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3. From understanding behaviour to facilitating behaviour change

Food behaviour is influenced by a complex interplay of numerous factors. The importance of any specific factor can differ among individuals or groups, and it can vary at different stages of life. Comprehending both the internal and external determinants that influence behaviour, as well as understanding the decision-making processes of individuals or groups, is crucial for designing effective policy measures to encourage dietary change (Atkins and Michie 2015; Leng et al. 2021).
This chapter outlines a Food Behaviour Framework applied to Nordic conditions (Figure 4). It serves as a foundational tool for understanding the variety of factors, also known as determinants, that influence individuals’ food consumption behaviours. This framework is instrumental in developing the Nordic Food Behaviour Change Framework (Figure 5). The latter is designed to enhance the understanding and implementation of strategies that effectively lead to behavioural change in the context of food consumption in the Nordic countries.
Food behaviour is complex, influenced by a multitude of factors and their interactions. The significance of any particular factor can vary between individuals or groups, and also across different life stages. Understanding the internal and external factors that affect people’s behaviour, and comprehending why and how individuals or groups make certain decisions and act accordingly, is crucial for the design of effective policy interventions promoting dietary change (Atkins and Michie 2015; Leng et al. 2021).
Behaviour occurs within constantly evolving systems and contexts (Atkins and Michie 2015). Theories of consumer behaviour suggest that food choices and dietary habit changes are influenced not only by the individual attitudes and motivations of consumers but also by societal norms, as well as economic and cultural factors (Lima et al. 2021). These habits are adaptable, with behavioural changes potentially resulting from shifts in skills, perceptions, and material aspects (Macura et al. 2022). Literature generally distinguishes three types of determinants influencing food consumption behaviour, highlighting the substantial interplay and interdependence among these factors (Contento 2011; Lima et al. 2021; Steenkamp 1993):
    • Food-related determinants encompass biological preferences and individual experiences with food, such as a penchant for sweet and salty flavours. Sensory and emotional reactions to the taste, smell, appearance, and texture of food considerably influence our food preferences and choices. This category also includes acquired tastes and the capacity to learn to enjoy certain foods.
    • Person-related determinants, such as an individual’s beliefs, values, attitudes, knowledge, skills, and social and cultural norms (intrapersonal determinants), have a significant effect on food choices. Interpersonal factors, involving family, friends, and other social networks, are equally influential. Socio-demographic factors like age and gender, as well as educational level, individual knowledge, and experience, also play a role in influencing food choices.
    • Socio-environmental determinants affecting food choices include the availability and accessibility of food, which can be influenced by geography. This category encompasses a range of economic, cultural, marketing, and policy factors (Contento 2011; Lima et al. 2021; Steenkamp 1993).
    Drawing on Steenkamp (1993) and Contento (2011), this report presents a newly developed Food Behaviour Framework applied to Nordic conditions (Figure 4). We have augmented these theoretical insights with reviews of articles examining the impact of various factors on the implementation of different policy instruments (Ammann et al. 2023; Collier 2022; Fesenfeld 2020).
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    Figure 4 Food Behaviour Framework applied to Nordic conditions: factors influencing food choices and dietary behaviour.

    Food-related determinants

    Food-related determinants include both biological factors and personal experiences with food. Numerous studies have confirmed that the sensory attributes of food significantly influence food selection. This preference is understandable, as sensory pleasure provides immediate satisfaction, often leading people to prioritise present enjoyment over future health benefits. Consequently, health claims and sustainably produced items, which offer long-term advantages, may not appeal as much to consumers due to their delayed rewards (Amman et al. 2023). Even the most sustainable and healthy food products lose their appeal if they are not palatable.
    A preference for certain foods typically develops over time through learned or conditioned preferences. This evolution occurs as consistent consumption of a food, resulting in outcomes like satiety or fullness, reinforces our liking for it. However, early food experiences play a crucial role in setting eating patterns, influencing not only the types of food individuals prefer but also their consumption quantities. Biologically determined preferences for certain foods might be challenging to alter through public policy interventions. Nonetheless, research suggests that early food experiences are critical in shaping lifelong eating habits (Contento 2011; Leng et al. 2016). In this context, exposing children to a variety of foods and fostering a positive social and emotional environment, such as observing the eating habits of peers and adults, can significantly influence food preferences. Hence, public interventions targeting early life experiences, for example by ensuring easy access to healthy and nutritious foods in kindergartens and schools, are vital. Given the significance of taste, it is equally important to improve the culinary skills of chefs in public kitchens to prepare delicious meals that align with nutritional recommendations.

