There is ample evidence from repeat food surveys that people are actually a
nd passively changing their food habits. Understanding the reasons for this
are Vital to any efforts by clinicians to enable individuals to move in an
increasing healthful direction with their food intake, and to dispel the p
essimism that often prevails about the ability to make a useful contributio
n to nutritional status by changing food intake. Current success and failur
e rates are predicated on inadequate methods and inappropriate outcome meas
ures, rather than an inability to achieve outcomes. Factors that allow for
or encourage change are food availability, exposure to new food experiences
, food memory, pleasure, eating with peers or companions, health interest a
nd changing constructs and beliefs about food. It is possible to change the
health impact of food by non-food means like physical activity, stress man
agement, recreational activities, improved relationships, changing the work
environment and through adequate sleep (including siesta). Yet another con
sideration is that the full consequences of food choice are not appreciated
with more and more food-health relationships being defined (e.g. with cata
ract, macular degeneration, in depression and cognitive function). These va
rious approaches require a management strategy that underpins the field of
behavioural therapy. In this approach it is possible to make progress throu
gh small but consequential changes, like climbing the stairs, or increasing
intake of particular foods like fish or drinking more water; and exploring
and contracting ways to do these things.