Download Appropriating functional foods? Users’ and non-users’ accounts of healthy eating and health-promoting foods

Appropriating functional foods? Users’ and non-users’ accounts of healthy
eating and health-promoting foods
Mari Niva
National Consumer Research Centre, PO Box 5 (Kaikukatu 3), FI-00531 Helsinki, Finland
Email [email protected], tel. +358 9 7726 7760
Draft 16.8.2005
NOTE. This is a preliminary draft. Please do not quote without the permission of the author.
1 Introduction
In modern societies food consumption is characterised by many competing, but at the same time,
overlapping, developments. One of these relates to health aspects, which appear more and more
dominant in the contemporary discussion of food. Health and its promotion have become one of the
salient characteristics of modern consumption society. Together with other elements of a “healthy
lifestyle”, food is seen to be one of the central means of maintaining good health. Indeed,
individuals are held increasingly responsible for their own health and keeping in good shape
(Bunton & Burrows 1995). Modern consumers are well aware of the principles of healthy eating
(e.g., IEFS 1996a) and report paying increasing attention to the wholesomeness of food (e.g., IEFS
1996b).
Another development relates to what might be called scientification of eating. Nutrition and
biomedical research produce both growing amount of and increasingly detailed knowledges of the
links between nutrition and health. To the lay consumers, the products of science and technology in
the vast area of food and nutrition research is most visible in public discourse and new food
products on the market. New foods, such as ‘functional foods’, bring science into everyday eating
by promising to advance human health and even to reduce the risk of diseases beyond the health
effects of conventional foods (Diplock et al. 1999). In the marketing literature, functional foods
have been characterised as a scientifically-grounded, high-technology, marketing-led and
unstoppable revolution in food and nutrition (Heasman & Mellentin 2001).
It is exactly this novelty that makes functional foods not only raising high expectations among food
scientists and the industry but also evoking public concerns about the future of eating and the
potential adverse effects of functional foods (Lawrence & Germov 1999, Nestle 2002). Being
products with medicine-like effects functional foods represent a fundamentally new kind of
healthfulness as opposed to conventional healthy eating recommendations and practices focusing on
the whole of diets. Culturally, functional foods form a distinct category of foods by incorporating
specially targeted health effects and by being positioned somewhere between foods and medicine.
Currently in Europe, the market for functional foods is increasing rapidly and includes a variety of
foods, such as foods lowering blood cholesterol or blood pressure, advancing the well-being of
stomach or preventing caries. However, functional foods are an ill-defined category of foods. In
most countries there is no legislative definition of the term and drawing a line between
‘conventional’ and ‘functional’ foods is challenging even for the experts in the field of nutrition.1 In
Europe, the product group is regulated by restricting the use of ‘health claims’ on packages and
marketing. In Finland, for instance, the marketers are allowed to advertise that the food ‘reduces the
1
risk of disease’ but only if they can show the food authorities scientific evidence backing up the
claim.
The focus of this paper is on the ways that consumers make sense of the relationship between
healthy eating and functional foods. My interest is in the ‘appropriation’ of new food products in
the context of lay ideas of healthy eating. In what follows, section two introduces the concept of
appropriation as an approach in studying consumers’ relationship with health-promoting foods. In
section three, I describe the data and methods employed, and the following parts present some
preliminary findings of the study. Section four analyses consumers’ interpretations and
categorizations of the concept of functional foods. Section five focuses on the relationship between
healthy foods and functional foods by examining lay ideas of health-promoting foods in the context
of healthy eating. In section six, I look briefly at the relationship of functional foods to medicine.
The concluding section draws the findings together and presents some preliminary conclusions of
appropriation of functional foods as something in between food and medicine.
2 Appropriation: making objects ‘own’
My approach on consumers and functional foods is based on the notion that consumers make
products their own and identify with them through consumption and use, but also through thinking
and conceptualising. In analyzing this process of ‘making own’, I will apply the concept of
‘appropriation’, which has in recent consumption studies been used to characterise the process
through which consumers adopt and interact with material culture in their daily lives.
