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Promoting and disseminating consistent and effective nutrition messages: challenges and opportunities

Published online by Cambridge University Press:  06 January 2023

Carrie HS Ruxton Open the ORCID record for Carrie HS Ruxton [Opens in a new window] ,
Maria A Ruani Open the ORCID record for Maria A Ruani [Opens in a new window]  and
Charlotte EL Evans
Carrie HS Ruxton*
Affiliation:
Nutrition Communications, Cupar, UK
Maria A Ruani
Affiliation:
Faculty of Education and Society, University College London, London, UK The Health Sciences Academy, London, UK
Charlotte EL Evans
Affiliation:
School of Food Science and Nutrition, University of Leeds, UK
*
*Corresponding author: Carrie Ruxton, email carrie@nutrition-communications.com
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Abstract

Nutrition messages are a central part of policy making as well as communication via product information, advertising, healthcare advice and lifestyle campaigns. However, with amplified information (and misinformation) from a growing number of sources, inconsistent and conflicting food landscapes, and limited engagement from the public, nutrition messaging tensions have become more accentuated than previously. In this review, we focus on the challenges facing those wishing to effect dietary change through communication; and identify opportunities and future research questions. Beginning with a new working definition and taxonomy for the term ‘nutrition message’, we consider the evolution of public health nutrition messages from the past century and discuss which types of messages may be more effective. We then turn to the challenges of implementation and highlight specific barriers to recipients' understanding and change. While the evidence has many gaps and there is a need for systematic evaluation of nutrition messages, research indicates that recipients are more likely to act on fewer messages that provide clear benefits and which resonate with their perceived health needs, and which are relatively straightforward to implement. Effectiveness may be improved through consideration of how nutrition messages can be designed to complement key non-health drivers of food choice (taste, cost) and societal/cultural norms. Consistency can be achieved by aligning the wider food and messaging environment to desired public health actions; that is by ensuring that retail settings provide and signpost healthier choices, and that mass media nutrition messages work with, not against, public health advice.

Keywords

Nutrition communicationPublic healthEffectivenessComplianceBarriers to change
Type
Conference on ‘Food and nutrition: Pathways to a sustainable future’
Information
Proceedings of the Nutrition Society , Volume 82 , Issue 3 , September 2023 , pp. 394 - 405
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Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of The Nutrition Society