    Person-related determinants

    Age is a significant factor influencing food behaviour, with diverse needs and preferences for food depending on one's age. Research suggests that for young adults, factors such as time constraints, price, mood, convenience, and taste preferences are common determinants of eating behaviour. As individuals age, barriers to healthy eating habits, like food costs and social group resistance, tend to diminish (Mediratta and Mathur 2023). However, with ageing, people develop expectations and sentiments about foods shaped by perceptions, attitudes, beliefs, values, emotions, and personal significance attached to different foods, as well as acquired knowledge and skills. Younger people may be more open to adopting new eating habits and trying novel foods, making them receptive to interventions promoting sustainability and health (Contento 2011).
    Research reveals varied results regarding how age influences attitudes towards eco-labels and sustainable food products. Some studies indicate that older individuals are more likely to purchase sustainable products and are willing to spend more on sustainability, possibly due to greater financial stability often found in older age groups. Conversely, other research shows that younger consumers are more concerned with environmental and ethical issues and are more inclined to pay extra for certified products. Younger individuals are also generally more open to adopting new practices in their workplace canteens (Ammann et al. 2023).
    Gender is another personal factor influencing dietary choices. Research suggests that women may be more health-conscious and more likely to heed dietary advice, potentially making gender-tailored messages more effective (Wardle et al. 2004). Studies also indicate that women are more likely than men to pay extra for products with eco-labels, have more knowledge about sustainability, and express greater concern over sustainability issues. Regarding men, studies suggest they are more inclined to choose eco-labelled products if they are cost-effective. Consequently, this suggests they might be willing to pay more for products with a reduced carbon footprint (Ammann et al. 2023; Sand 2022).
    Family structure, particularly during childhood and adolescence, plays a critical role in shaping dietary preferences, with active family involvement being essential in establishing early dietary habits (Duralia 2023; Scaglioni et al. 2018). Open communication with parents about nutrition and shared meals positively influences the development of healthy food habits among children (Haines et al. 2019). Additionally, the eating behaviour of older adults is influenced by their social status. A study on Dutch older adults living alone revealed that individual (i.e., habits) and financial (i.e., food accessibility) factors are among the most influential factors affecting their eating behaviour (Bukman et al. 2020).
    Research has highlighted spatial disparities in dietary choices and food preferences, indicating that areas with a higher proportion of well-educated residents typically display a more diverse range of nutritional choices and a tendency towards reduced caloric consumption. In contrast, communities with lower educational levels tend to have a higher prevalence of sweets and sugar-rich products (Azizi Fard et al. 2021). One could also assume that higher levels of education correlate with higher income levels. The study by Azizi Fard et al. (2021) suggests that educational background significantly influences the dietary patterns and food choices of different communities. Moreover, higher levels of education are associated with increased awareness of nutrition and understanding of health information (Azizi Fard et al. 2021), as well as sustainability issues, and a greater willingness to purchase products with sustainability labelling (Amman et al. 2023).  
    In a German context, a study by Perino and Schwickert (2023) found that personal values, such as considerations regarding animal welfare, significantly influence public support for meat taxation. Another study in Sweden shows that political ideology plays a role in the level of acceptance of a climate tax on beef (Harring 2020). Moreover, dietary choices are deeply intertwined with social norms. To achieve a substantial shift in consumption patterns, it is essential to bring about changes in these norms (Röös et al. 2021).

    Socio-environmental determinants

    Social and environmental factors play a significant role in influencing our food choices. These factors are often more amenable to change compared to food- and person-related factors, as they encompass broader, external aspects of our lives that can be modified through targeted policy instruments (Lima et al. 2021).
    Research shows that the environments where individuals form their dietary behaviours and make food choices significantly impact their eating habits (Hawkes et al. 2013). Studies have demonstrated that the presence of healthier options in local grocery stores correlates with greater availability of these foods at home. Consequently, the variety of food options in a community or neighbourhood directly affects purchasing and consumption habits (Contento 2011; Hawkes et al. 2013). The availability of food in areas surrounding workplaces and schools also influences the dietary habits of both children and adults (Contento 2011). Furthermore, place of residence impacts attitudes towards policies like a climate tax on beef, with individuals in rural areas of Sweden being more opposed to it (65 percent) compared to those in large urban areas (37 percent) (Harring 2020). This finding underscores the need to consider neighbourhood-specific factors and the particular social environment when developing public health policies and interventions to ensure their effectiveness and extensive reach (Azizi Fard et al. 2021; Bukman et al. 2020).
    Personal income levels and the prices of food items are known to influence the quantity and type of food that consumers purchase (Capacci et al. 2012; Lima et al. 2021; Steenkamp 1993). Research indicates that the prevalence of obesity in both men and women decreases with higher socioeconomic status, whereas interest in nutritional information, particularly about fat content, increases with social class (Leng et al. 2016; Steenkamp 1993). Individuals with lower income or education levels tend to prioritize price and familiarity over health when selecting food. Since the cost of food often correlates with its nutritional quality — where lower-priced products tend to be nutritionally inferior and energy-dense — it can be more challenging for individuals with lower income to prioritize health in their food purchasing decisions (Konttinen et al. 2012). Research shows that offering price discounts on healthier food options leads to an increase in their purchase across all education and income levels (Blakely et al. 2011). This suggests that making healthier foods more affordable can effectively encourage a wider range of people to choose these options, regardless of their socioeconomic status.
    Research further shows that individuals with higher incomes are more likely to buy products with eco-labels and consider animal welfare. This trend is often attributed to the greater financial flexibility of high-income households. Studies have found that these consumers are willing to pay more for sustainable products, although the extent of this price premium varies across different food categories. However, these studies often rely on stated preference methods, leading to varied results that are challenging to compare. Furthermore, there is often a gap between what consumers claim they value (as evidenced in stated preference studies or their declared willingness to pay) and their actual purchasing behaviour, especially regarding social, ethical, or environmental considerations (Amman et al. 2023).
    Cultural practices and family background are important determinants of food choices and eating habits, even in contemporary and multi-ethnic societies with a wide array of culinary options (Contento 2011; Duralia 2023). These cultural norms are evident across various cultures, including restrictions on certain foods that may carry religious or symbolic significance (Duralia 2023). However, the impact of perceived descriptive norms – what people think others are doing – is less influential compared to other factors like habitual choices, the visual appeal of food, its value for money, and satiety levels (Salmivara 2021).