As Daniel Miller has noted, goods and services are appropriated by consuming them. Artefacts are
encountered as materials but simultaneously they are the form through which the nature of our
cultural order is experienced. In the process of appropriation, mass-produced objects are “recast as
inalienable cultural material” (Miller 1987, 17). In fact, according to Miller, this is what
consumption is about: transforming artefacts so that they turn from alien to inalien and are invested
with particular and inseparable connotations (1987, 190). Ilmonen (2004) has described
appropriation of goods as a process of internalization and externalization. In the former, we make
goods our possessions, make them our ‘own’ by singularisation. In the latter, we transfer desires,
feelings, and social relations to them. The appropriation of a particular object carries two kinds of
consequences: it changes the relation to the object and it transforms everyday practices. In this
sense, objects can never be neutral.
In technology studies, the process through which consumers adopt and live with technical objects,
such as micro-computers or mobile phones, is often defined as ‘domestication’. Heinonen et al.
(2003), for their part, chose the term ‘rooting’ to describe the ways that lifestyle products were
domesticated in Finland. In my view, appropriation and domestication depict largely the same
process in which goods are actively adopted and made part of one’s own life. For instance,
Silverstone et al. (1992) define domestication as the appropriation of commodities into domestic
culture in which goods are incorporated and redefined according to the household’s values.
Lehtonen (2003) sees domestication of a technology (in this case, digital technologies) as
proceeding in sequential periods in which, first, the ‘need’ for the technology is assessed. Once
acquired, technology is then fitted into and adjusted to daily use until finally it may become an
integral part of everyday life. (See also Lie & Sørensen 1996.)
Usually the concepts of appropriation and domestication are used in the context of durables, such as
houses, cars, computers or other more or less permanent belongings. For instance, Ilmonen (2004)
notes in a footnote of his article on appropriation that he excludes all disposables from the analysis.
However, applying ‘appropriation’ as an approach to functional foods may be justified by two
2
reasons. First, functional foods are exceptional as food products in their ‘permanence’ once
adopted. To enjoy the beneficial health effect one has to use the product continually, day after day
preferably in similar dosages. They are thus prone to take an abiding place in the daily eating – or at
least, that is what the manufacturers try hard to convince consumers of. Their nature as products
that are indeed consumed and bodily incorporated naturally means that a singularisation process
hardly ever occurs in the same sense as with durables. However, developing new ways of using or,
e.g., novel recipes using functional foods might be considered as a kind of singularisation. Second, I
would argue that functional foods require a new mode of thinking about food. Their targeted health
effects assume that consumers are willing to adopt an exceptionally goal-oriented and rationalized
view of eating. Foods marketed as promoting health or reducing specific health risks are supposed
to affect bodily functions in a way that normal foods do not. In this paper, I will use the concept of
appropriation rather than domestication because the latter has been predominantly used referring to
technical devices and not to more mundane objects.
The approaches to appropriation and domestication above have largely focused on objects as used
in everyday life. However, as Dant and Martin (2001) have noted, goods are also appropriated at the
level of knowledge. This refers to the properties of objects and their limitations as to how they will
fulfill expectations. Some knowledge must necessarily precede the actual acquisition of a good,
otherwise the it would never be bought in the first place. This lay pre-knowledge will be
constructed based on a variety factors, including images presented in the media and marketing as
well as experiences of friends and family. Appropriation is thus about conceptualising, interpreting
and using the products. Culturally, novel foods form a distinct category of foods that consumers
appropriate, accept and adopt in diverse ways – or refuse to do so. Against this background, I will
functional foods in the context of everyday eating. The paper is based on the idea that appropriation
is produced as the outcome of interactions and overlappings between lay interpretations of
functional foods and the practices of using the products in everyday life.
3 Data and methods
The data for this study were collected in the context of a research project on consumer views of
food-related risks including both qualitative and quantitative sub-studies and several Finnish
research organisations2. The sub-study conducted at the National Consumer Research Centre
(NCRC) examined lay and expert interpretations of healthy eating and the role of functional foods
in healthy diets (Niva & Piiroinen 2005). However, in this paper, my focus is on lay people only
and the appropriation of functional foods in the context of healthy eating. In order to study the
experiential aspect of health-promoting foods we wanted to interview both current users and nonusers of functional foods. However, due to the variety of functional foods on the market, we
decided to focus on users and non-users of one specific type of health-promoting foods, cholesterollowering products that contain plant sitostanol or sitosterol. These type of foods emerged on the
Finnish market in 1995 accompanied by a huge media hype (Lehenkari 2003) and have since
established their position as one of the prime examples of functional foods in Finland. Today,
cholesterol-lowering foods are available in spreads, milk products, pasta and even a sausage.
