This paper reviews nutrition education theories as they apply to the Australian food labeling program. The first section of the paper addresses the relative effectiveness of the top-down approach used by the Australian government. The second section more closely examines theories and models of nutritional education and promotion.
Health
Criteria One
Food labeling is a critical component to freedom of information, and should be promoted robustly in Australia. The currently existing Percentage Daily Intake food labeling system is part of the Australian Health Department's overall strategy towards increasing consumer awareness about nutrition. Of course, not all of our foods are labeled. Food made and packaged on premises such as what is available at a local bakery, need not be labeled according to law. Similarly, deli products, fruits, vegetables, unpackaged foods, and foods sold for delivery are not required to carry labels ("Food Labeling" n.d.). In the case of products that are not labeled, consumers are strongly encouraged to use common sense and rely on a prior understanding of nutritional values, health, and food safety. For example, one of the functions of labeling is to alert the customer to use-by dates. When a customer purchases a loaf of bread from a bakery, there is no use-by date because the consumer is generally aware of when the bread is no longer fit for consumption.
The current food-labeling program of the Australian Health Department represents a top-down approach. This approach works best in the area of food labeling for several reasons. First, it would be unfeasible to consult with nutritionists every time a new food product hits store shelves. Second, the top-down approach ensures consistency of health-related messages. If too many individuals have a say in food labeling standards, the result would be chaos and confusion, which harms the consumer. Third, a top-down approach ensures that public safety is the number one concern. Consumers need to know that the source of nutritional and health-related data comes not from profit motive but from objective third party interests. Fourth, food labeling must be consistent nationwide. A top-down approach ensures that products purchased in Sydney share common information with those sold in Darwin.
Of course, there are some limitations with the top-down approach. One of the most glaring problems is that the top-down approach precludes any individualized information that may be helpful to specific population groups. For example, individuals with diabetes and other medical conditions requiring a radical change in dietary habits need to be aware of more than just ingredient lists. Another problem with the top-down approach is that health information is not the same as health education. A consumer can read a food ingredient label, but might not understand what that label means in terms of health, nutrition, and safety. For instance, partially hydrogenated oil and other trans-fats are in a wide range of processed foods available at grocery stores nationwide. Many of those products also happen to be marketed as low-sodium, low-fat, or dietary products. Yet trans-fats are not recommended as part of a healthy diet. The city of New York went so far as to ban trans-fats completely (Okie, 2007). Consumers unaware of the issues related to trans-fats would need education and awareness in addition to robust food labeling.
It is possible that Australia also needs to be more aggressive in its nutritional awareness campaigns. Rather than rely solely on food labeling as a means of increasing public health, the country should promote nutrition more comprehensively. The media is one of the keys to increasing public awareness of health and nutrition. Therefore, the government and the Australian Health Department need to collaborate with public and private media enterprises in the interests of health promotion. When the media offers regular segments on nutrition, the public has greater access to information related to understanding the food labels they read. Countries like Brazil have reported tremendous success with media collaboration programs designed to promote public health (Coitinho, Montiero & Popkin, 2002). Armed with knowledge, the consumer is more likely to make healthy choices. Even without a top-down intervention on food manufacturers, the consumer-driven market might help phase out unhealthy products in favor of healthier choices.
Another important drawback with a top-down approach is that it does not necessarily account for differences in demographic responses to food knowledge campaigns, food labeling programs, or nutritional promotion. Poverty, for example, is strongly correlated with a number of preventable health problems that are related to poor nutrition and diet (Haddad, 2002). A bottom-up approach may be more appropriate when targeting specific populations or health issues. The British government is well aware of the domestic public health issues related to poverty and has implemented community action programs specifically targeted at low-income neighborhoods (Kennedy, 2001). A combination of neighborhood action, local health promotion programs, and targeted promotional campaigns may be the best multifaceted approach toward improving public health. Therefore, a top-down approach used nationwide should be combined with a bottom-up approach implemented at the community level.
Criteria Two
Nutrition knowledge can be, but is not always, linked to behavioral change. Moreover, the Australian government's percentage daily intake labeling system does not necessarily improve nutrition knowledge; it is simply an adjunct to more global knowledge related to health and nutrition. The percentage daily intake labeling system requires some prior knowledge of the terms and issues related to nutrition and food safety. This prior knowledge must be established firmly in social norms and educational programs as well as the media in order to invoke widespread changes in consumer behavior.
Positive changes in food behavior will require a lot more than the current food labeling system. Models and theories of nutrition provide some guidance as to how to effectively tailor a food and nutrition awareness program that creates change. A results-based approach is one that is multifaceted. Behavioral change also requires awareness of the diversity of Australian society; it is impossible to generalize about what factors induce behavioral change. Gender, race, social class, and extraneous lifestyle factors will impact food and nutrition choices. Research by Booth & Shepherd (1988) revealed the importance of sensory input too, in the making of consumer food choices. In fact, sensory input was shown to be linked more closely to actual changes in behavior than intellectual knowledge alone (Booth & Shepherd, 1988).
While direct data is sparse regarding the relationship between nutritional knowledge and behavioral change in Australia, the United States and Great Britain both offer some parameters that can be applied down under. The diversity of Great Britain and the United States at least highlights some of the ways that heterogeneous societies can promote change in a results-oriented nutritional awareness campaign. American researchers have been distinguishing "between dietary guidance and nutrition promotion," (Sutton, S.M., Layden, W. & Haven, J., 1996). Ultimately the goal is to present hard science in a consumer friendly manner in ways that create measureable results: to "translate the science-based dietary guidance into consumer-oriented messages that facilitate behavior change," (Sutton et al., 1996). It is also crucial to create measures of behavior change such as the Healthy Eating Index (Kennedy, Ohls, Carlson & Fleming, 1995).
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