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Negotiating healthy eating: Lay, stakeholder and government constructions of official dietary guidance in Sweden
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of food studies, nutrition and dietetics.
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Description
Abstract [en]

This thesis approaches dietary guidance as socio-culturally produced and comprised in a specific historical context. The work is premised on the position that ideas and understandings of healthy eating are discursively constructed, and that we form our understandings of the world, ourselves and others through discourse. The theoretical approach builds on the Foucauldian notion of governing, which includes how the state governs people through strategic techniques and individuals’ self-governing in relation to discursive norms related to official institutions. The four studies included in the thesis therefore explore how healthy eating and official dietary guidance are negotiated and constructed from stakeholder, lay and policy perspectives. Paper I takes a stakeholder perspective on “appropriate” national dietary advice by exploring 40 written responses to updated official dietary guidelines. Paper II and III focus on lay people’s discourses on dietary guidance and healthy eating by examining their written correspondences (727 and 60 digital messages, respectively) with the Swedish Food Agency. Paper IV examines how the Swedish Food Agency’s official dietary guidelines frame the interplay of public health concerns and environmental concerns in making food choices.

The findings demonstrate the dominance of a nutrient-centered and scientific discourse in communication (arguments, statements, instructions and questions) related to official dietary guidance in the Swedish context, even among non-professionals (in stakeholder responses, lay messages and the official dietary guidelines). In lay people´s communication with the Swedish Food Agency, both resistance to and internalization of official dietary advice are expressed within this dominating discourse. Resistance is additionally expressed through emotional language and by referring to alternative authorities, including personal experiences. The nutrient-centered and scientific discourse builds on the basic assumption of individual responsibility for health and the taken-for-granted nature of the primacy of physical health. Environmental perspectives come secondary to nutrition, which is demonstrated by their subordinate status in the official dietary guidelines and limited presence in lay people´s correspondences. Most socio-cultural, emotional and structural aspects on eating are made invisible by these discourses, in which food figures as scientifically quantifiable or functional in relation to physical health. However, in the official dietary guidelines from 2015, an additional discourse of cultivating certain tastes as a key to a sustainable diet constructs an ‘ideal eater’ with ‘middle-class’ aspirations.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2019. , p. 83
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 1652-9030 ; 173
Keywords [en]
dietary guidance, official dietary guidelines, healthy eating discourse, holistic dietary advice, reductionism
National Category
Social Sciences Interdisciplinary Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Research subject
Food, Nutrition and Dietetics
Identifiers
URN: urn:nbn:se:uu:diva-395048ISBN: 978-91-513-0777-0 (print)OAI: oai:DiVA.org:uu-395048DiVA, id: diva2:1360479
Public defence
2019-11-29, A1:111a, Biomedicinskt centrum, Husargatan 3 (Ingång A11), Uppsala, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2019-11-08 Created: 2019-10-13 Last updated: 2019-11-08
List of papers
1. Stakeholder responses to governmental dietary guidelines: Challenging the status quo, or reinforcing it?
Open this publication in new window or tab >>Stakeholder responses to governmental dietary guidelines: Challenging the status quo, or reinforcing it?
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2018 (English)In: British Food Journal, ISSN 0007-070X, E-ISSN 1758-4108, Vol. 120, no 3, p. 613-624Article in journal (Refereed) Published
Abstract [en]

Purpose

The purpose of this paper is to explore how stakeholders in the food and nutrition field construct and conceptualise “appropriate” national dietary advice.

Design/methodology/approach

In total, 40 voluntarily written stakeholder responses to updated official dietary guidelines in Sweden were analysed thematically. The analysis explored the logics and arguments employed by authorities, interest organisations, industry and private stakeholders in attempting to influence the formulation of dietary guidelines.

Findings

Two main themes were identified: the centrality of anchoring advice scientifically and modes of getting the message across to the public. Stakeholders expressed a view of effective health communication as that which is nutritionally and quantitatively oriented and which optimises individuals’ capacities to take action for their own health. Their responses did not offer alternative framings of how healthy eating could be practiced but rather conveyed an understanding of dietary guidelines as documents that provide simplified answers to complex questions.

Practical implications

Policymakers should be aware of industrial actors’ potential vested interests and actively seek out other stakeholders representing communities and citizen interests. The next step should be to question the extent to which it is ethical to publish dietary advice that represents a simplified way of conceptualising behavioural change, and thereby places responsibility for health on the individual.

Originality/value

This research provides a stakeholder perspective on the concept of dietary advice and is among the first to investigate referral responses to dietary guidelines.