Selecting cholesterol-lowering foods as a case product had the advantage that unlike many other
products marketed as functional, they are developed specifically for reducing a risk factor of disease
and their effects have been relatively widely tested and documented. Thus, by focusing on these
products we could also get access to views of consumers with a health problem for which a
functional food product has already been developed.
The informants were recruited from the consumer panel maintained by the NCRC comprising of
approximately one thousand voluntary members willing to take part in the studies of the research
center. Our informants can thus be described as a ‘multiply filtered’ group of Finnish consumers.
3
They were active, relatively well-educated people living in the capital area of Finland, with an
interest in health, healthy eating and health-promoting foods. Many of them mentioned having
prepared themselves for the group discussion by reflecting on healthy eating and their own eating
habits as well as “finding out” about functional foods in advance.
As food-related health concerns often emerge only in the middle age and cholesterol-lowering foods
are used more generally by older age groups (Niva et al. 2003) the minimum age for the informants
was set at 40. In total, 45 users and non-users of cholesterol-lowering foods took part in eight group
discussions arranged in autumn 2004. The age of the informants varied between 40 and 74 and the
average age was 53. Of the participants, 25 were women and 20 were men. Our aim was to restrict
ourselves to ‘regular’ users and non-users but due to difficulties in recruiting enough active users
one group consisted of ‘occasional’ users. In addition, four discussions were arranged for non-users
and three for regular users. However, despite detailed instructions about separate groups for users
and non-users some informants signed up for ‘wrong’ groups. Therefore, the groups were not
‘pure’, i.e., users and non-users were somewhat mixed in the discussions.
Two researchers (Mari Niva and Sanna Piiroinen) were present in the discussions which made it
possible to write detailed memos during and right after the discussions. In addition, the discussions
were tape-recorded and transcribed verbatim. The analysis proceeded in stages by alternating
between reading the transcripts and memos and developing classifications in order to code the data.
In the coding, we used the Atlas/ti computer programme. The classifications developed were based
on both predetermined themes (both broad ones such as ‘healthy eating’, and minor ones, such as
‘own eating habits’ or ‘what is a functional food’), frequent themes emerging in the discussions
(such as ‘fat’ or ‘overweight’) and more theoretical concepts (such as ‘us/others’, ‘past/present’,
‘social aspects of eating’). In the analysis for the purposes of this paper, I focused on identifying the
various perspectives and ways of making sense of healthy eating and health-promoting foods that
the participants employed when they discussed the topics throughout the discussions. I used the
coded transcripts and when necessary, went back to the original texts.
4 Defining functionality: designed, inherent, genuine and alleged functionality
Previous studies have indicated that the concept of functional food is given different meanings
based on the divisions between ‘inherent healthiness’ and ‘designed healthiness’ and between
‘natural’ and ‘technological’ foods (Niva & Jauho 1999). Here it should be noted that unlike in
many other languages, the Finnish term most often used for the novel category of health-promoting
foods is not ‘functional foods’ but ‘health-affecting foods’3 (in Finnish, terveysvaikutteinen
elintarvike). This may partly account for the significance of the conceptual discourse around
functional foods both in Finland generally and in the group discussions. The ambiguity of the term
‘health-affecting foods’ easily leads to an extensive interpretation in which a variety of foods,
especially those with a positive health image, may be subsumed into the category of functional
foods. However, another point of view defines ‘functional’ foods and ‘healthy’ foods as separate
categories. Here functionality is strictly confined to foods developed by the industry and containing
specific, added, health-advancing substances. Whereas expert approaches are most often based on
the latter, strict definition (e.g., Weststrate et al. 2002, Korhonen 2005), in lay discourses both broad
and strict definitions have been found (Niva & Jauho 1999).
The group discussions illustrated the complexity of consumer interpretations of the concept of
functional food. When asked what kind of foods may be regarded as functional our informants
mentioned a variety of foods. The uncertainties surrounding the definition and boundaries of the
category were expressed in various ways. On one hand, both users and non-users problematised the
4
whole concept by pointing out that “all foods affect health” (Ossi, RU, DG7)4. From this
perspective, there were lengthy discussions about the sensibility of the term ‘functional food’.
