Consumer Behavior and Nutrition: Preventive Health Perspectives

M. Venkatesan, University of Oregon
ABSTRACT - There is increasing interest in consumer behavior and nutrition. However, the present attempts are inadequate inasmuch as they follow the "curative" approach. What is needed is a "preventive health approach." Such an approach recognizes that changing consumer nutritional habits is a long-term phenomenon. A brief summary of the current state of our knowledge in this area is provided and suggestions for future research are outlined.
[ to cite ]:
M. Venkatesan (1978) ,"Consumer Behavior and Nutrition: Preventive Health Perspectives", in NA - Advances in Consumer Research Volume 05, eds. Kent Hunt, Ann Abor, MI : Association for Consumer Research, Pages: 518-520.

Advances in Consumer Research Volume 5, 1978      Pages 518-520

CONSUMER BEHAVIOR AND NUTRITION: PREVENTIVE HEALTH PERSPECTIVES

M. Venkatesan, University of Oregon

ABSTRACT -

There is increasing interest in consumer behavior and nutrition. However, the present attempts are inadequate inasmuch as they follow the "curative" approach. What is needed is a "preventive health approach." Such an approach recognizes that changing consumer nutritional habits is a long-term phenomenon. A brief summary of the current state of our knowledge in this area is provided and suggestions for future research are outlined.

Ever since the Federal Trade Commission issued a proposed Trade Regulation Rule on food advertising aimed at regulating the claim and information contained in the advertisements for food products, considerable attention is being devoted to consumers and nutrition. Much of this attention has been directed in the forms of suggestions -- some of which resulted from recent studies -- towards the formats in which such information should be provided [Kendall, 1977; Scammon, 1976], the type of information that should be provided [Bettman, 1975], and the attributes of such information [Quelch, 1977]. Other studies have concentrated on the current level of knowledge and the use of such knowledge by consumers [Jacoby, 1976, USDHEW, 1974, 1975].

It is interesting to note that these flurries of activities did not deal with the reasons for the attempts of the Federal Trade Commission and others to provide nutritional information. The current attempts at disclosure are based on the belief that there is nutritional deficiency among consumers and is based on the findings of three major studies, viz., The Ten State Nutrition Survey [1972], First Health and Nutrition Examination Survey (HANES) [1974] and the USDA Survey of Dietary Levels of Households in the United States [1965]. There are unresolved controversies surrounding the interpretations of the findings from these three studies and the segments of population to which such findings properly relate. Irrespective of these difficulties, the philosophy behind the TRR of the Federal Trade Commission, and therefore, of the studies that have attempted to research and suggest ways in which to communicate the nutritional information have all taken a "curative" approach to the problem. That is, a "malnutrition" problem is perceived to exist among consumers and therefore the researchers are suggesting "cures" to the policy makers. It is clear that our studies of consumer knowledge of nutrition [Jacoby, 1976] and their use of such information and our suggestions [Bettman, 1975, Scammon, 1976, Venkatesan, 1977] have all been influenced by this "curative" perspective of the problem of nutritional deficiency among consumers. In short, we have taken the same approach as much of the medical practitioners and which has come under increasing criticism. The reason for this can be traced to lack of clarity in our thinking with regard to nutrition and consumer behavior and our haste to apply our "consumer behavior approach" to this area of human behavior and assuming the results will be similar to buying behavior research for a variety of products and services.

We have finally come to understand that in order to affect the behavior of consumers in the area of nutrition, we have to be concerned not with the "curing" aspects of nutritional deficiency, if any, but with the preventive health behavior aspects of consumer behavior. It is becoming increasingly clear that more and more consumers are exhibiting concerns about food additives, ingredients of food products, trace minerals, etc. reflecting an interest in prevention. We, as a society, are becoming more convinced that prevention is both simpler and cheaper than cure in all aspects of our behaviors. There is increasing emphasis on prevention of every kind -- medical, occupational, environmental, and nutritional. For purposes of this paper, preventive health behavior for consumers in the nutritional area can be defined (with a slight modification of the existing definition of health behavior of Kasl and Cobb, 1966) "as any activity undertaken by a consumer who believes himself/herself to be healthy, for the purpose of preventing nutritional inadequacies.

In general, there are two types of prevention activities that can be undertaken by individuals, viz., passive prevention and active prevention. Passive prevention does not involve any active participation by the consumers to get prevention. An example of such prevention might include fortification of all food products with required levels of vitamins, minerals, etc., or elimination of all additives/ingredients (and even products) which are not fully tested and which are suspected or even remotely linked to some cancer producing agent. As is obvious, passive prevention measures will not, for the most part, involve the consumer. However, such passive preventive measures are not feasible because providing fortification of food products becomes prohibitively expensive. Secondly, much is not known about the long term effects of such fortification efforts. Thirdly, not all of the individuals require the same level of nutrition intake.

