise awareness in this group for the need of modifications.

Perception versus intake of fruit and vegetables

“…As for national investigations, only two studies that assessed the reclassification in PM and/or NRA for FV intake were found [11,16]. However, the comparison of the results with the present study proved to be inadequate due to the different groups studied and methodologies used to classify and reclassify the stages of change, which reveals the lack of reproducibility of current national studies in this field.…”

“…The PAS was chosen for this study because of its unique characteristics concerning health promotion, which are intrinsically related to the intake of FV, its focus on empowerment and autonomy of the participants, and its recent implementation in the SUS. A study conducted on the perception of food intake in this healthcare service found 19.4% of pseudo-maintenance for FV intake (assessed as a single group) among obese individuals [11].…”

“…The five stages of change (pre-contemplation, contemplation, preparation, action, and maintenance) are obtained from the initial classification of individuals that is carried out by applying an algorithm that can be based on the individuals' perception of their intake (e.g., selfreport: Do you consider your current intake of FV to be adequate?) or by the estimation of food intake (application of nutrition surveys) without, however, contemplating the two aspects simultaneously [11].…”

“…Methods that evaluate the individuals' perceptions have become a trend, particularly in large-scale studies such as national surveys, as they allow a simple and fast evaluation [12] based on self-reports, "opinions", "attitudes" or self-assessments of food intake [11,13]. This approach is promising as it broadens the understanding of the mechanisms related to behavior change, and it is fundamental that individuals recognize their eating habits and deal with their health conditions [11].…”

“…This approach is promising as it broadens the understanding of the mechanisms related to behavior change, and it is fundamental that individuals recognize their eating habits and deal with their health conditions [11].…”