Several types of distinctions relating to the nature and boundaries of functional foods were apparent
in the discussions. These were not always explicit but were evident in the ways that one type of
food was contrasted with another, and in disagreements of whether a certain food is functional or
not. First, foods designed to be functional were separated from the inherently healthy foods that are
naturally health-promoting. Accordingly, both kinds of foods were mentioned as examples of
functional foods. However, there were apparent differences in the use of the term. Sometimes the
solution was to disregard the term functional food altogether. Instead, the discussants referred to the
designed functional foods as “a special thing”, “target eating”, “target food”, “industrial food”,
“purpose-made foods”, “commercial [functional] foods” and “foods marketed as functional”. The
inherently health-enhancing foods were referred to as “ordinary functional”, ”natural functional”
and “traditionally functional”. On other occasions, the discussants noted that they themselves used
the term ‘functional food’ ambiguously in two senses, meaning both the designed health-enhancing
foods and the ordinary healthy foods.
The ‘inherently’ functional category included products “from nature”: fruits, berries, vegetables and
mushrooms in general as well as rye and oats. Moreover, “organic foods” (Paavo, RU, DG3),
“simple foods that people feel are functional” (Saara, EU, DG5) and “all foods without additives”
(Olavi, RU, DG5) were described as functional. Not surprisingly, the most vividly discussed
functional foods in the ‘designed’ category were spreads that lower blood cholesterol levels. Also
products for the well-being of the stomach, a milk drink that affects blood pressure, and xylitol
chewing gum for preventing caries were mentioned as functional. Interestingly, xylitol was often
only “remembered” when the moderator particularly asked about it. In contrast to other designed
functional foods xylitol was something that was described as a food that “you don’t think about as a
functional food” (several discussants). In Finland, xylitol chewing gum that has since the 1970s
been recommended by dentists and advertised as a teeth-friendly option seems to have been
appropriated to the extent that has taken a stable position in everyday life. In the process, it has lost
its specialness long time ago and is apparently used habitually by a substantial part of Finns (see
Niva et al. 2003).
The second distinction apparent in the discussions was a dichotomy between genuinely and
allegedly functional foods. As mentioned above, naturally healthy foods were seen as genuinely
functional. However, the ‘genuine’ category may also include foods that are “proven” to enhance
health and/or the effects of which one can feel once tried. Cholesterol-lowering foods, xylitol and
some lactic acid bacteria foods were examples of products that the participants mostly “believed in”
either because of the convincing research results or their own experiences. Generally, enriching or
fortifying foods with vitamins or minerals may move a food into the functional food category – but
perhaps only in the sense of ‘alleged’ functionality. Vitamin-enriched juices were a frequently cited
example of this type of functional foods: despite containing healthful ingredients they were mostly
regarded as not truly enhancing health. Their functionality remained at the level of marketing and
health claims. However, here it is worth noting that the genuine–alleged dichotomy is more
ambivalent and negotiable that the inherent–designed distinction. People have not only varying
experiences but also different ideas of what kind of evidence justifies believing in functional foods.
In the discussions, there were sometimes disputes and hesitation about whether the health effects of
certain products were real or not.
5
5 Functional foods and the complexities of healthy eating
Healthy eating is simultaneously a complex and a simple issue. Modern consumers are well aware
of the basic principles of healthy eating advice. However, it is well-known that there are a number
of other ‘rationalities’ (Holm 2003) besides health considerations that operate in everyday eating
habits and food choices. These may relate to symbolic and social meanings of food, economic
factors or the practical contexts of eating, such as the daily rhythm of meals and expectations of
family members. In addition, despite the basic simplicity about the principles or rules of thumb of
healthy eating, the interpretations about the details vary.
The discussions revealed a variety of approaches and ‘rationalities’ in talking about healthy eating,
irrespective of whether the participants found themselves eating healthily or whether they used the
case products. Indeed, without knowing whether the discussants were users or non-users of
cholesterol-lowering foods one could not have judged it only by the tone of the discussion. This is
why in the following, users and non-users will not be particularly compared. One of the most
distinctive features in the discussions related to the ‘level’ of talking about healthiness. On one
hand, single foods were described as ‘good’ or ‘bad’, wholesome or unwholesome (cf. Warde 1997;
Mäkelä 2002). On the other, healthiness was about the whole of diets, in which it was the
intertwinings of everyday practices of eating and moral accounts of proper eating that played a
salient role.
