They’re stuck at the crossroads. They’re convinced that they should eat a healthful diet, but they still don’t act on their convictions.
That describes most Americans’ attitudes as expressed in the American Dietetic Association’s latest nationwide survey. Since 1991 the ADA has grouped Americans into three categories based on their attitudes toward food and nutrition. This year’s study shows that even though more people are aware of healthful eating habits, fewer are making great improvements.
The smallest group, which the ADA dubs “I’m Already Doing It,” consists of people who say they have made significant changes in eating to achieve a healthful diet. About 28 percent of respondents fall into this category, up 2 percent since 1997.
The largest group, the “I Know I Should, But …” types, is made up of people who believe they know how to eat healthfully, but for one reason or another haven’t done so. Forty percent fall in this category, up 6 percent since 1997.
The group in the middle? “Don’t Bother Me.” These people may or may not consider themselves informed about eating right, but either way they don’t really care. The second largest group in the study, 32 percent fall in this category, an 8 percent drop since 1997.
So, the good news is that the group practicing healthful eating has increased slightly, and the group of the unconcerned has decreased quite a bit. But the bad news is that the number of Americans who can’t seem to act on what they know has increased to a majority.
The puzzle of this group’s inertia is probably as complex as human nature itself, but dietitians are already supplying some of the missing pieces.
“It’s a huge step from knowing to doing,” says Wahida Karmally, director of nutrition at the Irving Center for Clinical Research at Columbia University in New York. “Compliance behavior has long been a concern in medical circles.” And she says that behaviors that require lifestyle changes, such as diet and exercise, have the highest rates of “non-compliance.”
On the one hand, “it’s great to see the trend heading upward,” says Diane Quagliani, a Chicago-based registered dietitian and ADA spokesperson, “but there is definitely still room for improvement in Americans’ eating habits.”
And although losing weight is not the only or best reason to eat a healthful diet, it is a compelling one. The National Center for Health Statistics estimates that 53 percent of the U.S. population is overweight. Eighty percent of men and 70 percent of women over 40 are above their desirable weights, and one-third of children are overweight.
So how do you get people to change? “You need to identify the barriers,” Karmally says. “That’s an important step to developing a plan of action.”
Quagliani says the survey identifies four barriers to change: One is that people don’t want to give up their favorite foods. A second barrier is the belief that change is just too difficult. A third: Eating right takes too much time. And finally, people say they are confused by information overload on nutrition.
Karmally identifies another big roadblock: portion size.
” `Super sizes’ are available in foods like French fries, and children grow up having access to this and don’t really understand portion size.” She also mentions huge portions in restaurants. “People are attracted by this, thinking the larger the meal, the better the value.”
“Changing habits is usually much harder than we anticipate,” says Mary Abbott Hess, a registered dietitian who runs Hess and Hunt Nutrition Communications in Chicago. “We need a strong motivation.”
Complicating any attempt at change is humans’ naturally short-term thinking, Hess says: “We want a quick fix, right away. And you can’t get instant gratification from a healthy diet and exercisewhich offer you long-term rewards.”
But all of these barriers can be overcome, the dietitians say:
– First, you don’t have to give up any favorite foods. Just cut back on frequency and portion size.
And, says Quagliani, “If you really want that big hunk of chocolate cake, then get some extra exercise that day and cut back on other things that aren’t so importantskip the appetizers and save calories for dessert.”
– It’s also easier to make changes if you don’t think of eating healthfully as a black-and-white, either-or issue.
“You need to look at one meal at a time; you don’t have to change everything overnight,” Karmally says. “Try a high-fiber cereal with fruit and low-fat milk for breakfast instead of pancakes and sausage. Try that five times a week. Small changes add up.”
Says Hess: “It’s always better to improve by adding food rather than deleting it. For example, if you do add five servings of fruits and vegetables a day-ones that are a potential new source of enjoyment-you are less likely to have room for some of the other, less healthy choices.”
– Eating healthfully takes less time than ever, Quagliani says, because “so many terrific options exist in the supermarkets-prepared fruits, precut vegetables, low-fat milk, lean beef, skinless chicken, high-fiber cereals. How much time does it take to check out the labels?”
“Pay attention at the grocery store,” Hess says. “What you put in your basket is what you have at home-and ultimately what you eat.”
– To deal with the real problem of information overload (much of it contradictory), just let the USDA Food Guide Pyramid be your guide, dietitians say. You also can get reliable information from the ADA (www.eatright.org; 312-899-0040 or 800-877-1600), the American Heart Association, the American Cancer Society and other credible health organizations.
– The starting point in cutting down portion sizes is to learn some standard portions: 1/2 cup cooked rice or pasta, 1 slice bread, 2 to 3 ounces lean meat, poultry or fish, 1 egg, 1 medium apple, banana or orange, 1/2 cup cooked or chopped raw vegetables and 1 cup raw leafy greens. Aim for those target amounts.
And about that magic bullet? It doesn’t exist.
“It’s a matter of a shift in balance,” Hess says. “Add fruits and vegetables, but don’t say, `I’m never again going to eat a -,’ whatever it is you really enjoy. Then you will only feel deprived.”
Quagliani has some words of encouragement for the “I Know I Should” group:
“Congratulate yourself because you do realize the importance of healthy eating as a way of staving off health problems down the line.”
MESSAGE IN THE BOTTLES
For the first time since the survey began in 1991, the American Dietetic Association asked questions about non-food sources of nutrition: vitamin and mineral and herbal supplements.
Vitamin and mineral supplements scored high:
49 percent of adults take vitamin or mineral supplements daily.
18 percent never take them.
Men and women are about equally likely to take them every day-47 percent of men; 50 percent of women.
Older adults use daily supplements more-65 percent of people over age 55; 47 percent of people 35 to 54 years old; 34 percent of people 25 to 34 years old.
Herbal supplements scored low:
12 percent use herbal supplements daily.
61 percent never use herbal products.
