Research reviewThe importance of habits in eating behaviour. An overview and recommendations for future research
Highlights
► Habit is one of the most powerful predictors of eating behaviour. ► Research in the food domain should pay more attention to the fundamental differences between habitual and non-habitual behaviours. ► Interventions to change habitual behaviour can try to (i) change the situation that triggers the habitual behaviour, (ii) promote inhibition of the habitual response and (iii) change relevant contingencies.
Introduction
Given the current alarmingly high prevalence of nutrition-related disease and mortality in Western countries (Lobstein et al., 2005, Peeters et al., 2003, WHO, 2002, WHO, 2003) and the need to change eating patterns in the population (Kumanyika et al., 2000), it is imperative to develop effective behavioural interventions to improve diet quality. Grounded in the psychological tradition, many interventions aimed at promoting healthy eating rely on educating the public in order to change eating intentions and, ultimately, behaviour (e.g., Brug et al., 2003, Grunert and Wills, 2007, Larsson et al., 1999, Wammes et al., 2005). However, the results of a meta-analytic study suggest that such an approach is especially effective for one-off or infrequently performed behaviours, such as obtaining a mammography or a flu shot. For behaviours that are performed frequently in a stable context, the success of information-based interventions was found to be more limited (Webb & Sheeran, 2006). Likewise, a meta-analysis of the effectiveness of mass-media campaigns showed that campaigns that promoted the commencement of new health behaviours were more effective than campaigns which aimed to change frequently performed behaviour (Snyder et al., 2004). Presumably, these frequently performed behaviours have developed into habits.
In colloquial language, habits are understood as behaviours that are frequently repeated over time. In food research, this colloquial meaning of the word habits seems also to predominate. A recent search on Web of Science using ‘habit’ and ‘food’ as search terms yielded almost 800 papers, most of which used the term habit in the sense of repeated behaviour, a diet or an established eating pattern. In the present paper, however, we argue that habits are much more than repeated behaviours. In fact, habits can be understood as learned sequences of acts that have been reinforced in the past by rewarding experiences and that are triggered by the environment to produce behaviour, largely outside of people's conscious awareness (Neal et al., 2006, Wood and Neal, 2007). Research shows that habitual behaviour is fundamentally different from non-habitual behaviour. That is, enacting habitual behavioural appears more dependent on the environment and to a lesser extent under intentional control than enacting non-habitual behaviour. Consequently, traditional health educational approaches may be insufficient to change habitual behaviour (Rothman, Sheeran, & Wood, 2009).
It is estimated that up to 45% of behaviour tends to be repeated in the same physical location almost every day (Barker and Schoggen, 1978, Wood et al., 2002). It seems, then, that ‘most of the time what we do is what we do most of the time’ (Townsend & Bever, 2001; page 2). Because eating is something most people do every day and because, in many cases, meals are consumed at the same place and time from day to day, it may be assumed that eating behaviour is in large part habitual (Conner, Norman, & Bell, 2002). Indeed, studies using household panel data to investigate patterns in food purchases show that most food purchases are repeated over time (Carrasco et al., 2005, Naik and Moore, 1996). Moreover, a recent meta-analysis of habit-behaviour effects yielded a medium-to-large effect size of r = .43 (using a fixed model; for a random effects model the effect size was r = .42) for the effects of habit on dietary behaviour, suggesting that habit accounts for 18% of variance in dietary behaviour (Gardner, De Bruijn, & Lally, in press). Similar summary correlations have been reported for intention and PBC (e.g., Armitage & Connor, 2001), indicating that habits may be as relevant for behavioural action as commonly utilized socio-cognitive concepts. This modest-to strong relationship between habit and behaviour may be a viable explanation for the fact that educational interventions attempting to change eating behaviour often have small effects (Brug, 2008, Cohen and Farley, 2008, Downs et al., 2009, Knight et al., 2006, Rothman et al., 2009). Interventions that are specifically underpinned by habit theory are likely to be more effective than information-based efforts (cf. Verplanken & Wood, 2006). For instance, a recent study investigated the effectiveness of weight-loss advice that was specifically inspired by habit theory (Lally, Chipperfield, & Wardle, 2008), promoting repetition in stable contexts and thereby fostering the development of automaticity. This habit-informed approach resulted in increased weight loss in the habit-intervention condition as compared with a no-intervention control condition. Although future research should compare the effectiveness of such habit-change interventions with traditional information-based approaches before definitive conclusions can be drawn, we will outline in the present paper that there are conceptual reasons to think that specific habit-change intervention offer potential for promoting healthy eating.