Much of our problem in the nutritional area (deficiency, obesity, etc.) are "self-imposed" such as excessive eating, eating of junk foods and improper diets, etc. Nutritional knowledge and use of such knowledge in the choice and consumption of nutritionally beneficial food products fall under "consumer behavior," as such activities involve consumer awareness about nutrition and relating such knowledge to foods and food products and consumption of such products relate to consumer choice processes. Here, our understanding of consumer behavior and applying it to nutritional settings might be of help to both the producers of these products and to the policy makers. Thus our concern is with consumers' active prevention behavior and that implies that the individuals have specific things to do, some of which might affect and/or change their life styles. That is, consumers are fully expected to actively $ participate to gain benefits of prevention. Even if such preventive measures are taken by consumers, there is no guarantee that any illness or deficiency will be prevented for the individual nor can it be claimed that such prevention may lead to elimination of any disease, etc.

The active prevention notion in the nutritional area involves social change concepts, that is, changes in the life styles of individuals over a long period of time and deliberate intervention programs may become part of change strategies. Some claims have been made that such social changes can be brought about by "social marketing." [Kotler and Zaltman, 1971]. We do not currently have ample demonstrations or empirical evidence of success in this area. There are also a number of ethical and public policy considerations in any attempt to implement active prevention measures by consumers in the nutritional area. There are still controversies regarding the RDA levels that are set as guidelines and there will be problems in policy makers attempting to suggest not only consumption of specific foods (eggs vs. beef, etc.) but consumption of specific brands of food products.

Current State of Our Knowledge

The Food and Nutrition Surveys (1974, 1975) of the Food and Drug Administration are the most comprehensive studies to date. By and large, these two surveys indicate that a substantial proportion of consumers are knowledgeable about the concept of "well-balanced diet" and only a small proportion of consumers have indicated that they were not getting a well-balanced diet and this was not due to any lack of awareness on their part, but that it was due to other reasons such as "fussy eating" and too much time spent away from home and the like. The Red Book surveys (1974, 1976) also indicated that a very high proportion of their respondents are aware of the basic food groups, and recognized the need for well balanced meals and the like.

If the awareness level is high, why then is their consumption behavior presumably not consistent with their awareness? For one thing, none of the national surveys have found any serious concern or perception of a serious problem with nutritional deficiency. Most consumers are concerned with obesity and other similar problems. Bauman [1973] correctly identified the reasons for lack of concern when his surveys found that most housewives believed that they were serving their families with a variety of basic foods over a period of time, which they believed will achieve nutritional balance. The second reason Bauman attributed for nutritionally inadequate eating habits is the breakdown of traditional three-meals-a-day pattern of eating behavior and the growing tendencies of families to eat more meals away from home. Another reason advanced by some is that while there may be general awareness of nutrition, the need for well-balanced diet and the like, consumers generally lack information on specific nutrients. Their problem is compounded by the fact that consumers have difficulties connecting their already meager knowledge of specific nutrients with the food products in general and with specific brands of food products in particular. There may also be a confusion factor, as Lachance [1973] observed:

The consumer wants a balanced diet, but the confusion over how to attain it is fantastic. Not only are there more foods to choose from, but we nutritionists have contributed to the confusion. One can take any one of several college level textbooks on nutrition to learn that the good sources of protein, several vitamins, and minerals are organ means (e.g., liver), egg, milk, cheese, etc., only to advise in a separate chapter or article that to avoid heart disease one must limit the intake of --you guessed it -- organ meats, milk, eggs, certain cheeses, etc.

Finally, as the surveys have repeatedly found that the unshakeable belief among consumers seems to be that one can get enough nutrition from eating a variety of foods from the supermarket and this contributes to the problem of consumer education. There are other reasons and there are a number of studies that point out problems and difficulties in attempting to change the eating habits of consumers. [For a summary of these studies and a critique, see Kendall, 1977].

Proposal for Research

Research in how consumers make choices of food products in the supermarket is very sketchy and much less is known about how they combine their nutritional information with actual choice of branded products. It is obvious that food choices are not the same as brand choices of food products. The recent research studies that deal with consumers evaluative criteria for food products and with attributes of food products and the type of information that needs to be provided are all concerned with way "ought" to be provided and not with how and why consumers make their choices of food products the way they do. For example, we know very little about the criteria consumers seem to use in choosing brands of food products. Bayton [1968] has reported that he had found from his research in the purchase of food products that consumers had the following parameters, which he grouped into seven categories:

