Individual and Environmental Factors Influencing Adolescents' Dietary Behavior in Low- and Middle-Income Settings.

OBJECTIVE: Given the public health importance of improving dietary behavior in chronic disease prevention in low- and middle-income countries it is crucial to understand the factors influencing dietary behavior in these settings. This study tested the validity of a conceptual framework linking individual and environmental factors to dietary behavior among Ecuadorian adolescents aged 10-16 years. METHODS: A cross-sectional survey was conducted in 784 school-going Ecuadorian adolescents in urban and rural Southern Ecuador. Participants provided data on socio-economic status, anthropometry, dietary behavior and its determining factors. The relationships between individual (perceived benefits and barriers, self-efficacy, habit strength, and a better understanding of healthy food) and environmental factors (physical environment: accessibility to healthy food; social environment: parental permissiveness and school support), and their association with key components of dietary behavior (fruit and vegetables, sugary drinks, breakfast, and unhealthy snack intake) were assessed using structural equation modeling. RESULTS: The conceptual model performed well for each component of eating behavior, indicating acceptable goodness-of-fit for both the measurement and structural models. Models for vegetable intake and unhealthy snacking showed significant and direct effects of individual factors (perceived benefits). For breakfast and sugary drink consumption, there was a direct and positive association with socio-environmental factors (school support and parental permissiveness). Access to healthy food was associated indirectly with all eating behaviors (except for sugary drink intake) and this effect operated through socio-environmental (parental permissiveness and school support) and individual factors (perceived benefits). CONCLUSION: Our study demonstrated that key components of adolescents' dietary behaviors are influenced by a complex interplay of individual and environmental factors. The findings indicate that the influence of these factors varied by type of dietary behavior.

Consumers' health risk-benefit perception of seafood and attitude toward the marine environment: Insights from five European countries.

This research classifies European consumers into segments based on their health risk-benefit perception related to seafood consumption. The profiling variables of these segments are seafood consumption frequency, general attitude toward consuming fish, confidence in control organizations, attitude toward the marine environment, environmental concern and socio-demographics. A web-based survey was performed in one western European country (Belgium), one northern European country (Ireland) and three southern European countries (Italy, Portugal and Spain), resulting in a total sample of 2824 participants. A cluster analysis was performed based on risk-benefit perception related to seafood and the profiles of the segments were determined by a robust 2-way ANOVA analysis accounting for country effects. Although this study confirms consumers' positive image of consuming seafood, gradients are found in health risk-benefit perception related to seafood consumption. Seafood consumption frequency is mainly determined by country-related traditions and habits related to seafood rather than by risk-benefit perceptions. Segments with a higher benefit perception, irrespective of their level of risk perception, show a more positive attitude toward consuming seafood and toward the marine environment; moreover, they report a higher concern about the marine environment and have a higher involvement with seafood and with the marine environment. Consequently, information campaigns concentrating on pro-environmental behavior are recommended to raise the involvement with seafood and the marine environment as this is associated with a higher environmental concern. This research underpins that in such information campaigns a nationally differentiated rather than a pan-European or international information strategy should be aimed for because of significant cultural differences between the identified segments.

Food choice questionnaire revisited in four countries. Does it still measure the same?

This study focuses on the implementation of the food choice questionnaire (FCQ) across four countries. The first objective is to examine the degree to which the factor structure of the FCQ is invariant across different populations. The second objective is to analyse the motives for food choice in different countries. The cross-sectional sample of 1420 consumers consisted of Belgians (N=458), Hungarians (N=401), Romanians (N=229) and Filipinos (N=332). Data analyses included estimation of five multi-group confirmatory factor analysis models; calculation of mean importance ratings for each food choice factor across countries; ANOVA and Tukey post hoc tests; and a rank order test of most to least important factors within each country. The results confirm that the factorial structure of the FCQ is invariant with respect to factor configuration, factor loadings and item intercept. Sensory appeal is the most important factor among all European consumers, while health, convenience and price were all among the five most important factors shaping food choice in Belgium, Hungary and Romania. For Filipinos, the most important were health, price and mood. Sensory appeal ranked on the fourth place.

Association of overweight and obesity with interest in healthy eating, subjective health and perceived risk of chronic diseases in three European countries.

This paper analyses cultural differences in consumers' interest in healthy eating, subjective health and perceived risk of (chronic) diseases, and identifies the association between nutritional status (obesity and overweight) and the above mentioned variables as well as people's socio-demographic characteristics and health conditions that may influence food choice. Cross-sectional data were collected through a consumer survey (n=2400) in 2008 with samples representative for age and region in France, Poland and Spain. Body-mass-index (BMI) was inversely associated with education and positively associated with age. Women were less likely to be overweight than men. Subjective health was negatively associated with the likelihood of being obese. The likelihood of being obese decreased with higher perceived risk of suffering from stress and from cancer, whilst the likelihood of being overweight decreased with higher perceived risk of suffering from stress. Despite a tendency of lower interest in healthy eating among obese consumers, interest in healthy eating was not significantly associated with the likelihood of being obese or overweight after Holm-Bonferroni correction. The findings of this study suggest that health consequences and disease risks of excessive weight should be better communicated to European populations. Furthermore, factors associated with obesity such as subjective health and perceived risk of chronic diseases should be considered both at individual counselling and at public health policy levels.

Association between traditional food consumption and motives for food choice in six European countries.

This study investigates the association between traditional food consumption and motives for food choice in six European countries. Cross-sectional data were collected through the TRUEFOOD pan-European consumer survey (n = 4828) with samples representative for age, gender and region in Belgium, France, Italy, Norway, Poland and Spain. Importance attached to familiarity with a product is found to be strongly and positively associated with general attitude toward traditional food as well as traditional food consumption. The importance attached to convenience was negatively related to both general attitude toward traditional food and traditional food consumption, while the importance of weight control negatively influenced the general attitude. Natural content of food was positively associated with the attitude toward traditional food and traditional food consumption. The importance of price when purchasing food failed to be significantly related with general attitude and traditional food consumption both for the pooled sample as well as within each country except in Spain. The proposed model contributes to a better understanding of factors shaping the image and influencing the consumption of traditional foods in Europe. General attitude toward traditional foods, familiarity, and importance of food naturalness emerged as drivers for traditional food consumption. Importance attached to convenience and health acted as direct barriers to traditional food consumption, whereas importance of weight control emerged as an indirect barrier through lowering general attitude toward traditional foods.