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References

Ruxton, C (1999) Why is so much good dietary advice being ignored? Nutr Bull 24, 117–121.CrossRefGoogle Scholar
NHS (2022) Why 5-a-day? https://www.nhs.uk/live-well/eat-well/5-a-day/why-5-a-day/ (accessed September 2022).Google Scholar
GBD 2019 Risk Factors Collaborators (2020) Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the global burden of disease study 2019. Lancet 396, 1223–1249.CrossRefGoogle Scholar
Chen, Y & Chai, L (2022) How far are we from the planetary health diet? A threshold regression analysis of global diets. Foods 11, 986.CrossRefGoogle Scholar
Springmann, M, Spajic, L, Clark, MA et al. (2020) The healthiness and sustainability of national and global food based dietary guidelines: modelling study. Br Med J 370, 2322.CrossRefGoogle ScholarPubMed
Chen, C, Chaudhary, A & Mathys, A (2019) Dietary change scenarios and implications for environmental, nutrition, human health and economic dimensions of food sustainability. Nutrients 11, 856.CrossRefGoogle ScholarPubMed
Paris, JMG, Falkenberg, T, Nöthlings, U et al. (2022) Changing dietary patterns is necessary to improve the sustainability of Western diets from a One Health perspective. Sci Total Environ 811, 151437.CrossRefGoogle ScholarPubMed
Eat-Lancet Commission (2019) Healthy diets from sustainable food systems. https://eatforum.org/eat-lancet-commission/eat-lancet-commission-summary-report/ (accessed September 2022).Google Scholar
Bach-Faig, A, Wickramasinghe, K, Panadero, N et al. (2022) Consensus-building around the conceptualisation and implementation of sustainable healthy diets: a foundation for policymakers. BMC Public Health 22, 1480.CrossRefGoogle ScholarPubMed
Steenson, S & Buttriss, JL (2021) Healthier and more sustainable diets: what changes are needed in high-income countries? Nutr Bull 46, 279–309.CrossRefGoogle Scholar
Scheelbeek, P, Green, R & Papier, K (2020) Health impacts and environmental footprints of diets that meet the Eatwell Guide recommendations: analyses of multiple UK studies. BMJ Open 10, e037554.CrossRefGoogle ScholarPubMed
Food and Agricultural Organisation of the United Nations (2022) Dietary guidelines and sustainability. https://www.fao.org/nutrition/education/food-dietary-guidelines/background/sustainable-dietary-guidelines/en/ (accessed September 2022).Google Scholar
Department for Environment, Food and Rural Affairs [DEFRA] (2015) 75 years of family food. https://www.gov.uk/government/statistics/family-food-2015 (accessed September 2022).Google Scholar
Ministry of Food (1952) Domestic Food Consumption and Expenditure, 1950. London: HMSO.Google Scholar
DEFRA (2022) Family food 2019/20. https://www.gov.uk/government/statistics/family-food-201920/family-food-201920#chart-11-uk-average-expenditure-on-food-and-drink-per-person-per-week-201920 (accessed September 2022).Google Scholar
Moseley, KL (2021) From Beveridge Britain to Birds Eye Britain: shaping knowledge about ‘healthy eating’ in the mid-to-late twentieth-century. Contemp Br Hist 35, 515–544.CrossRefGoogle Scholar
Shao, A, Drewnowski, A, Willcox, DC et al. (2017) Optimal nutrition and the ever-changing dietary landscape: a conference report. Eur J Nutr 56(Suppl. 1), 1–21.CrossRefGoogle ScholarPubMed
Mozaffarian, D, Rosenberg, I & Uauy, R (2018) History of modern nutrition science-implications for current research, dietary guidelines, and food policy. Br Med J 361, k2392.CrossRefGoogle ScholarPubMed
Department of Health and Social Security (1976) Prevention and Health: Everybody's Business: A Reassessment of Public and Personal Health. London: HMSO.Google Scholar
Evans, CEL (editor) (2022) Transforming Food Environments. London: CRC Press.CrossRefGoogle Scholar
National Advisory Committee on Nutrition Education (1983) Nutritional guidelines and NACNE – what next? Health Educ J 42, 96–96.CrossRefGoogle Scholar
Committee on Medical Aspects of Food Policy (1991) Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. London: HMSO.Google Scholar
FAO (2022) Food-based dietary guidelines – United Kingdom. https://www.fao.org/nutrition/education/food-dietary-guidelines/regions/countries/united-kingdom/en/ (accessed September 2022).Google Scholar
World Health Organisation (2004) Promoting fruit and vegetable consumption around the world. https://web.archive.org/web/20040629234326/http:/www.who.int/dietphysicalactivity/fruit/en/index.html (accessed September 2022).Google Scholar
Scientific Advisory Committee on Nutrition (2015) Carbohydrates and Health. https://www.gov.uk/government/publications/sacn-carbohydrates-and-health-report (accessed September 2022).Google Scholar
Public Health England (2015) Why 5%? https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/769482/Why_5__-_The_Science_Behind_SACN.pdf (accessed September 2022).Google Scholar
Scarborough, P, Matthews, A, Eyles, H et al. (2015) Reds are more important than greens: how UK supermarket shoppers use the different information on a traffic light nutrition label in a choice experiment. Int J Behav Nutr Phys Act 12, 151.CrossRefGoogle Scholar
