We can be certain that men and women have always needed to eat. We can also assume that they shared advice about what to eat from the time they first learned to communicate. And they have never stopped.

In the United States, nutrition communication traces its origins to early 19th century preachers who prescribed dietary remedies to cure the physical—and in some cases moral—ills of the day. Sylvester Graham, a Presbyterian minister, believed that a high-fiber, vegetarian diet would cure alcoholism, cholera, premature aging and sexual urges (Deutsch 1967).

The first science-based government recommendations on diet arrived at the end of the 19th century, when the U.S. Department of Agriculture and its first chief of nutrition investigations, W.O. Atwater (1844–1907), connected food composition, dietary intake and health. Atwater’s recommendations on the importance of variety, proportionality and moderation in a healthful diet (Davis & Saltos 1999) laid the foundation for the development of a more formal food guide.

The Dietary Guidelines for Americans, revised and published every 5 years since they were first issued in 1980, provide evidence-based nutrition information and advice. However, despite more than three decades of such advice, most Americans fail to meet the recommendations for a healthful diet.

What Are Americans Eating?

Data published with the release of the most recent Dietary Guidelines for Americans in 2010 (new guidelines are to be released in 2015) paint a sharp picture of the shortcomings in American diets.

  • Americans consume just two-thirds of the recommended amount of vegetables and only half the recommended amount of fruit.
  • They do not eat enough whole grains, dairy or fish, and consume too much in the way of meats, solid fats and added sugars (USDA & HHS 2010).
  • Recent data compiled by NPD Group, a market research firm, found that average consumers meet the Dietary Guidelines only about 7 days per year, or 2% of the time (NPD Group 2012).

Consumers live in the midst of an abundant food supply and conflicting nutrition claims. Making consistently healthful food choices is difficult. How do we turn this around? It starts with understanding the challenges we face in communicating the value of a nutritious diet.

Why the Message Doesn’t Always Get Through

Sound nutrition communication aimed at promoting healthy lifestyles—particularly when delivered one-on-one—can shift behavior. Understanding how different factors influence your clients is crucial in helping them adopt healthy behaviors. As you consider how to encourage people to consume healthier diets, bear the following in mind:

People Eat Diets, Not Foods Or Nutrients

On almost any given day, the latest newspaper headline or morning-show “expert” exclaims how this or that nutrient, vitamin or individual food is critical for (or detrimental to) good health. Consumers are told to focus on one particular food group or nutrient—stay away from trans fat, consume more vitamin D, avoid carbohydrates. These directives, which often urge people to consume or avoid these things to prevent cancer or reduce the risk of cardiovascular disease, overlook the fact that most people do not eat to reduce the risk of one disease or another; rather, they consume an array of foods that make up their overall diet.

Everyone Is An “Expert”

We all have belief systems associated with specific food preferences. Consciously or not, people draw on their lifetime of experience with food each time they decide what foods to buy, how to prepare them and how much of them to eat. As consumers, they accept or reject nutrition information based on their experiences, beliefs and preferences. When new nutrition information conflicts with this conditioning, people must decide whether to use that information to modify their choices.

The Nutrition Story Isn’t Always “Ready For Prime Time”

The popular media frequently portray nutrition research as revolutionary, report- ing findings as absolute truths that should be acted on immediately. In reality, the nutrition story is evolutionary, but the media often neglect to frame new findings in a larger nutritional, social or historical context. That undoubtedly breeds frustration and confusion. Consumers cannot help wondering why they should bother trying to change their diets if the professionals “can’t make up their minds.”

Basic Guidance Is Boring

Though the public sees nutritional “truths” as moving targets, the basic guidance on healthful eating hasn’t changed all that much over time. Nutrition professionals still focus on the importance of variety, emphasizing the value of fruits and vegetables and urging people to avoid too much sugar, fat and salt. In contrast, the media like to bombard consumers with “sexier” messages, such as the health benefits of red wine or dark chocolate. Faced with information that seems to affirm the healthful qualities of foods they prefer, consumers may see this as permission to eat those foods
and to ignore less-attractive but accurate advice from more reputable sources.

While these factors are by no means the only reasons for the gap between dietary recommendations and dietary intake, they shed light on the challenge that lies in communicating sound nutrition guidance to influence behavior.

Close the Gap

We might wonder how we can meaningfully shift people toward eating healthier diets. The good news is that it is possible—and that working individually with clients affords a meaningful opportunity to provide this guidance. The strategies offered below are not an exhaustive list of approaches to try, but rather reminders of what to do and keep in mind when you work with your clients. You may already be doing these things.

Develop Simple, Actionable Messages And Strategies

Nutrition information can seem confusing, particularly when consumers feel that switching to a more healthful diet requires an overhaul of everything they eat. Instead, focus on one or two simple things your clients can do to improve their diets.

  • Want to encourage a client to eat more whole grains? Encourage him or her to choose bread with whole wheat as the first ingredient, or to swap white rice for brown.
  • Trying to motivate someone to make the switch from sugary drinks to water? Suggest adding a tablespoon of juice or slices of lemon, lime or orange to plain water. It goes a long way in adding flavor for just a few calories.

