Food choice motives and risk perceptions about food and chronic diseases in the consumer perspective

Introduction: In recent years, there has been a change in the population's eating pattern, an increase in the consumption of ultra-processed foods (UPF), and, in parallel, an increase in the prevalence of obesity and chronic diseases. Several factors can influence the food choice process, among them the perception of risk about food and on different health risks. It is known that underestimating a hazard leads to negligent behavior, as well as reducing it appears to be a stimulant for promoting behavioral changes. Objectives: To evaluate the perception of risk and benefit of consumers on the consumption of certain foods and the development of diabetes mellitus (DM), hypertension (SAH) and weight gain, as well as their relationship with the reasons for choosing food, with the perception of food and the perception of health control. Methodology: The study was approved by the ethics committee (CAAE number: 91222418.5.0000.5404). Questionnaires were applied to 525 individuals over the age of 18 from the region of Limeira - SP. To measure the risk and benefit perceptions related to the consumption of certain foods, a seven-point scale was used, (-3) very bad for health, (3) very good for health, and about the effect on body weight (- 3) gain much weight to (3) lose much weight. The food choice motives were assessed using the translated and adapted to Brazilian culture version of the Food Choice Questionnaire, using a seven-point scale, (1) strongly disagree with (7) strongly agree. The optimistic bias was assessed by the indirect method, using a seven-point scale (-3) extremely low to (3) extremely high. Results: The average age of the participants was 34.5 years, and 61.1% were female. Through the Principal Component Analysis, foods were grouped according to their perception of their effects on health into eight factors, and in general, they were grouped according to their degree of processing or nutritional composition, with few exceptions. In general, UPF was seen as more harmful to health and unprocessed or minimally processed foods more beneficial to health. However, some healthy stereotype UPF has been positively evaluated (e.g., gelatin, turkey breast, cereal bar, light foods). Regarding the effect on body weight, seven factors were formed, grouped according to possible dietary patterns or roles that foods play in the diet. UPF, rich in carbohydrate and fat were considered more fattening foods, no food obtained the perception of slimming. After the Confirmatory Factor Analysis rejected the original structure of the FCQ, through Exploratory Factor Analysis, eight factors were formed: Nutritional Composition, Preparation Convenience, Purchase Convenience, Mood, Sensory Appeal, Health, Price and Familiarity. The Sensory appeal was the most important factor for food choices, while Familiarity was the least important factor. Aspects such as high educational level, high income, age, and female sex had a positive effect on all factors except the Price. Five clusters were formed based on the scores attributed to the FCQ factors, which are: Health Driven, Practicality Concerned, Shape Concerned, Food Concerned, and Cooking Enthusiast. The optimistic bias was observed for DM, SAH, and weight gain. The perception of health control, the attribution of importance to the factors of Nutritional Composition, Purchase and Preparation Convenience, and the perceptions about some foods affected the perception of risk proper to the events studied. Conclusion: In general, foods were classified as healthy or unhealthy based on their processing. However, it was noted that the presence of several stereotyped foods, UPF perceived as healthy. The public was optimistic about their health, thinking that they are less prone to weight gain, DM, and SAH than other people. Several variables of risk perception and food choices were related to biased perception. The results reinforce the complexity involved in choice and consumption, taking into account the different motivating factors that may be prevalent in different groups of the population, so that healthy eating messages can reach everyone (AU)