Nutritional behavior has received increasing interest among healthcare providers and policy makers as the incidence of overweight and obesity has increased. Although considerable attention has been directed toward determining most appropriate foods to consume, information on other aspects, such as the context in which foods are consumed, has not been well covered until recently. However, consideration of eating patterns, eating norms, and social context is equally important in understanding nutritional behavior and insuring adequate knowledge upon which to base nutritional advice.

A different perspective

Nutrition is usually studied in the context of "requirements for the optimal functioning of the body and food and eating as the means by which nutrients are delivered to the biological system" (Delormier, Frohlich, & Potvin, 2009, p 287); however, eating behaviors should be considered from a more comprehensive perspective (Delormier, Frohlich, & Potvin, 2009). Delormier et al. suggest examining eating patterns from a social perspective, that is, a perspective that recognizes the role played by an individual, rules, and resources. Doing so takes into account the forces that are in play when food choices are made, as choices can be informed by family or peer social norms.

This more comprehensive perspective was explored by Robinson, Thomas, Aveyard, and Higgs (2014) in their systematic review of eating norms as a form of informational influence on food intake and choice. They found that social influence is in play when individuals make use of the behavior of those around them to decide whether a course of action is adaptive (e.g., if everyone else is doing it, it will probably be a good idea for me to it). They concluded that social context, such as the behavior of others, influenced eating behavior. Therefore, a person who associates with individuals who consume large portions may increase his or her intake of food. Moreover, persons who are closer to a person [social proximity] exert greater influence on a person's eating behavior.

Savoca et al. (2011) provided an excellent example of how this perspective plays out in real life. They assessed meal patterns and food choices of young African American men between 15 and 22 years of age within the context of specific life activities [social context] and found that eating patterns were influenced by degree of participation in sports: meal pattern was more regular for athletes than for nonathletes. Conversely, employment contributed to an erratic eating pattern, one that was more reflective of a "grab and run" pattern rather than "sit and take time" pattern. Consequently, young men who were employed consumed less nutritious foods. "Dinner was eaten regularly by all groups and, when occurring at home with family or roommates, was an important source of a balanced meal" (p 1338). Participants rarely mentioned consumption of legumes, whole grain foods, or nuts; consumption of fruits and vegetables was limited to home or cafeteria. These results help healthcare providers gain insight into complexities surrounding eating behaviors.

What does this information mean for nurses?

Appreciating the complexity of eating behaviors is consistent with the philosophical underpinning of our profession. Nurses historically have appreciated the need to adopt a comprehensive perspective when performing assessments. The information presented here reinforces nurses continuing to undertake a comprehensive assessment of eating patterns, one that takes social context into account. Doing so will enhance the nurse's ability to provide the most appropriate direction for individuals and families.

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