In the present article, we will discuss the importance of habits for eating behaviour, focusing primarily on habit research that has been conducted in a food choice context. In some cases, however, we will first mention studies from the psychological literature that have pioneered theoretical insights and then discuss food studies that have applied these findings to eating behaviour. When relevant theoretical insights have not been illustrated in the food choice literature we use studies from other domains to illustrate our reasoning, but we acknowledge that additional research in a food context is necessary. Because we hypothesize that interventions targeting eating behaviour are more likely to be effective when they take into account the habitual nature of most eating behaviours (cf. Verplanken & Wood, 2006), we will propose several intervention strategies that may be effective in changing and creating eating habits, and that should be tested empirically in future research. Thoroughly testing and evaluating such interventions can offer new insights into the habitual nature of dietary behaviours, but can also contribute to improved public health. So far, however, there is a dearth of research investigating the effectiveness of nutrition interventions that are informed by habit theory. We therefore propose a conceptual framework for interventions targeting eating habits that can act as a starting point for future behaviour-change research. While several articles provide overviews of habit research (Verplanken and Aarts, 1999, Verplanken and Wood, 2006, Wood and Neal, 2009) and two articles have stressed the need to investigate non-reflexive and non-rational determinants of eating behaviour (Cohen and Farley, 2008, Rothman et al., 2009), no reviews have yet been published on the importance of habit in eating behaviour.
Section snippets
Habits and repeated behaviour
In expectancy-value accounts of human behaviour, such as given by the Theory of Reasoned Action (Ajzen & Fishbein, 1980) and the Theory of Planned Behaviour (TPB) (Ajzen, 1991), intention is assumed to be the immediate antecedent of behaviour. Although it is well-documented that measures of past behavioural frequency contribute significantly to the prediction of future behaviour over and above intention and other TPB constructs (Bagozzi and Kimmel, 1995, Beck and Ajzen, 1991, Godin et al., 1993
Future research: designing and testing habit change interventions
In recognition of the importance of habitual behaviour, the concept of habit has been incorporated in several conceptual models of eating behaviour (e.g., Booth and Shepherd, 1988, Furst et al., 1996). Also, habit is increasingly incorporated into cross-sectional and longitudinal studies investigating the behavioural and psychosocial determinants of food choice. Usually, it is investigated whether habit can predict eating behaviour over and above other relevant factors, oftentimes TPB variables
Creating healthy eating habits: changing the performance cue
As mentioned above, research has shown that habitual behaviours are cued by situational factors. Therefore, one promising approach to changing habits may be stimulus control: altering the situation in which eating behaviour is performed. For example, in his book ‘Mindless Eating’, Brian Wansink (2006) gives an overview of several strategies people can use to make their direct environment more conducive to healthy food choices, such as placing foods in smaller boxes and bowls, placing tempting
Creating healthy eating habits: triggering the healthy response
As we have seen above, we hypothesize that altering exposure to situational cues constitutes an effective way to create desirable habits. However, even when the environment provides ample opportunities to engage in healthy eating, the actual behaviour still needs to be enacted. Forming implementation intentions, specific plans as to when and how to implement the behaviour in an IF-THEN format, has been shown to be a helpful tool to promote desirable behaviour (Gollwitzer & Sheeran, 2006).
Creating healthy eating habits: changing contingencies
As mentioned above, habit strength increases when behaviour is repeatedly reinforced by satisfactory experiences (Aarts et al., 1998, Hull, 1943, Wood and Neal, 2007). In fact, when a behaviour is first executed, some kind of reinforcement needs to take place before the behaviour can become habitual. Or, to put it another way, if a behaviour results in a neutral or negative experience upon first execution, it is unlikely to develop into a habit. It follows that, besides changing environmental
Breaking existing habits: changing the performance cue
We have seen above that stimulus control, altering the situation in which the behaviour can be performed, may be an effective way to establish health eating habits. The question now is whether it can also be used to change existing habits.
Early work by Prochaska and colleagues (Prochaska and DiClemente, 1985, Prochaska et al., 1988) has shown that people often use stimulus control as a means to changing unhealthy behaviour. For instance, in order to quit smoking, some smokers remove things from
Breaking existing habits: inhibiting responses
As we have seen above, research is needed to investigate whether altering exposure to situational cues can be an effective way to establish desired habits or break undesirables existing ones. Sometimes, however, people may be able to inhibit the performance of the behaviour after it has been mentally activated by the situational cue. That is, although we have seen that habits exert a powerful influence on human behaviour, in some cases habitual responses to situational cues may be inhibited by
Breaking existing habits: changing contingencies
One important question in habit research is whether, besides changing environmental cues and helping people inhibit their habitual response, changing the contingencies associated with behavioural options may be helpful in changing existing unwanted habits. It is generally accepted that habit strength increases when behaviour is repeatedly reinforced by positive contingencies (Aarts et al., 1998, Hull, 1943, Wood and Neal, 2007). However, little is known about whether punishing habitual
A conceptual framework for testing habit change interventions
Habits constitute learned responses to situational cues that have been rewarded by satisfactory experiences in the past. When designing habit interventions, it therefore makes sense to try to change situational cues, promote or inhibit habitual responses and change the contingencies that are associated with the behaviour. We have identified several behaviour change intervention strategies that can achieve these goals, and have included them in a conceptual framework for testing habit
Conclusions
More and more, habits are recognized as important factors in eating behaviour (e.g., Gardner et al., in press). However, while many researchers in the food domain have been satisfied to include the habit construct in their studies as an additional determinant of food choice, little attention has been paid to the fundamental differences between habitual and non-habitual eating behaviour. As we have argued above, habits can be understood as learned sequences of acts that are triggered by the
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