Franco-Arellano, B, Vanderlee, L, Ahmed, M et al. (2020) Consumers’ implicit and explicit recall, understanding and perceptions of products with nutrition-related messages: an online survey. Int J Environ Res Public Health 17, 8213.CrossRefGoogle ScholarPubMed
Public Health England (2016) National Diet and Nutrition Survey. https://www.gov.uk/government/collections/national-diet-and-nutrition-survey#full-publication-update-history (accessed September 2022).Google Scholar
Qiao, J, Lin, X, Wu, Y et al. (2022) Global burden of non-communicable diseases attributable to dietary risks in 1990–2019. J Hum Nutr Diet 35, 202–213.CrossRefGoogle ScholarPubMed
Public Health England (2020) NDNS: results from years 9 to 11 (2016 to 2017 and 2018 to 2019). https://www.gov.uk/government/statistics/ndns-results-from-years-9-to-11-2016-to-2017-and-2018-to-2019 (accessed September 2022).Google Scholar
Barton, KL & Ronald, C (2021) Estimation of food and nutrient intakes from food purchase data in Scotland 2001–2018. https://www.foodstandards.gov.scot/publications-and-research/publications/estimation-of-food-and-nutrient-intakes-from-food-purchase-data-in-scotland-between-2001-and-2018 (accessed September 2022).Google Scholar
Scottish Government (2016) Scottish dietary goals: March 2016. https://www.gov.scot/publications/scottish-dietary-goals-march-2016/ (accessed September 2022).Google Scholar
Food Standards Scotland (2021) Food in Scotland Consumer Tracker Survey Wave 12. https://www.foodstandards.gov.scot/publications-and-research/publications/food-in-scotland-consumer-tracker-survey-wave-12 (accessed September 2022).Google Scholar
Brown, K, Timotijevic, L, Barnett, J et al. (2011) A review of consumer awareness, understanding and use of food-based dietary guidelines. Br J Nutr 106, 15–26.CrossRefGoogle ScholarPubMed
Food Standards Agency (2021) Healthy and sustainable diets: consumer poll. https://www.food.gov.uk/research/wider-consumer-interests/healthy-and-sustainable-diets-consumer-poll (accessed September 2022).Google Scholar
Mötteli, S, Keller, C, Siegrist, M et al. (2016) Consumers’ practical understanding of healthy food choices: a fake food experiment. Br J Nutr 116, 559–566.CrossRefGoogle ScholarPubMed
Action on Sugar (2020) Public Health England – sugar reduction programme. https://www.actiononsugar.org/reformulation-/sugar-reduction-programme/ (accessed September 2022).Google Scholar
Stewart, C, Piernas, C, Cook, B et al. (2021) Trends in UK meat consumption: analysis of data from years 1–11 (2008–09 to 2018–19) of the National Diet and Nutrition Survey rolling programme. Lancet Planet Health 5, e699–e708.CrossRefGoogle ScholarPubMed
The Guardian (2013) Horsemeat scandal: the essential guide. https://www.theguardian.com/uk/2013/feb/15/horsemeat-scandal-the-essential-guide (accessed September 2022).Google Scholar
Public Health England (2019) New report shows further sugar reduction progress by food industry. https://www.gov.uk/government/news/new-report-shows-further-sugar-reduction-progress-by-food-industry-1 (accessed September 2022).Google Scholar
World Health Organisation (2012) Communication for behavioural impact (COMBI) – toolkit. https://www.who.int/publications/i/item/communication-for-behavioural-impact-(combi) (accessed September 2022).Google Scholar
World Health Organisation (2017) Strategic communications framework for effective communications. https://www.who.int/docs/default-source/documents/communicating-for-health/communication-framework.pdf?sfvrsn=93aa6138_0 (accessed September 2022).Google Scholar
Moran, MB, Frank, LB, Zhao, N et al. (2016) An argument for ecological research and intervention in health communication. J Health Commun 21, 135–138.CrossRefGoogle ScholarPubMed
Morrison, FP, Kukafka, R & Johnson, SB (2005) Analyzing the structure and content of public health messages. AMIA Annu Symp Proc 2005, 540–544.Google ScholarPubMed
Zahid, A & Reicks, M (2018) Gain-framed messages were related to higher motivation scores for sugar-sweetened beverage parenting practices than loss-framed messages. Nutrients 10, 625.CrossRefGoogle ScholarPubMed
Wansink, B & Pope, L (2015) When do gain-framed health messages work better than fear appeals? Nutr Rev 73, 4–11.CrossRefGoogle ScholarPubMed
Godinho, CA, Alvarez, MJ & Lima, ML (2016) Emphasizing the losses or the gains: comparing situational and individual moderators of framed messages to promote fruit and vegetable intake. Appetite 96, 416–425.CrossRefGoogle ScholarPubMed
Gallagher, KM & Updegraff, JA (2012) Health message framing effects on attitudes, intentions, and behavior: a meta-analytic review. Ann Behav Med 43, 101–116.CrossRefGoogle ScholarPubMed
Verbeke, W (2008) Impact of communication on consumers’ food choices. Proc Nutr Soc 67, 281–288.CrossRefGoogle ScholarPubMed
Bassett-Gunter, RL, Martin Ginis, KA & Latimer-Cheung, AE (2013) Do you want the good news or the bad news? Gain- versus loss-framed messages following health risk information: the effects on leisure time physical activity beliefs and cognitions. Health Psychol 32, 1188–1198.CrossRefGoogle ScholarPubMed
Scott, E, Kallis, G & Zografos, C (2019) Why environmentalists eat meat. PLoS ONE 14, e0219607.CrossRefGoogle ScholarPubMed