I. Nutrition Parameters

1. Body growth needs

2. General health needs (rather than specific health needs)

3. Vitality; energy

4. Energy "carry-through" (concern over longlasting energy)

II. Economic parameters

5. Price, per se

6. Value (what you get from the money)

III. Sensory--aesthetic Parameters

7. Taste-aroma-appearance complex

8. Refreshment (especially "coolness" relief of thirst)

IV. Personableness Parameters

9. Personableness-in-general (lively; good complexion, bright and sparkling eyes; general attractiveness)

10. Sex personableness Males--vigorous, athletic; masculinity Females--lovely complexion; nice figure, femininity

V. Appropriateness (suitability to my kind of person or to given situations)

11. Religious-cultural appropriateness

12. Age--group appropriateness (milk for children, coffee for older ages)

13. Status-group appropriateness (class-relatedness of some foods)

14. Social setting appropriateness (family privacy; intimate friends, special guests; restaurants)

VI. Convenience

15. Convenience in purchasing; availability

16. Convenience in storing

17. Convenience in preparation

18. Convenience in serving

19. Convenience in consumption

VII. Health apprehensions

20. Weight apprehension

21. Cardiac apprehension

22. Contamination apprehension (pesticides, bacterial, animal medications, atomic fall out)

23. Allergies

There is not much research evidence available on these parameters. However, it is clear that jumping to conclusions or extrapolations from findings on the use of nutrient labeling to the whole area of nutrition and consumer behavior is both imprudent and premature. Secondly, changing or influencing consumer behavior in this area, as pointed out earlier, is a long-term problem. In a study [Wilson, 1972] attempts were made to educate six families, on a longitudinal basis, on nutrition information. The resultant improvements in their food habits was minimal. Thus, quick solutions and grandiose short-term suggestions are not likely to succeed in changing the behavior of consumers. What is needed is a program of painstaking experimental research for a long period and implementation of the research based approach by policy makers will in all likelihood increase the chance of maximum benefit at least cost for the society and enhance the nutritional well being of our society.

REFERENCES

Howard E. Bauman, "What Does the Consumer Know About Nutrition?" Journal of the American Medical Association, Vol. 225, No. 1, July 2, 1973, pp. 61-62.

James A. Bayton, "Psychodynamics of Food Consumption." Paper presented at the 12th Annual Nutrition Forum, Virginia Council on Health and Medical Care. Richmond, Virginia, April 22, 1968.

James R. Bettman, "Issues in Designing Consumer Information Environments," Journal of Consumer Research, Vol. 2, December 1975, 169-177.

First Health and Nutrition Examination Survey, United States, 1971-72. (Preliminary Findings) Dietary Intake and Biochemical Findings U.S. Department of Health, Education, and Welfare. Public Health Service, Health Resources Administration, National Center for Health Statistics, Rockville, Maryland, Jan. 1974.

Jacob Jacoby, R. W. Chestnut, and William Silberman, "Consumer Use and Comprehension of Nutrition Information.'' Paper No. 163 Purdue Papers in Consumer Psychology, 1976.

Stanislav V. Kasl, and Sidney Cobb, "Health Behavior, Illness Behavior, and Sick Role Behavior," Archives of Env. Health Vol. 12 (February 1966) pp. 216-267.

Kenneth W. Kendall, Methods of Presenting Nutrient Information in the Media. An Experimental Investigation. Unpublished Doctoral Dissertation, University of Iowa, 1977.

Phillip Kotler, and Gerald Zaltman, "Social Marketing: An Approach to Planned Social Change," Journal of Marketing, July 1971, pp. 3-12.

Paul A. Lachance, "Nutrition and the Public Health," Presentation before the New York Section of the American Association of Cereal Chemists, New York City, April 3, 1973.

Red Book Reader Survey. How Do You Feel About Food? What Do You Know About Food? The Results of a Red Book Reader Survey, May, 1974.

Red Book Nutrition Study. Princeton, New Jersey. The Gallop Organization, 1976.

Debra Lynn Scammon, The Effects on Consumers of Varying the Amount and Format of Purchase-Relevant Information. Unpublished Doctoral Dissertation, University of California, Los Angeles, 1976.

Ten State Nutrition Survey, 1968-70. U.S. Department of Health, Education, and Welfare. Health Services and Mental Health Administration, Center for Disease Control, Atlanta, Georgia, 1972.

United States Department of Agriculture. Household Food Consumption Survey 1965-66. Report No. 6 Dietary Levels of Households in the United States, Spring 1965. (Agricultural Research Service)

U.S. Department of Health, Education and Welfare. Public Health Service, Food and Drug Administration. Consumer Nutrition Knowledge Survey. Report I 1973-74. (DHEW Publication No. FDA 76-2058)

U.S. Department of Health, Education and Welfare. Consumer Nutrition Knowledge Survey Part II, 1975. DHEW Publication No. FDA 76-2059.

M. Venkatesan, "Preventive Health Care and Marketing: Positive Aspects." A paper presented to the Preventive Health Workshop, American Marketing Association, April, 1977 (in press).

M. Venkatesan, "Providing Nutritional Information to Consumers." Paper presented at the special NSF/MIT Conference. "Consumer Research for Consumer Policy," Cambridge, Mass., July, 1977 (in press).

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