Abstract
This article uses a population health perspective to examine the complex set of interactions among the determinants of healthy eating. An overview of current knowledge on determinants of healthy eating was organized as follows: 1) individual determinants of personal food choices and 2) collective determinants, including a) environmental determinants as the context for eating behaviours and b) public policies as creating supportive environments for healthy eating. A conceptual synthesis of the literature revealed that individual determinants of personal food choice (physiological state, food preferences, nutritional knowledge, perceptions of healthy eating and psychological factors) are necessary, but not sufficient, to explain eating behaviour, which is highly contextual. Collective determinants of eating behaviour include a wide range of contextual factors, such as the interpersonal environment created by family and peers, the physical environment, which determines food availability and accessibility, the economic environment, in which food is a commodity to be marketed for profit, and the social environment, in which social status (income, education and gender) and cultural milieu are determinants of healthy eating that may be working “invisibly” to structure food choice. Policy is a powerful means of mediating multiple environments. There are gaps in our understanding of the process of intervening in macro-level environments and the impact of such interventions on the promotion of healthy eating. Collective determinants of food choice and policy contexts for promoting healthy eating, therefore, require investment in research. Applying a population health promotion lens to understanding the multiple contexts influencing healthy eating provides insight into prioritizing research and action strategies for the promotion of healthy eating.
Résumé
Le présent article traite des interactions complexes observées au niveau des divers déterminants de la saine alimentation, dans une optique de santé de la population. Nous examinerons l’état actuel des connaissances à l’égard des déterminants de la saine alimentation à partir des catégories suivantes: 1) les déterminants individuels des choix alimentaires personnels et 2) les déterminants collectifs, à savoir a) les déterminants environnementaux en tant que contexte entourant les comportements alimentaires et b) les politiques publiques en tant que créatrices d’environnements favorables à la saine alimentation. Une synthèse de la littérature scientifique a révélé que les déterminants individuels des choix alimentaires (état physiologique, préférences alimentaires, connaissances en nutrition, perceptions de la saine alimentation et facteurs psychologiques) pouvaient expliquer en partie le comportement alimentaire, mais qu’ils ne pouvaient l’expliquer totalement, étant donné que ce comportement est fortement influencé par le contexte. On entend par déterminants collectifs du comportement alimentaire, une vaste gamme de facteurs contextuels, à savoir l’environnement interpersonnel composé de la famille et des pairs, l’environnement physique qui détermine la disponibilité des aliments et leur accessibilité, l’environnement économique dans lequel les aliments sont avant tout des produits mis en marché dans une optique de profit et enfin l’environnement social qui inclut à la fois le statut social (revenu, niveau d’instruction et sexe) et le milieu culturel. Tous ces déterminants de la saine alimentation peuvent structurer les choix alimentaires de façon plus ou moins consciente. On sait que l’adoption de politiques peut influencer fortement de multiples environnements, mais on comprend encore mal le processus d’intervention nécessaire à l’échelle macroscopique et le véritable impact des différentes interventions sur la promotion de la saine alimentation. De nouvelles études s’imposent sur les déterminants collectifs des choix alimentaires et le contexte politique entourant la promotion de la saine alimentation. En s’efforçant de mieux comprendre les multiples contextes entourant la saine alimentation, dans une optique de promotion de la santé de la population, on pourra dégager des priorités de recherche et concevoir des stratégies d’intervention en matière de promotion de la saine alimentation.
Article PDF
Similar content being viewed by others
Références
Organisation mondiale de la santé. WHO Technical Report Series No 894. Obesity: Preventing and managing the global epidemic. Genève, Suisse: Auteur, 2000.
Hamilton N, Bhatti T. Promotion de la santé de la population: Modèle d’intégration de la santé de la population et de la promotion de la santé. [mise à jour du 29 nov. 2002; cité le 9 sept. 2004. Disponible à l’adresse suivante: https://doi.org/www.phac-aspc.gc.ca/ph-sp/phdd/php/php.htm.
McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ Q 1988;15(4):351–77.
Green LW, Richard L, Potvin L. Ecological foundations of health promotion. Am J Health Promot 1996;10(4):270–81.
Taylor J. Les déterminants de la saine alimentation chez les enfants et les jeunes du Canada. Rev can santé publique 2005;96(Suppl. 3):S22–S29.
Payette H, Shatenstein B. Les déterminants de la saine alimentation chez les personnes âgées vivant dans la collectivité. Rev can santé publique 2005;96(Suppl. 3):S30–S35.
Payette H, Gray-Donald K, Cyr R, Boutier V. Predictors of dietary intake in a functionally dependent elderly population in the community. Am J Public Health 1995;85(5):677–83.