NHS (2020) Vitamin D. https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/ (accessed September 2022).Google Scholar
Food Standards Scotland (2021) Your questions on vitamin D answered by Food Standards Scotland's expert. https://www.foodstandards.gov.scot/news-and-alerts/your-questions-on-vitamin-d-answered-by-food-standards-scotlands-expert (accessed September 2022).Google Scholar
Segal, L & Opie, RS (2015) A nutrition strategy to reduce the burden of diet related disease: access to dietician services must complement population health approaches. Front Pharmacol 6, 160.CrossRefGoogle ScholarPubMed
Wilson, BJ (2007) Designing media messages about health and nutrition: what strategies are most effective? J Nutr Educ Behav 39, S13–S19.CrossRefGoogle ScholarPubMed
Pollard, CM, Howat, PA, Pratt, IS et al. (2016) Preferred tone of nutrition text messages for young adults: focus group testing. JMIR Mhealth Uhealth 4, e1.CrossRefGoogle ScholarPubMed
Food Standards Scotland (2022) Eat Well Your Way. https://www.foodstandards.gov.scot/consumers/healthy-eating/eat-well-your-way (accessed September 2022).Google Scholar
Livingstone, KM, Celis-Morales, C, Navas-Carretero, S et al. (2021) Personalised nutrition advice reduces intake of discretionary foods and beverages: findings from the Food4Me randomised controlled trial. Int J Behav Nutr Phys Act 18, 70.CrossRefGoogle ScholarPubMed
Fong, M, Scott, S, Albani, V et al. (2021) ‘Joining the dots’: individual, sociocultural and environmental links between alcohol consumption, dietary intake and body weight – a narrative review. Nutrients 13, 2927.CrossRefGoogle ScholarPubMed
Wilson, K, Senay, I, Durantini, M et al. (2015) When it comes to lifestyle recommendations, more is sometimes less: a meta-analysis of theoretical assumptions underlying the effectiveness of interventions promoting multiple behavior domain change. Psychol Bull 141, 474–509.CrossRefGoogle Scholar
White, C, Drummond, S & De Looy, A (2010) Comparing advice to decrease both dietary fat and sucrose, or dietary fat only, on weight loss, weight maintenance and perceived quality of life. Int J Food Sci Nutr 61, 282–294.CrossRefGoogle ScholarPubMed
Jongenelis, MI, Pettigrew, S, Wakefield, M et al. (2018) Investigating single- versus multiple-source approaches to communicating health messages via an online simulation. Am J Health Promot 32, 979–988.CrossRefGoogle ScholarPubMed
Chén, OY & Roberts, B (2021) Personalized health care and public health in the digital age. Front Digit Health 3, 595704.CrossRefGoogle Scholar
YouGov (2022) The YouGov food study. https://yougov.co.uk/topics/society/articles-reports/2022/04/20/yougov-food-study (accessed September 2022).Google Scholar
Jones, NRV, Tong, TYN & Monsivais, P (2018) Meeting UK dietary recommendations is associated with higher estimated consumer food costs: an analysis using the National Diet and Nutrition Survey and consumer expenditure data, 2008–2012. Public Health Nutr 21, 948–956.CrossRefGoogle ScholarPubMed
Chen, PJ & Antonelli, M (2020) Conceptual models of food choice: influential factors related to foods, individual differences, and society. Foods 9, 1898.CrossRefGoogle ScholarPubMed
Lee, CJ, Nagler, RH & Wang, N (2018) Source-specific exposure to contradictory nutrition information: documenting prevalence and effects on adverse cognitive and behavioral outcomes. Health Commun 33, 453–461.CrossRefGoogle ScholarPubMed
Goldberg, J & Sliwa, S (2011) Communicating actionable nutrition messages: challenges and opportunities. Proc Nutr Soc 70, 26–37.CrossRefGoogle ScholarPubMed
Ruxton, C (2022) Interpretation of observational studies: the good, the bad and the sensational. Proc Nutr Soc 81, 279–287.CrossRefGoogle ScholarPubMed
Vijaykumar, S, McNeill, A & Simpson, J (2021) Associations between conflicting nutrition information, nutrition confusion and backlash among consumers in the UK. Public Health Nutr 24, 914–923.CrossRefGoogle ScholarPubMed
Mozaffarian, D & Forouhi, NG (2018) Dietary guidelines and health-is nutrition science up to the task? Br Med J 360, k822.CrossRefGoogle ScholarPubMed
Nagler, RH (2014) Adverse outcomes associated with media exposure to contradictory nutrition messages. J Health Commun 19, 24–40.CrossRefGoogle ScholarPubMed
British Dietetic Association (2017) Survey finds that almost 60% of people trust nutrition advice from underqualified professionals. https://www.bda.uk.com/resource/survey-finds-that-almost-60-of-people-trust-nutrition-advice-from-underqualified-professionals.html (accessed September 2022).Google Scholar
De Groeve, B, Bleys, B & Hudders, L (2019) Okay to promote eating less meat, but don't be a cheat – The role of dietary identity, perceived inconsistency and inclusive language of an advocate in legitimizing meat reduction. Appetite 138, 269–279.CrossRefGoogle ScholarPubMed
DJS Health on behalf of the Royal Society for Public Health (2014) Britons more likely to ignore diet recommendations from overweight doctors, survey finds. https://www.djsresearch.co.uk/HealthMarketResearchInsightsAndFindings/article/Britons-more-likely-to-ignore-diet-recommendations-from-overweight-doctors-survey-finds-01926 (accessed September 2022).Google Scholar