Nutrition education : Linking research, theory, and practice

Abstract

The increase in obesity and chronic diseases such as diabetes and heart disease worldwide reflects the complex interactions of biology, personal behaviour and environment. Consequently there has been a greater recognition of the importance of nutrition education. An analysis of the evidence from 300+ studies shows that nutrition education is more likely to be effective when it focuses on behaviour/ action (rather than knowledge only) and systematically links theory, research and practice. There are three essential components to nutrition education: 1. A motivational component, where the goal is to increase awareness and enhance motivation by addressing beliefs, attitudes through effective communication strategies. 2. An action component, where the goal is to facilitate people's ability to take action through goal setting and cognitive self-regulation skills. 3. An environmental component, where nutrition educators work with policymakers and others to promote environmental supports for action. Each component needs to be based on appropriate theory and research. The procedure for program design can use the logic model: Inputs are the resources needed as well as the needs analysis process. The outputs are the activities within the three components of nutrition education described above. Here the be-havioural focus is selected and theory and research are used to design appropriate educational strategies to achieve the targeted behaviours. The outcomes are the short, medium or long-term impacts of the nutrition program. These are evaluated through the use of appropriate designs and instruments. Nutrition education programs that link research, theory, and practice are more likely to be effective. INTRODUCTION The increase in obesity and chronic diseases such as diabetes and heart disease worldwide reflects the complex interactions of biology, personal behavior and the environment. As shown in Figure 1, people's food choices are influenced by many factors: 1,2 (a) Biologically determined behavioral predispositions include humans' liking at birth for sweet and dislike for bitter and sour, hunger/ satiety mechanisms, and sensory specific satiety. (b) Experience with food. Humans have the capacity to learn to like foods through associative conditioning, both physiological and social. Young children overcome their fear of new foods (neopho-bia) through repeated experience with new foods, offered by the family and often reflecting cultural preferences, leading to familiarity. These two sets of influences are sensory-affective in nature and contribute greatly to peo-ple's food preferences. (c) Personal factors. Intra-person factors such as beliefs, attitudes, knowledge and skills and social norms, and inter-personal factors such as families and social networks also influence our food choices. (d) Environmental factors powerfully influence peoples' food-related behaviors as well. Food availability and accessibility as well as the social environment and cultural practices, material resources, and food marketing practices either facilitate or hinder individuals being able to act on their beliefs, attitudes, and knowledge about healthful eating. All of these influences interact with each other dynamically.