Gray-Donald K. The frail elderly: Meeting the nutritional challenges. J Am Diet Assoc 1995;95(5):538–40.
Keller HH, Østbye T, Bright-See E. Predictors of dietary intake in Ontario seniors. Rev can santé publique 1997;88(5):305–9.
Finley B. Nutritional needs of the person with Alzheimer’s disease: Practical approaches to quality care. J Am Diet Assoc 1997; 97(10 Suppl 2):S177–80.
Payette H, Ferland G. La malnutrition chez les personnes âgées démentes: étiologie, évolution et efficacité des interventions. Dans: La collection l’année gérontologique. Paris, France: Maison Serdi, 1999;131–45.
Shatenstein B, Ferland G. Absence of nutritional or clinical consequences of decentralised bulk food portioning in elderly nursing home residents with dementia in Montreal. J Am Diet Assoc 2000;100(11):1354–60.
Drewnowski A. Taste preferences and food intake. Annu Rev Nutrition 1997; 17(1):237–53.
Brody H. Living Arctic: Hunters of the Canadian North. Vancouver/Toronto: Douglas & McIntyre, 1987.
Wein EE, Freeman MM. Inuvialuit food use and food preferences in Aklavik, Northwest Territories, Canada. Arctic Med Res 1992;51(4):159–72.
Kuhnlein HV. Factors influencing use of traditional foods among the Nuxalk people. J Can Diet Assoc 1989;50:102–8.
Kuhnlein HV. Change in the use of traditional foods by the Nuxalk native people of British Columbia. Ecol Food Nutrition 1992;27(3–4):259–82.
Trifonopoulos M. Anthropometry and diet of Mohawk schoolchildren in Kahnawake [Masters thesis]. Montreal, QC: McGill University, 1995.
Bernard L, Lavallee C, Gray-Donald K, Delisle H. Overweight in Cree schoolchildren and adolescents associated with diet, low physical activity, and high television viewing. J Am Diet Assoc 1995;95(7):800–2.
Bernard L, Lavallee C. Eating habits of Cree school children: A pilot study. Montreal, QC: Community Health Department, Montreal General Hospital, 1993.
Morley JE, Thomas DR. Anorexia and aging: Pathophysiology. Nutrition 1999;15(6):499–503.
Morley JE. Decreased food intake with aging. J Gerontol A Biol Sci Med Sci 2001;56(Spec No 2):81–88.
Pirouznia M. The correlation between nutrition knowledge and eating behavior in an American school: The role of ethnicity. Nutr Health 2000;14(2):89–107.
Birch LL. Children’s preferences for high fat foods. Nutr Rev 1992;50(9):249–55.
Murphy SP, Davis MA, Neuhaus JM, Lein D. Factors influencing the dietary adequacy and energy intake of older Americans. J Nutr Educ 1990;22(6):284–91.
Mcintosh WA, Kubena KS, Walker J, Smith D, Landmann WA. The relationship between beliefs about nutrition and dietary practices of the elderly. J Am Diet Assoc 1990;90(5):671–76.
Toner HM, Morris JD. A social-psychological perspective of dietary quality in later adulthood. J Nutr Elderly 1992;11(4):35–53.
Lahmann PH, Kumanyika SK. Attitudes about health and nutrition are more indicative of dietary quality in 50- to 75-year-old women than weight and appearance concerns. J Am Diet Assoc 1999;99(4):475–78.
Shatenstein B, Nadon S, Ferland G. Determinants of diet quality among Quebecers aged 55–74. J Nutr Health Aging 2004;8(2):83–91.
Paquette M-C. Perceptions of healthy eating: State of knowledge and research gaps. Rev can santé publique 2005;96(Suppl. 3):S16–S21.
Falk LW, Bisogni CA, Sobal J. Food choice processes of older adults: A qualitative investiga-⇔on. J Nutr Educ 1996;28(5):257–65.
Furst T, Connors M, Bisogni CA, Sobal J, Falk LW. Food choice: A conceptual model of the process. Appetite 1996;26(3):247–65.
Willows N. Les déterminants de la saine alimentation chez les peuples autochtones du Canada: état actuel des connaissances et lacunes au niveau de la recherche. Rev can santé publique 2005;96(Suppl. 3):S36–S41.
Polivy J, Herman CP. La santé mentale et les comportements alimentaires: une relation bidirectionnelle. Rev can santé publique 2005;96(Suppl. 3):S49–S53.
Baranowski T, Cullen KW, Baranowski J. Psychosocial correlates of dietary intake: Advancing dietary intervention. Annu Rev Nutr 1999;19:17–40.
Davison KK, Birch LL. Childhood overweight: A contextual model and recommendations for future research. Obes Rev 2001;2(3):159–71.