5.1 “Natural”, “unprocessed” and “home-made”
When single foods were categorized as good or bad, some foods should be favoured, some
avoided. As noted above, foods such as berries, fruit, vegetables or rye were by definition placed in
the good and healthy category. Healthy food was described as “natural”, “pure”, “basic food”,
“home-made” and “unprocessed”. The foods mentioned as healthful were inherently healthy and
without them, eating cannot be healthy. In the discussions, especially fruit and vegetables were
often mentioned ‘in passing’: their healthiness or health effects were usually not elaborated in
detail. A certain ‘everyone knows’ principle applied here. In a way, the goodness of unprocessed
foods did not need to be articulated: it was assumed as shared everyday knowledge.
When discussing what healthy eating is all about, foods marketed as health-enhancing were in no
instance referred to as “healthful”. The label of healthy foods was reserved to the above-mentioned
“natural” foods category in which there was no place for processed foods. Indeed, it has been noted
before that the healthfulness of many foods is closely connected to their unrefined, nonmanufactured, unprocessed images (cf. Atkinson 1983, Lupton 1996, Lien 2003). In addition, the
health image of unrefined foods is fragile. This was reflected in the informants’ ideas about how
“purity” and “naturalness” are lost by the contaminating effect of man-made substances. In a sense,
when technology and culture penetrate the pure image of the natural world the “naturalness” of
nature itself is destroyed. Fruits, vegetables and grains are healthy not only because of the
substances they contain (the ‘goods’, such as vitamins) or do not contain (the ‘bads’, such as fat or
sugar) but because they represent the essence of the natural.
In unprocessed foods, the good things were seen to be in a perfect, balanced and optimal form: the
whole is more than the sum of its parts. Foods enriched or fortified with ‘goods’ extracted from the
natural package cannot attain the original balance and perfection. As Elli (RU, DG7) describes:
”The ordinary basic food, if you eat fruits and berries and vegetables you get enough vitamins, […]
if you use those [vitamin-enriched foods] you might get too much vitamins and that’s not a good
thing either.” Consequently, processing moves foods into the realm of manufactured foods with the
risk that they lose the original goodness and virtue. It is probably this aspect that explains the
6
absence of functional foods – here defined as foods developed to be health-promoting – in the
descriptions of healthy foods.
5.2 ”Varied” and ”moderate”
On the other hand, healthfulness was tied to the notion of a healthy diet as a whole. In fact, the
accounts of healthy food and healthy eating overlapped. Both aspects were discussed
simultaneously without articulately contrasting them. For instance, it was noted that a healthy diet
“consists of lots of vegetables, but is above all varied – in a week’s period there’s quite a lots of
various stuffs included –, and as little as possible salt and sugar and […] that you eat when you’re
hungry” (Kai, NU, DG1). From this perspective healthy eating is a multifaceted complex including
favouring some foods, avoiding others and paying attention to the balance and daily rhythm of
eating. However, a simpler approach stresses moderation and the balance between energy supplied
and consumed: “It doesn’t make that much difference what you eat as long as you eat in
moderation, that’s the basic thing” (Arto, NU, DG1).
The informants demonstrated quite a thorough knowledge about the principles of healthy eating
which was described using the very terms of nutrition recommendations. Healthy eating was
described as “varied”, “moderate”, “regular” and “balanced”. One should eat “often but little at a
time” and “think about the proportions”. Jarkko (NU, DG6) describes the plate model: “Well, it’s
the plate where you have like this (shows with his hands) meat and a bit of rice or potatoes and then
half of it is vegetables. That’s healthy you know.” Sini (RU, DG7) notes that “you should eat half a
kilo of vegetables every day according to the latest recommendations”. These basic principles of
healthy eating seemed so familiar to consumers that they did not inspire much debate. They were
the shared basis against which the ideas of practices and problems of healthy eating and functional
foods were constructed.
When asked whether the participants felt their own eating habits were healthy the answers varied
from one extreme to the other. Some would state briefly “no”, whereas others might say they eat
“very healthily”. Between these ends many would characterize their eating as being both ‘good’ and
‘bad’. Own habits may be healthy “in principle”, “seasonally” or “relatively”, or there may be “a
certain amount of unhealthfulness as well”. In addition, the two ends of healthful/unhealthful eating
habits tended to approach each other during the discussions. Those who at first described their own
eating as “unhealthful” may later come to note that they eat “just normal” food, not “healthy” food
or tell that they take healthfulness into account by eating lots of vegetables or by avoiding fats.
