Research report
Understanding the propensity of consumers to comply with dietary guidelines
directed at heart health
Spencer Henson, Jose Blandon
*
, John Cranfield, Deepananda Herath
Department of Food, Agricultural and Resource Economics, University of Guelph, Guelph, ON N1G 2W1, Canada
Introduction
Inappropriate eating behaviour is considered a major risk factor
for obesity (Keith et al., 2006) and a range of non-communicable
chronic diseases (Katzmarzyk & Janssen, 2004; Potkin, Kim, Rusev,
Du, & Zizza, 2006). The economic and social costs of chronic
diseases, both in terms of the direct demands on health care and
the indirect costs of morbidity and premature mortality, are
recognised to be high (Caro et al., 2007; Katzmarzyk & Janssen,
2004; Potkin et al., 2006), and indeed their increasing prevalence in
many industrialised countries has long been considered a public
health ‘crisis’ (Brownson, Haire-Joshu, & Luke, 2006; Darnton-Hill,
Nishida, & James, 2004). Therefore, it is not surprising that efforts
towards the promotion of healthier diets are considered to offer
substantial benefits to individuals and society in general (Cash,
Goddard, & Lerohl, 2006; Malla, Hobbs, & Perger, 2007).
A number of industrialised countries have published national
dietary guidelines (see for example DHHS/USDA, 2005; Health
Canada, 2007), while strategies oriented towards the promotion of
healthier eating patterns have also been established internation-
ally, for example through the World Health Organization (WHO)
(WHO, 2004). A ‘healthy’ diet is generally conceived as encom-
passing significant consumption of fruits and vegetables and whole
grains and cereals, and limited consumption of fats (especially
saturated or mono-saturated facts), salt and simple sugars
(Putnam, Allshouse, & Kantor, 2002; Srinivasan, 2007). In most
industrialised countries, however, despite a relatively long history
of promotional efforts directed at bringing about changes in
dietary behaviour, the typical gap between the published guide-
lines and the diet of consumers remains large (Kumanyika et al.,
2000; Putnam et al., 2002; Srinivasan, 2007). Indeed, it is evident
that many consumers face considerable difficulty in bringing about
changes to their diet (Kumanyika et al., 2000), especially where
substantial changes are required in the amounts of particular foods
that are consumed (De Vries, Kremers, Smeets, & Reubsaet, 2008;
Srinivasan, 2007).
To reduce the gap between dietary recommendations and
consumer behaviour we need to understand better the range of
factors that facilitate or impede healthy eating. As Blaylock,
Smallwood, Kassel, Variyam, & Aldrich (1999, p. 269) point out
‘‘consumers make dietary decisions based on economic, physio-
logic, psychologic, sociologic and even spiritual considerations.’’
Appetite 54 (2010) 52–61
ARTICLE INFO
Article history:
Received 14 April 2009
Received in revised form 6 August 2009
Accepted 11 September 2009
Keywords:
Healthy eating
Diet
Cholesterol
Health
Rasch model
ABSTRACT
The aim of this paper is to explore the difficulty faced by consumers in complying with health-related
dietary guidelines, focusing on those guidelines that consumers find it more/less difficult to meet and the
factors driving the ability to make associated dietary changes. Participants reported self-assessed
compliance with 12 dietary recommendations predominantly directed at reducing the risk of heart
disease. The difficulty of complying with each of the dietary guidelines was measured using a Rasch
model, while the determinants of ability to comply with the dietary recommendations as a whole were
identified using regression analysis. The more difficult dietary recommendations included limiting
consumption of red meats and consuming the recommended daily intake of fruits and vegetables.
Attitudinal variables associated with food, nutrition and health, perception of cholesterol risk and a
range of socio-demographic variables, including age, gender and education, were significant
determinants of person ability to comply with the dietary recommendations. The results show that
there are significant differences in the difficulty faced by consumers in complying with particular dietary
recommendations, while there is substantial variation in the ability to eat a healthy diet across
participants.
ß 2009 Elsevier Ltd. All rights reserved.
* Corresponding author at: Department of Food, Agricultural and Resource
Economics, University of Guelph, 50 Stone Road East, J.D. MacLachlan Building,
Room 220, Guelph, ON N1G 2W1, Canada.
E-mail address: jblandon@uoguelph.ca (J. Blandon).
Contents lists available at ScienceDirect
Appetite
journal homepage: www.elsevier.com/locate/appet
0195-6663/$ – see front matter ß 2009 Elsevier Ltd. All rights reserved.
doi:10.1016/j.appet.2009.09.006