Healthy diet: Health impact, prevalence, correlates, and interventions

Abstract

Objective: To discuss healthy diet from a psychological perspective by considering definitions of healthy diet in terms of consumer understanding; the health effects of specific dietary elements in terms of overweight and (chronic) illness; the prevalence of healthy diet; the psychological and environmental determinants of healthy diet; and the psychological interventions that have been designed to promote healthy diet. Design: A systematic review of the psychological literature on healthy diet. Results: Our findings suggest that consumers have a relatively poor understanding of a healthy diet. The literature also demonstrates that there is poor evidence on the health protective effects of single foods or nutrients. We further show that low SES is the single consistent risk factor for not adhering to a healthy diet. Our review of the literature on determinants demonstrates that intentions, habits, self-regulatory skills, and the social and physical environment are the most important determinants of a healthy diet, which are in turn amenable to change by intervention strategies with varying levels of effectiveness. Educational interventions generally show a limited effect on practising a healthy diet whereas interventions targeting habitual behaviour and/or the physical environment seem more promising. Conclusions: In view of the large number of people who are concerned about their diets and make attempts to change their dietary patterns, we conclude that it is crucial to gain a better understanding of both the automatic and environmental influences that are responsible for people not acting upon their good intentions for diet change.

Health behaviour: Current issues and challenges

“…For example, objective measures of blood alcohol levels only assess alcohol consumption over a limited (recent) timeframe. In relation to healthy diet, the difficulties are amplified due to the current lack of any simple objective measurement (de Ridder et al, 2017). Selfreported measurement of healthy diet is also problematic due to the complexity of the behaviour 4 (e.g., estimating the macronutrient content of consumed items to produce a measure of fat intake or the extent to which one complies with a set of recommendations in the Mediterranean diet).…”

“…Unfortunately, although there is a growing body of research that details variations in health behaviours across the population, there is also considerable unevenness in the data and its availability. A lot more is known about the distribution of behaviours such as smoking (West, 2017) and physical activity (Rhodes et al, 2017) than about binge drinking (Kuntsche et al, 2017) and healthy diet (de Ridder et al, 2017). The surveillance of health 6 behaviours using standard definitions and measures across countries (as is being explored in the EU) could contribute to furthering our understanding of both the determinants and consequences of these behaviours.…”

“…However, such comparisons of data across countries are dependent on common approaches to defining and measuring health behaviours. Unfortunately we are some way from such common approaches in relation to diet (de Ridder et al, 2017) and binge drinking (Kuntsche et al, 2017) although we may be somewhat closer in relation to smoking (West, 2017) and physical activity (Rhodes et al, 2017).…”

Emotion, health decision making, and health behaviour

“…Because behaviour such as smoking, overeating, and drinking alcohol can be used to regulate emotion or reduce stress (see also Adam & Epel, 2007;DeSteno et al, 2013;de Ridder, Kroese, Evers, Adriaanse, & Gillebaart, 2017;Ferrer et al, 2015;Kuntsche, Kuntsche, Thrul, & Gmel, 2017), poorly managed negative affect can have deleterious consequences for health. For example, maladaptive emotion regulatory strategies have been linked to unhealthy eating behaviour (Evers, Marijn Stok, & de Ridder, 2010;Ferrer et al, 2017;Vandewalle, Moens, Beyers, & Braet, 2016; although see Adriaanse, de Ridder, & Evers, 2011).…”

Evaluation of an approach–avoidance training intervention for children and adolescents with obesity: A randomized placebo‐controlled prospective trial

“…Nevertheless, this can be considered as a first tentative hint for a beneficial treatment effect. The excessive consumption of high‐caloric food is an important maintaining factor in obesity (de Ridder, Kroese, Evers, Adriaanse, & Gillebaart, ), and even small reductions (as provoked by AAT) might be associated with positive weight and health outcomes.…”