Eating healthy choices and avoiding junk food

Research shows that there are differences between perception and reality regarding many diets. People trying to lose weight tend to overestimate how healthy their diet is, and their own perception of how much their diet improved during the study is often inaccurate.

  • A new study shows that adults who are making lifestyle changes to lose weight tend to overestimate how healthy their diet is.
  • Additionally, confidence in how much their diet improved during the 12-month study was often inaccurate—most thought they improved their diet, but there was very little change based on researchers’ assessments.
  • Future research focusing on subjective perceptions of nutrition may lead to healthier eating patterns.

According to a small body of research, most adults who want to lose weight overestimate their nutritional health. These are the findings of a preliminary study presented at the American Heart Association Scientific Sessions 2022. The meeting is held in person in Chicago and is virtually the premier international exchange of the latest scientific advances, research and evidence-based clinical practice improvements. Cardiovascular Science.

“Although people generally know that fruits and vegetables are healthy, we found that there may be a disconnect between what researchers and health professionals believe is a healthy and balanced diet compared to what the public thinks is a healthy and balanced diet,” he said. Study author Jessica Cheng, PhD, a fellow in epidemiology at the Harvard TH Chan School of Public Health and a postdoctoral fellow in general internal medicine, both in Boston. This research was conducted when Dr. Cheng was a pre-doctoral fellow/Ph.D. candidate in the Department of Epidemiology at the University of Pittsburgh School of Public Health.

As of 2011 Centers for Disease Control and Prevention (CDC), about half of adults in the US try to lose weight each year, most of them trying to eat more fruits, vegetables, and salads. A healthy diet is important for heart and general health as well as longevity.

The American Heart Association’s 2021 Dietary Guidelines recommend that adults eat a variety of fruits and vegetables; Choose whole grains instead of refined grains; Choosing healthy protein sources; Replacing non-fat and low-fat dairy products with full-fat versions; Choose thin cuts of meat (for meat eaters); Use liquid vegetable oils instead of vegetable oils and animal fats; choosing minimally processed foods over highly processed foods; Reduce foods and drinks with added sugar; Choose foods with little or no salt; And limit or avoid alcohol.

Researchers evaluated the diets of 116 adults ages 35-58 in the greater Pittsburgh, Pennsylvania area who were trying to lose weight. The study participants met one-on-one with a nutritionist to talk about their diet and then tracked everything they ate and drank each day on the Fitbit app. They also wear a Fitbit device to track their physical activity by weighing themselves daily.

“Although people generally know fruits and vegetables are healthy, we found that there may be a disconnect between what researchers and health professionals believe is a healthy and balanced diet compared to what the public thinks is a healthy and balanced diet.”

Jessica Cheng, Ph.D.

Researchers calculated the Healthy Eating Index (HEI) based on the types of foods participants reported eating at the beginning and end of the study. Participants were asked to complete a 24-hour food diary for two days at each time point. The HEI is a benchmark for evaluating how well a diet complies with the US government. Dietary Guidelines for Americans. Points can be obtained from 0 to 100, a higher score indicates a healthier diet. The results depend on the frequency of consumption of different dietary components such as fruits, vegetables, whole and refined grains, meat and seafood, sodium, fat and sugar.

Participants self-reported their initial and final dietary quality to determine their perceived outcomes. Their scores are based on HEI components on a scale of 0-100. At the end of the study, a self-assessment of their initial diet was a “look back” when they recorded both their initial and final intakes. The difference between baseline and endpoint outcomes was perceived dietary change. A difference of 6 points or less between the researchers’ HEI score and the participant’s estimated score was considered “good agreement.”

At the end of the study, about 1 in 4 participants’ scores had good agreement between their predicted dietary scores and the researcher’s assessed scores. The remaining 3 out of 4 participants’ scores had poor agreement, and most reported that their perceived score was higher than the HEI score assigned by the researchers. The mean perceived score was 67.6, and the mean HI score was 56.4.

When we assessed dietary change over 12 months, only 1 in 10 participants had good agreement between self-assessed changes compared to the researchers’ HI score change. At the end of the study, participants improved their diet quality by one point based on a score assessed by the researcher. However, it was an 18-point improvement in participants’ self-esteem.

“People who are trying to lose weight, or health professionals who support weight loss or diet-related goals, should be aware that there is room for improvement in nutrition than expected,” Cheng said. She suggests providing concrete information on which areas of their diet can be improved and how to go about making healthy, sustainable dietary changes.

“Future studies should examine the effects of helping people close the gap between their perceptions and actual measures of diet quality,” she said.

“Overestimating the healthfulness of food intake can lead to weight gain, frustration over not achieving weight loss goals, or a lower likelihood of following healthy eating habits,” said Deepika Ladoo, PhD, assistant professor in the College of Applied Health. Sciences at the University of Illinois, Chicago and the American Heart Association Council on Lifestyle Behavioral Change to Improve Health Conditions. “Despite misconceptions among dietitians, these findings provide additional support for behavioral counseling interventions, which include frequent contact with health professionals, such as dietitians or health coaches, to address perception gaps and support long-term, realistic, healthy eating behaviors.”

Among the limitations of the study were that participants were predominantly female (79%) and predominantly White (84%) reporting race, and findings may not apply to other populations in the same way. In addition, the researchers evaluated the perception of the quality of the diet only at the end of the study. Assessments during the study may have helped to answer questions such as whether understanding during the study process was more realistic or whether a person’s understanding of their diet would help them avoid dietary changes or barriers.

Co-authors Tina Costacu, Ph.D.; Susan M. Serica, Ph.D. Bonnie Rockett-Wagner, Ph.D. Andrea M. Kriska, Ph.D.; Mary Lou Klem, Ph.D., MLIS; Margaret B. Conroy, MD, MPH; Bambang Parmanto, Ph.D. and Lora E. Burke, Ph.D., MPH Author disclosures are listed in the abstract.

The study was funded by the National Heart, Lung, and Blood Institute, a division of the National Institutes of Health.



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