Place, publisher, year, edition, pages
Emerald Group Publishing Limited, 2018
Keywords
Food policy, Concept of advice, Dietary guidelines, Nutritional reductionism, Stakeholder influences
National Category
Social Sciences Interdisciplinary Ethics
Research subject
Food, Nutrition and Dietetics
Identifiers
urn:nbn:se:uu:diva-341383 (URN)10.1108/BFJ-08-2017-0466 (DOI)000427495600008 ()
Available from: 2018-02-07 Created: 2018-02-07 Last updated: 2019-10-13Bibliographically approved
2. Public expressions of trust and distrust in governmental dietary advice in Sweden
Open this publication in new window or tab >>Public expressions of trust and distrust in governmental dietary advice in Sweden
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2019 (English)In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 29, no 8, p. 1161-1173Article in journal (Refereed) Published
Abstract [en]

We examine public trust and distrust in governmental food and nutrition authorities, through analyzing 727 letters sent electronically to the Swedish National Food Agency by lay people. Using thematic analysis, four themes were developed, defining public expressions of trust and distrust in official dietary advice. Trust was expressed as (a) seeking to confirm and clarify dietary advice, or (b) seeking official arbitration between competing dietary advice. Distrust was expressed as (c) questioning and scrutinizing dietary advice, or (d) protesting and resisting dietary advice. Notably, expressions of distrust employed discursive practices that both mirrored authoritative discourses and subverted official advice, by appealing to scientific language and 'alternative' evidence. All letters positioned the agency as the ultimate authority on healthy eating; notwithstanding whether the agency’s advice was to be followed or resisted. Thus, the letters revealed how the same authoritative discourses can simultaneously be a site of public trust and distrust.

National Category
Sociology Social Sciences Interdisciplinary Other Health Sciences
Research subject
Food, Nutrition and Dietetics
Identifiers
urn:nbn:se:uu:diva-371985 (URN)10.1177/1049732318825153 (DOI)000471163000007 ()30741093 (PubMedID)
Available from: 2019-01-04 Created: 2019-01-04 Last updated: 2019-10-13Bibliographically approved
3. 'Writing nutritionistically': A critical discourse analysis of lay people´s digital correspondence with the Swedish Food Agency.
Open this publication in new window or tab >>'Writing nutritionistically': A critical discourse analysis of lay people´s digital correspondence with the Swedish Food Agency.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

This article analyzes lay people’s use of nutritionistic discourse in written correspondence with the Swedish Food Agency, an authority responsible for dietary advice. Examining 60 food related written digital messages, we apply a critical discourse analysis to parse the terms and grammar people use when constructing “food” in scientific terms. Findings show that message writers place nutrients at the discursive center and frequently use terms that indicate preciseness, such as numbers and amounts, reinforced by modality (auxiliary verbs) and transitivity (nominalizations). Messages therefore emphasize the what, but not the how, of eating, implying a focus on food as subject to regulation and control. As such, eating is discursively reduced to an act of ingesting nutrients that can be decontextualized and managed in isolation – as entities to increase or avoid separately. These discursive features preclude the conceptualization of food choice and eating as subjective experiences of feelings, taste, and tradition.

National Category
Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Research subject
Food, Nutrition and Dietetics
Identifiers
urn:nbn:se:uu:diva-395044 (URN)
Available from: 2019-10-11 Created: 2019-10-11 Last updated: 2019-10-13
4. 'A holistic approach': Incorporating sustainability into biopedagogies of healthy eating in Sweden’s dietary guidelines
Open this publication in new window or tab >>'A holistic approach': Incorporating sustainability into biopedagogies of healthy eating in Sweden’s dietary guidelines
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Dietary guidelines advise individuals on how to think and act in relation to food choices. As such, they can be considered a pedagogical tool, designed to promote a healthy lifestyle and eating patterns at the general population level. In this study, we critically examine the biopedagogies implicated in Sweden’s official dietary guidelines. Published in 2015, these guidelines take a “holistic approach” to food and eating, addressing the challenge of formulating dietary advice that considers both human health and environmental concerns. The guidelines therefore offer a potentially innovative, sustainability-driven approach to authoritative dietary advice. Applying Bacchi´s ‘What’s-the-problem-represented-to-be’ approach, we interrogate how the guidelines frame the interplay of public health concerns and environmental concerns in making food choices. We find that the biopedagogies of sustainable eating, as presented in these guidelines, implicate the subject position of the ideal eater. The ideal eater values sustainability, has high cultural capital, and draws on both taste and nutritional knowledge to make good food choices. However, while the ideal eater is expected to be aware of environmental issues, these are incorporated into the ideal eater’s choices only in addition to the primary concern of health. Thus, although the guidelines frame a “holistic approach” as the solution to both health and environmental concerns, in cases where health and environmental priorities conflict, the guidelines’ biopedagogies of sustainable eating align with earlier biopedagogies of healthy eating.

National Category
Social Sciences Interdisciplinary
Research subject
Food, Nutrition and Dietetics; Food, Nutrition and Dietetics; Food, Nutrition and Dietetics
Identifiers
urn:nbn:se:uu:diva-395045 (URN)
Available from: 2019-10-11 Created: 2019-10-11 Last updated: 2019-10-13

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Bergman, Karolin

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