No doubt some of your clients have already identified simple ways to start eating healthier diets—use their tips and strategies to help others who are just starting out.

Serve “Small Helpings” of Information

Nutrition advice is best served in reasonable portions, but health professionals and communicators often want to provide more than individuals can digest. Not all material on a given nutritional topic will be relevant to each client. It is important to know what information your clients need immediately, and to prioritize your communications accordingly. For instance, if a client is looking for guidance on eating for heart health, it may be more useful and important to help her understand how to substitute unsaturated fat for saturated fats in her diet, rather than focusing on dietary cholesterol.

Understand Your Audience

Though nutrition recommendations tend to target a broad audience, it is important to understand that audiences consist of individuals. There is no generic consumer to whom all messages will be equally relevant. Age, culture, education and health status are just some of the factors that influence whether somebody will respond to nutrition advice. As you encourage clients to adopt healthier behaviors, it is important to meet them where they are. Find out what they already know, what they are already doing and what they are willing to do.

Accept That Change Occurs Slowly

We are all creatures of habit, and changing behavior takes time. While it may seem obvious, it is important to remember as health professionals that if we are to help clients change behavior, we cannot focus exclusively on the long-term picture. We must learn to praise small changes, no matter how slowly they occur.

Nutrition communication by itself cannot be expected to influence individual eating behavior. It must be acknowledged that consumers will have to take responsibility for their own diets and that behavior change ultimately lies in their hands. However, understanding the factors that influence individual eating behavior, and designing specific strategies that will help you meet your clients where they are, can help your message to resonate and can drive clients on to accomplish the desired change.

Understanding The Context Of Food Choices

Figuring out why consumers do not follow dietary recommendations—and getting them to change their behavior—requires (1) understanding the context surrounding how they choose their food and (2) recognizing the multiple factors that influence those choices.

Knowledge Isn’t Enough

Decades of research show that knowledge alone does not shift behavior, and that nutrition knowledge in particular is not a primary driver of food choice. Take the case of fruit and vegetable consumption. A recent survey by the International Food Information Council Foundation found that although consumers knew what they should do to improve their diets—including eating more fruits and vegetables—only a third of them had started doing it in the previous year (IFIC 2013).

In most cases, nutrient abundance or health benefits do not motivate people toeat fruits, vegetables or anything else for that matter. The primary concern is whether items taste good. Consumers consistently rank taste as the primary determinant of food and beverage choices. Concern about healthfulness ranks third or fourth behind price and convenience (Glanz et al. 1998; IFIC 2013). It follows that we must address consumer attitudes toward taste if we hope to succeed in shifting their behavior.

The Food Environment

The disconnect between nutrition recommendations and dietary behavior is only part of the story. Consumers make choices about what food to purchase and consume in an environment that has been referred to by some as “toxic” (Brownell & Horgen 2004). While that description is extreme, it is important to recognize that many foods that are widely available are not the most healthful choices. While food in general is relatively inexpensive, foods recommended from a nutritional standpoint tend to be more expensive than highly processed foods that contain lots of sugars and fats. Restaurant portions are too big and contribute to diets that exceed recommendations for fat, saturated fat and sodium (Wu & Sturm 2013). In some geographic areas, often called “food deserts,” healthier options are not available.

Changing the larger food environment may not be within the control of those of us who work with individual consumers on changing their behavior. However, it is our responsibility to help them understand how to navigate a very complex food environment in order to select healthful diets.


Brownell, K.D., & Horgen, K.B. 2004. Food Fight. Chicago: Contemporary.

Davis, C., & Saltos, E. 1999. Dietary recommendations and how they have changed over time. In E. Frazao (Ed.), America’s Eating Habits: Changes and Consequences (Agriculture Information Bulletin No. 750). Economic Research Service, USDA. www.ers.usda.gov/ersDownloadHandler.ashx?file=/media/91022/aib750b_1_.pdf; accessed Feb. 11, 2014.

Deutsch, R.M. 1967. The Nuts Among the Berries. New York: Ballantine.

Glanz, K.B., et al. 1998. Why Americans eat what they do: Taste, nutrition, cost, convenience, and weight control concerns as influences on food consumption. Journal of the American Dietetic Association, 98 (10), 1118-26.

IFIC (International Food Information Council). 2013. 2013 Food & Health Survey: Consumer attitudes toward food safety, nutrition, and health. www.foodinsight.org/Resources/Detail.aspx?topic=2013_ IFIC_Foundation_Food_Health_Survey_Media_ Resources; accessed Jan. 21, 2014.

NPD Group. 2012. Nutrition: Identifying where Americans fall short. NPD Insights. www.npdinsights.com/nutrition-identifying-where-americans-fall-short/; accessed Feb. 11, 2014.

USDA & HHS (U.S. Department of Agriculture & U.S. Department of Health and Human Services). 2010. Dietary Guidelines for Americans, 2010 (7th ed.). www.health.gov/dietaryguidelines/2010.asp; accessed June 11, 2014.

Wu, H.W., & Sturm, R. 2013. What’s on the menu? A review of the energy and nutritional content of US chain restaurant menus. Public Health Nutrition, 16 (1), 87-96.

Jeanne Goldberg, PHD, RD

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