Financial constraints, stress, unhealthy food offerings, and social environment together make a healthy meal far from straightforward, research by Sanne Djojosoeparto and colleagues shows.
According to the National Institute for Public Health and the Environment, only one in three Dutch people follow a healthy diet. The rest of the population doesn't adhere to the guidelines of the "Schijf van Vijf," often failing to meet recommended vegetable intake or consuming too much alcohol. Eating healthier, however, is not that simple. Previous research from Wageningen University & Research (WUR) shows supermarkets are filled with unhealthy options, a constant temptation.
"A healthy meal is also more expensive than an unhealthy one. Particularly for people with limited budgets, this can be a significant barrier. And that's not their only obstacle," says Sanne Djojosoeparto, a researcher at the Consumption and Healthy Lifestyle Group. Together with her colleagues, she mapped out the complex factors making it challenging for people with limited finances to choose healthily.
Insights from experts by experience
Djojosoeparto collaborated with colleagues Nieke Sonneveld, Maartje Poelman, and with Carlijn Kamphuis from Utrecht University. To understand exactly how the eating behavior of people with limited means is shaped, they organized three meetings with professionals and experts by experience, all from the Ede area.
Specifically, eleven professionals knowledgeable about nutrition, health, or debt assistance, and fourteen residents of the Veldhuizen neighborhood who live with or have experienced financial constraints. "It was crucial for us to place their experiential knowledge at the center of our research," says Djojosoeparto.
Together with the researchers, these participants identified barriers faced by people on tight budgets regarding healthy eating. The result is a system map of sixty-two factors:
"People who daily choose between groceries and other essential expenses have insights you cannot capture by data and theory alone," Djojosoeparto explains. "This map provides a more comprehensive and realistic view of their situation. Policies created with these factors in mind, will better align with their reality."
Three dynamics that complicate healthy eating
Within this intricate web of factors, Djojosoeparto and her colleagues identified three "core dynamics" that keep the system in tact: the impact of scarcity, the food environment, and the socio-cultural environment.
1. Lack of money and mental bandwidth restricts people
During the meetings, professionals and residents both highlighted how financial trouble can strongly influence food choices. "On the one hand, your budget may not cover all ingredients for a healthy meal, which often costs more," Djojosoeparto says. "On the other hand, financial stress itself predisposes people toward unhealthy choices."
"If you constantly struggle financially, that means continuous stress, potentially causing mental health issues. Even without severe problems, stress reduces your mental bandwidth and decision-making capacity." Simply put, there isn't enough mental space to plan meals, shop, cook, and evaluate good versus poor choices. This leads people to for the easy choice: convenient, highly processed food.
Additionally, the conversations revealed a widespread misunderstanding of scarcity, colleague Sonneveld notes. "Even caregivers sometimes don't grasp its impact. This misunderstanding complicates asking for help, adding shame on top of stress."
2. Most of the food sold and promoted is unhealthy
People with limited budgets-often more susceptible to unhealthy choices-must navigate an environment brimming with unhealthy food options. Supermarkets predominantly offer unhealthy items, and promotional offers further encourage these choices by making unhealthy foods cheaper. In 2021, 80% of supermarket offerings and promotions in the Netherlands were unhealthy, according to WUR. In restaurants, it was 91%.
Choosing healthy options amidst this scenario is challenging even for average consumers, let alone those dealing with financial stress. The government provides minimal assistance here, Sonneveld observes. "Currently, retailers are expected to self-regulate, but little evidence of this exists. And most food producers are motivated by profit. Unhealthy products allow for much better margins."
In neighborhoods with many financially constrained residents, food options are notably poorer, Sonneveld adds. "Research from University Medical Center Groningen shows these neighborhoods feature significantly more fast-food restaurants."
3. The social environment reinforces unhealthy habits
Half of the Dutch who claim to want to eat healthier continue to eat unhealthy meals because their environment does so, the Dutch Central Bureau of Statistics reported in 2023. "Exposure to healthy eating habits partially depends on your socio-cultural environment," Djojosoeparto emphasizes. "Upbringing, local eating habits, and social media influence your willingness and motivation to change your eating habits."