    The Nordic Behaviour Change Framework for Better Diets

    This report enhances the Food Framework applied to Nordic conditions (Figure 4) by also developing the Nordic Behaviour Change Framework (Figure 5). It offers a comprehensive analysis of the factors that influence individual food consumption behaviours and outlines strategies designed to support behavioural shifts. The objective of this framework is to steer and inform the formulation of policy interventions that effectively encourage healthier and more sustainable dietary habits (Atkins and Michie 2013).
    Figure 5 The Nordic Behaviour Change Framework for Better Diets
    In Figure 5, the innermost circle pertains to factors influencing individual choice, the middle circle covers components that help explain behavioural influences, and the outermost circle refers to enablers, specifically policy instruments, that can give incentives for behavioural change. See chapter 4 for examples of specific policy instruments.
    The Nordic Behaviour Change Framework is predicated on the understanding that food policies and interventions aimed at promoting better diets should focus on enhancing the availability, affordability, accessibility, and appeal of healthy dietary options, while simultaneously reducing these factors for unhealthy diets (Hawkes et al. 2013). These ‘4 A’s’ elucidate behavioural influences and are closely associated with the concept of opportunity, as described below. Availability refers to the physical presence of food within the local area. Affordability denotes the ability to purchase food at a reasonable price. Accessibility concerns the ease with which food can be obtained and is impacted by factors such as transportation (Leng et al. 2016). Appeal relates to the qualities of food that make it attractive or desirable to individuals, for example, taste and ease of preparation.
    The ‘COM-B’ model, as detailed by Atkins and Michie (2013) provides a framework for understanding and influencing behavioural change. It posits that for a behaviour to occur, individuals must have both the physical and psychological capability (C) to perform it, the right physical and social opportunities (O), and the motivation (M) to engage in this behaviour (B). Therefore, it is essential that individuals understand how to perform the behaviour, comprehend its importance, and possess the necessary skills to facilitate change. According to this model, three core components are essential for any behaviour to occur (Atkins and Michie 2013):
    Capability: This involves the individual’s ability to engage in the desired behaviour, encompassing physical skills and abilities as well as psychological aspects like knowledge and understanding of how and why to perform the behaviour. To facilitate change, individuals must be equipped with the necessary skills and clear instructions.
    Opportunity: This pertains to the external environment that enables the behaviour, including factors such as the availability of resources, time, and the physical environment, as well as social opportunity like social norms, cultural practices, and the influence of others in an individual’s social circle. The behaviour is more likely to be adopted if it is perceived as normal within their peer group.
    Motivation: This involves the drive to engage in the behaviour over other competing actions, influenced by habitual processes, emotional responses, and analytical decision-making. Individuals must believe that the behaviour is worthwhile and important enough to prioritise over other activities.
    To facilitate behavioural change towards healthier and sustainable diets, a variety of policy instruments can be employed to enhance the capability, opportunity, and motivation of individuals to choose better diets. These strategies vary, ranging from altering the food environment through instruments like labelling and creating a healthy retail environment, to restricting food advertising and directly targeting individuals (Hawkes et al. 2013). The challenge in altering health-related behaviours lies not only in enhancing people’s motivations to eat healthier through policy instruments and interventions but also in bridging the gap between these intentions and actual behaviour. Effectively addressing this intention-behaviour gap is crucial for successful behaviour change (Broers et al. 2017). Different policy instruments giving the incentive to change behaviour towards healthier and more sustainable diets will be discussed in more detail in the next chapter.