Personalized nutrition advice : an everyday-life perspective

Abstract

This thesis presents societal preconditions for Personalized Nutrition Advice (PNA) that result from an everyday-life perspective on this innovative approach. Generally, PNA is regarded as promising, because it provides users with highly specific information on individual health risks and benefits of eating habits and the desirable changes, which may induce a high sense of personal relevance. Rapid developments in interactive computer technology (ICT) and nutrigenomics science are the innovative drivers in this area. Although indicated as promising, the limited impact of personalized advice on eating practices up to now, signals a mismatch with consumers’ everyday life. In our studies, we found that the pursuance of nutrition advices assumes that consumers have a focal concern on health, which is not always the case. Consumers value uncomplicatedness and convenience of healthful eating and the flexibility to eat for pleasure as well. More flexible advice would therefore better match with consumers’ complicated everyday life, in which health is just one of several ambitions, including social ones. A change of eating practices requires the alteration of other practices besides those directly related to the food choice chain. Advice should provide for consumers’ ability to organize healthful eating within existing chains of social practices, including discursive ones. In everyday-life, consumers have to persist in their intentions to eat healthfully vis-a-vis relevant others. In our study, consumers presented themselves as being uncomplicated, to avoid the image of health freakiness. Based on the finding that being someone who makes great effort in relation to healthful eating is a disfavored image, we conclude that for structural change, the healthy choice should become a ‘practically and socially easy choice’. We propose that PNA can contribute to this goal by using an ‘Action Approach’. The basic idea of this approach is that, besides being well-informed and motivated, consumers need to become actively involved in eating for health. By this, we mean that they are able to practically and socially organize their eating practices in order to ensure health benefits. This would involve the stimulation of a process of critical reflection on the uncomplicatedness of healthful eating and the integration of advice on the practical and social organization of changing eating practices towards health. Consumers themselves should become co-designers of this advice, as they are experts on everyday-life problems and solutions which occur when they try to pursue their healthful eating intentions. The integration of a diversity of expertise on social, ethical and practical requirements in early stages of the development process of innovative PNA is essential. Yet, our study showed that actors in diverse societal sectors were reluctant to engage in the development process of ICT and gene-based PNA. Their evidence-based working practices required that first, scientific support on the effectiveness should become available. Based on their expertise on public needs and wants, they called for a request to slow down the innovation process on behalf of the public. Current working life also does not allow for much change in roles and responsibilities, which may be needed to integrate the innovation in working practices of societal actors. In our qualitative study amongst general practitioners (GPs), we found that participants hold rather critical views on nutrition advice, and certainly on the innovative drivers. A lack of robustness, a low match with patients’ needs and equivocalness of nutritional studies were perceived as blocking GPs involvement. The social acceptability of PNA requires a participatory process. But an invitation to join the innovation process does not of necessity elicit pro-active involvement. This requires the stimulation of a critical reflection process on the meaning of ‘evidence’ from the perspectives of concerned actors and the consequences for the innovation processes. Such an exercise should aim at finding solutions, as to overcome the block about involvement. It should also target reflection on the meaning of expertise, keeping in mind the required increasing role of consumers in the design of PNA. In sum, we conclude that the alignment of PNA with societal preconditions is possible if the development process evolves as a participatory process, in which all societal actors are convinced about the valuable contribution their experience and expertise offers to this search for new ways to effectively promote healthful eating. <br/