Baranowski T, Smith M, Hearn MD, Lin LS, Baranowski J, Doyle C, et al. Patterns in children’s fruit and vegetable consumption by meal and day of the week. J Am Coll Nutr 1997;16(3):216–23.
Power EM. Les déterminants de la saine alimentation chez les Canadiens à faible revenu. Rev can santé publique 2005;96(Suppl. 3):S42–S48.
Rozin P, Vollmecke TA. Food likes and dislikes. Annu Rev Nutr 1986;6:433–56.
Statistique Canada. Statistiques sur les aliments 2001. Ottawa, ON: Ministère de l’Industrie, 2003.
Raine K. Le surpoids et l’obésité au Canada: une perspective de la santé de la population. Ottawa, ON: Institut canadien d’information sur la santé, 2004.
Booth SL, Sallis JF, Ritenbaugh C, Hill JO, Birch LL, Frank LD, et al. Environmental and societal factors affect food choice and physical activity: Rationale, influences, and leverage points. Nutr Rev 2001;59(Suppl. 3):57–65.
Tarasuk VS, Maclean H. The institutionalization of food banks in Canada: A public health concern. Rev can santé publique 1990;81(4):331–32.
Jacobs Starkey L, Kuhnlein HV. Montreal food bank users’ intakes compared with recommendations of Canada’s Food Guide to Healthy Eating. Can J Diet Pract Res 2000;61(2):73–75.
Schlosser E. Fast Food Nation: The Dark Side of the All-American Meal. New York, NY: Perennial, 2002.
Nestle M. Soft drink “pouring rights”: Marketing empty calories. Public Health Rep 2000;115(4):308–19.
Drewnowski A, Specter SE. Poverty and obesity: The role of energy density and energy costs. Am J Clin Nutr 2004 Jan;79(1):6–16.
Nestle M. Food Politics: How the Food Industry Influences Nutrition and Health. Berkeley, CA: University of California Press, 2002.
Schmitz KH, Jeffery RW. Prevention of obesity. In: Wadden TA, Stunkard AJ (Eds.), Handbook of Obesity Treatment. New York, NY: The Guilford Press, 2002;556–93.
Battle Horgen K, Brownell KD. Comparison of price change and health message interventions in promoting healthy food choices. Health Psychol 2002;21(5):505–12.
Toronto Food Policy Council. Toronto Food Policy Council [Web Page]. Available at https://doi.org/www.ryerson.ca/~foodsec/food-policy/. (Accessed 2002 Dec).
Stone DA. Policy Paradox and Political Reason. Glenview, IL: Scott, Foresman, 1988.
DeVault M. Feeding the Family: The Social Organization of Caring as Gendered Work. Chicago, IL: University of Chicago Press, 1991.
Santé Canada. Guide alimentaire canadien pour manger sainement [mise à jour du 1er oct. 2002; cité le 3 mars 2003. Disponible à l’adresse suivante: https://doi.org/www.hc-sc.gc.ca/hpfb-dgpsa/onpp-bppn/food_guide_rainbow_f.html.
Santé et Bien-être social Canada. Action concertée pour une saine alimentation: recommandations alimentaires pour la santé des Canadiens et Canadiennes et stratégies recommandées pour la mise en application. Ottawa, ON: Ministère des Approvisionnements et Services Canada, 1990.
Bureau de la politique et de la promotion de la nutrition. La nutrition pour un virage santé: voies d’action. Ottawa, ON: Santé Canada, 1996. Disponible à l’adresse suivante: https://doi.org/www.hc-sc.gc.ca/hpfb-dgpsa/onpp-bppn/nutrition_health_agenda_f.html
Nestle M, Jacobson MF. Halting the obesity epidemic: A public health policy approach. Public Health Rep 2000;115(1):12–24.
Jeffery RW. Public health strategies for obesity treatment and prevention. Am J Health Behav 2001;25(3):252–59.
Battle Horgen K, Brownell KD. Policy change as a means for reducing the prevalence and impact of alcoholism, smoking and obesity. In: Miller WR, Heather N (Eds.), Treating Addictive Behaviors. New York, NY: Plenum Press, 1998;105–18.
Jacobson MF, Brownell KD. Small taxes on soft drinks and snack foods to promote health. Am J Public Health 2000;90(6):854–57.
Advertising Standards Canada. Canadian Code of Advertising Standards. Toronto, ON: ASC, 2004.
Author information
Authors and Affiliations
Corresponding author
French language version/Version en Français
Rights and permissions
About this article
Cite this article
Raine, K.D. Determinants of Healthy Eating in Canada: An Overview and Synthesis. Can J Public Health 96 (Suppl 3), S8–S15 (2005). https://doi.org/10.1007/BF03405195
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03405195