Many Organizations Promote the DGA Consumer Messages, But Are They Compelling?

The scope of the DGAC, recently made clearer by the Federal agencies (https://www.dietaryguidelines.gov/sites/default/files/2019-05/2020%20DGAC%20Bylaws%20Final.pdf), is to assess the science relative to the big nutrition questions of the day, and make conclusions on which the dietary recommendations are based. The process has evolved to assess the latest science with objective integrity, using advice from the National Academies (https://www.nap.edu/resource/24637/DGAs-report-highlights.pdf).  The Federal agencies tasked with setting the dietary policy have advanced the process by using improved evidence analysis methods commensurate with increased transparency of the topics covered, which will now be extended to assess the weight of the science for recommendations that include the birth to 24 months age segment.  Nonetheless, what continues to be a missing component in this process is a parallel effort singularly dedicated to assess the science-based recommendations from a consumer behavior and values perspective.

There are many public, food sector, academic and non-profit organizations working every day to advance messages to help consumers make better choices based on the DGA.  They work to put the DGA into action but need a unifying mechanism.  These efforts individually may not be compelling enough to consumers today. The 2015-2020 DGAC and the DGA policy document (2015-2020 DGA, Chapter 2) clearly show the typical eating patterns currently consumed by many in the United States do not align with the Dietary Guidelinesrecommendations. When compared to the Healthy U.S.-Style Pattern, about three-fourths of the population has an eating pattern that is low in vegetables, fruits, dairy, and oils.  More than half of the population is meeting or exceeding total grain and total protein foods recommendations, but are not meeting the recommendations for the subgroups within each of these food groups.  Most Americans exceed the recommendations for added sugars, saturated fats, and sodium.  In addition, the eating patterns of many are too high in calories.  It’s safe to say that, even with the preponderance of the best scientific evidence to base recommendations, only a single digit percentage of Americans are actually following the DGA.  This situation begs the question, are updated, re-validated science-based recommendations alone likely to change consumer behavior, particularly when values that consumers apply in today’s food environment are likely to persuade decisions that may counter or confuse DGA recommendations?

A Glaring Gap:  Dietary Recommendations Messages Need to Be Crafted to Appeal to Consumer Values

A point of view among those engaged in the DGA process is that science on its face through simple messaging should be adopted to affect consumers; however, there is no adjunct effort parallel to the DGA process taking the next step – how to do this to affect a meaningful population behavior change. People know what to do about keeping calories within their needs; limiting sugar calories; being active; shifting to eat more fruits and vegetables, low-fat dairy, lean protein foods and whole grains.  They know what to do, but they need to value it to actually do it. Considering the host of consumer values-drivers in the food environment today and how they impact the application of the DGA is critical to getting the recommendations applied in everyday habits and lifestyles.  This is a glaring gap in the DGA process regarding national implementation and, although the MyPlate(.gov) program was designed to put the DGA into action (I led the effort to create it!), according to the IFIC Foundation 2019 Food and Health Survey, it isn’t recognized by over a third of consumers surveyed.  More important, the MyPlate DGA education system and its resources do not reflect the prevailing consumer values that complicate consumer food decisions today.

Today’s Consumers Filter Their Food Choices Through a Variety of Factors

Dietary guidelines on their face are not likely to be compelling if not presented in a way that appeals to consumers’ values.  Consumers have begun to weigh a new set of factors when purchasing food and beverages, according to a study by Deloitte, the Food Marketing Institute and the Grocery Manufacturers Association (January 2016 – see Figure below).

The study, “Capitalizing on the Shifting Consumer Food Value Equation,” found that roughly 51% Americans surveyed weigh “evolving drivers” – health and wellness, safety, social impact, experience and transparency – in their purchasing decisions, in addition to the “traditional drivers” of taste, price and convenience. This occurs regardless of demographic factors. The research reveals that the preference for these attributes does not differ by generation, income level or region, but is pervasive across the socioeconomic, age, and geographic groups.

According to the study, “Today’s consumers want to know more than previous generations and they are putting the assessment of that information [and I would add, the access to that information], into their values equation.” The Deloitte study reports “There is no doubt that the consumer value equation has changed – taste, price and convenience are now only the foundation with the need to leverage the emerging value drivers.”

Further evidence of the disconnect between science-based recommendations and today’s values-based consumer food selection factors exists in the IFIC Foundation’s 2019 Food and Health Survey.  It reports the types of diets that consumers say they follow today (see Figure below), many of which aren’t addressed in the scope or recommendations of the DGA but that may impede the implementation of science-based recommendations that don’t relate to the factors in consumer food decisions today.

