Attitudes to food and the role of food in life in the U.S.A., Japan, Flemish Belgium and France: possible implications for the diet-health debate.

For human beings, food is a critical contributor to physical well being, a major source of pleasure, worry and stress, a major occupant of waking time and, across the world, the single greatest category of expenditures. This is a first study of the way food functions in the minds and lives of people from four cultures. Adults and college students from Flemish Belgium, France, U.S.A. and Japan were surveyed with questions dealing with beliefs about the diet-health link, worry about food, the degree of consumption of foods modified to be "healthier" (e.g. reduced in salt or fat), the importance of food as a positive force in life, the tendency to associate foods with nutritional vs. culinary contexts, and satisfaction with the healthiness of one's own diet. In all domains except beliefs about the importance of diet for health, there are substantial country (and usually gender) differences. Generally, the group associating food most with health and least with pleasure is the Americans, and the group most food-pleasure-oriented and least food-health-oriented is the French. In all four countries, females, as opposed to males, show a pattern of attitudes that is more like the American pattern, and less like the French pattern. In either gender, French and Belgians tend to occupy the pleasure extreme, Americans the health extreme, with the Japanese in between. Ironically, the Americans, who do the most to alter their diet in the service of health, are the least likely to classify themselves as healthy eaters. We conclude that there are substantial cross-cultural differences in the extent to which food functions as a stressor vs. a pleasure. These differences may influence health and may partially account for national differences in rates of cardiovascular diseases (the "French paradox").