First, there is a general concern about the composition of food intake rather than the amount and frequency of the intake. Such concern is based on an idea that there are good and bad kinds of food.

As a result, many people believe that eating the wrong kinds of food, rather than an imbalance in calories, is the cause of obesity. In other words, they tend to focus on the composition and kinds of food while paying less attention to how often and the amount they eat.

A consequence of this belief is that people may change their diets more radically than necessary in order to prevent obesity. For example, they may stop eating the foods they used to enjoy.

Second, there is a mental rule that eating in a balanced way will help prevent obesity. Such an idea is sound, but it is often applied in ways that are unlikely to help prevent obesity. For example, many Chinese believe that drinking hot tea will reduce the "heat" of greasy food, and many Vietnamese believe that eating something sour will prevent weight gain if taken after sweet or creamy food.

Americans and Australians talk about balancing unhealthy out-of-home eating with healthier at-home eating, while others may believe that strongly flavoured food is higher in energy than mildly flavoured food.

In addition, the frequency needed in balancing such diets is not easy to measure, or people may believe that they are balancing a period of heavy eating with a period of light eating but may not estimate this accurately.

Third, there is a perception that Asian and local fast foods are less likely to cause obesity than Western fast foods. This was very common in all 21 markets covered in the survey.

Fourth, people believe that they should skip meals in order to lose weight.

Fifth, there is a belief that freshness is a good indicator of low calorie content and that processed food is more likely to cause weight gain.

Many people have rules about deciding which foods are healthy for them, and their perception of what is healthy is intertwined with the idea that food must be fresh and as unprocessed as possible. As a consequence, there is confusion about which foods really cause weight gain.

The survey found that people could benefit from prioritising the rules they followed, as they sometimes believed the most effective strategies were the ones most difficult to do. On the other hand, they are not aware that some "easy" strategies could be more effective than the tough ones they have chosen.

An example of this is the idea of "balance". While you may believe that you eat a balanced and varied diet, you may not be aware of how often you consume the same kinds of food and drink.

If this is a key message for health communicators, then they may need to find ways to demonstrate what it actually means or encourage people to challenge their eating behaviour.

In preventing obesity, it is also more cost-effective to try and influence people during their early working days, when they establish their adult eating habits.

Another opportunity to communicate to families is when their children are in late primary or early middle school. As a unit, the family is more open to changes in out-of-home food habits.

At this age, children are usually able to tolerate a wider range of foods, so they may start to contribute to decisions on where and what to eat.

In addition, children in many places are communicating to their parents the health messages learnt in school, so openness to change increases as families adapt to new possibilities and priorities in out-of-home eating.

Since obesity is often taken to mean the extremely overweight, public education may also need to define healthy weight, overweight and obesity more clearly so that the issue can be addressed more effectively.

Also, there should be more education to help people understand the calorie information on food and drink packaging, since many still do not know what calories are or how many are required in a healthy diet.

Nophakhun Limsamarnphun

nop1122@yahoo.com

The Nation