The 2020 Dietary Guidelines Advisory Committee and the Nutrition Community Should Appreciate the Views that Consumers Have for Dietary and Lifestyle Choices Even If Behaviors Conflict with Science

The 2020 Dietary Guidelines Advisory Committee forming recommendations and the nutrition community should appreciate the views that consumers have for the dietary and lifestyle choices they make while using science communications strategies to infuse public health benefits if the behaviors conflict with science.  For example, the “clean” and “clear” labeling movement is very real to consumers and impacts the choices they make, which may confuse or contradict the DGA recommendations.  In fact, the concept of “clean labels” is a reality so much so that FDA has acknowledged it as a basis for improved nutrition policies in its nutrition innovation strategy (https://www.fda.gov/food/food-labeling-nutrition/fda-nutrition-innovation-strategy). Further, in addition to consumer purchase trends research, a national multi-sector DGA implementation strategy is also best informed by marketing data, food distribution data, and consumer purchasing psychology research, all of which are out of the scope of the DGAC’s charge to consider and apply.

The Need for a “DGA Implementation Advisory Taskforce” for Guidance That Considers Consumer Values

Because there is no parallel advisory committee adjunct to the DGAC working to create a nationally-focused, public-private DGA recommendations implementation plan, which adds the dimension of shared-values, we stand to, once-again, succeed in publishing a set of evidence-based guidelines but fail to inspire consumers of all ages to value, adopt and act on them.  The 2015 DGAC report acknowledges there are many factors (see Figure), including individual factors, that influence food choices; however, further consideration of messaging to appeal to values is not within the scope of the DGAC nor in the implementation through the MyPlate nutrition education program.  We need “three-dimensional” recommendations that give us the what and how much to eat, and evidence-based, values-related “how-tos” to really make the DGA recommendations stick.

What might work is the formation of a federally-sanctioned “DGA Implementation Advisory Taskforce” made up of stakeholders from implementing sectors, i.e., the food sector (manufacturers, food service, institutions, trade groups), nutrition and health programs, nutrition and health communicators and educators, sports and fitness organizations, led by consumer behavior research experts.  The taskforce would be federally-sanctioned and activated to coincide with the release of the DGA policy.  The charge for such a taskforce would consider the following points, which are by no means complete.

1. Work according to a well-coordinated public/private sector framework to accommodate values driving consumer food choice behaviors to achieve a consumer shift toward healthy dietary patterns. Use an evidence-based implementation plan with equal multi-sector involvement.

2. Relate science-based dietary guidance to consumer interests.

• Conduct a systems-wide analysis of evidence on dietary habits with evaluation of economic, social, technological, and environmental concerns among consumers and subgroups of consumers that impede or override the application of dietary recommendations.  This should include food production issues and practices that influence consumer choices.

3. Conduct a robust assessment of market factors, informed by marketing and consumer behavior experts and studies/surveys/food distribution data/food purchase data.

4. Formulate educational messaging that is shown to appeal to beliefs and dispel myths.

• Implementing the DGA recommendations should be in the context of the food environment, connecting nutrition to consumer demands, and talking about how food production and processing relate to shared values in the areas of food safety, affordability, accessibility, food waste, nutrient preservation, convenience, sensory/taste, cultural proscriptions, lifestyle beliefs (includes corporate social responsibility), and other factors shown in the Figure above.
• A national implementation strategy based on evidence of best practices to affect positive behavioral changes should consider adopting healthcare and other proven models for science-based shared values approaches to communications.
• Guide consumers to healthy options that appeal to their views of “better-for-you” choices and which align with dietary recommendations.

5. Identify, synthesize, and identify gaps and priorities in research on the relationship between healthy dietary patterns, health, and values-led consumer dietary behaviors.

6. Ultimately, the food sector and other stakeholders must partner with policy makers to “test-drive” the DGA with the public before the DGA become committed to messaging, in order to assess the potential for affecting behavior change and to diminish unintended effects.

A “Dietary Guidelines Implementation Advisory Taskforce” Can Finally Make Dietary Guidelines Sticky

By establishing a nationally-focused DGA Implementation Advisory Taskforce with a charge such as that described above, there’s a possibility that the DGA recommendations may become integrated into the values-based filters that today’s consumers use in their everyday food choices.  With this additional dimension to national science-based dietary advice, we may all finally inspire consumers and influencers of consumers of all ages to embrace the changes needed to improve public health.