Once the discussion proceeded, own eating habits were considered in relation to other participants’
accounts. For example, Arto (NU, DG1) states first that he doesn’t eat healthily but eats what he
likes. However, after Kai (NU, DG1) says that the “base” of his diet is healthful but that “all that
extra junk destroys the whole” Arto specifies his notion: “[W]ell in fact I think it’s the same for me,
the basic base is healthful, but then when you put cheese, […] this cream cheese, […], it must be
thirty per cent fat. That wrecks it all.” Hence the reflections on one’s eating may well change during
the discussions as part of the approaches constructed by the participants together.
5.3 ”You can’t always feel guilty”
The tension between healthfulness and indulgence is one of the most profound modern dilemmas
relating to food and eating (Warde 1997). According to Lupton (1996), the relationship between the
two is dialectical, and one would not exist without the other. In the discussions, the relation of
healthy eating to the duality of indulgence and ascetism proved to be complex. This section focuses
on the ways that our discussants approached the dilemma. In these approaches, two diverse but to
some extent overlapping approaches can be discerned. First, healthy eating was indeed contrasted
with hedonism. Here it was also presented as being about finding a balance between god and bad
7
and searching for the “golden mean”. Second, in some accounts healthiness and indulgence were
not separated at all but were more or less equated by depicting cravings for goodies as “bodily
requirements”.
When healthfulness and indulgence were separated the former was associated with control, selfdiscipline and avoiding various kinds of ‘bads’. Everyday life was separated from festivities,
workdays from holidays, the ordinary from the exceptional. Everyday life was characterized by
healthfulness, but exceptional situations gave room for what Mäkelä (2002) has described as
‘controlled relapses’ in which abundance of food as well as fat, salt and sugar were allowed. These
can even be necessary as without them, the feast could not be differentiated from the mundane. As
part of everyday life eating unwholesome foods must be controlled and enjoyed in moderation:
“Well sometimes you have to, like I’ve promised myself that once a month I can have a pizza and a
couple of times a small bun. You must have these, too, you can’t wipe it all away” (Taina, OU,
DG2). In addition, it was emphatically agreed that food must taste good – even if it’s healthy. As
Warde (1997) has noted, a popular justification for indulgence is that we have a ‘right’ to please
ourselves. Not surprisingly, functional foods had no place in indulgence. They are precluded as they
by definition encompass a controlled and planned health-orientation.
A strict diet may itself produce gratification that Coveney and Bunton (2003) have characterized as
‘ascetic pleasure’ (see also Lupton 1996). Here the nature of pleasure is different from the one
described above. Ascetic pleasure derives from food that produces fitness and inner satisfaction as
well as keeps one slim. The idea of self-disciplined pleasures appears, for instance, in the
participants’ accounts of low-fat cheeses the taste of which may not be perfect but which are
rewarding in their lightness. Some functional foods provide an another example. Cholesterollowering spreads were regarded as “not particularly good” – even though regular users were less
eager to criticize the taste than those who had just tried it or heard rumours of poor taste. The taste
of a milk-drink that lowers blood pressure was depicted by some as “weird” or “very peculiar”.
Indeed, in some cases the medicinal nature of the product may move it so close to the realm of
drugs that taste is no longer an issue.
Some of our interviewees had resolved the problem of health and indulgence by incorporating
pleasure inextricably in healthfulness per se. Now pleasure would no longer be a (controlled)
relapse but rationalized as a part of healthy lifestyle. Health would expand from measurables such
as cholesterol or body mass index into a more comprehensive idea of well-being and feeling good.
The discussants wondered whether it is better to “constantly think and ruminate about what you
should eat and what you can eat – and how much that may cause depression – or just take what you
feel like” (Hannu, NU, DG1). In some interpretations healthfulness did not seem to even exist
without pleasures, and the lines between good and bad were drawn anew. In the following account,
blue cheese (“Aura”) turns into wholesome food as it brings forth pleasure not only mentally but
also physically: “For me at least […] sometimes I get this ‘got to get some Aura cheese or
something really unhealthful’, […] there must be some deficiency in the body when you get this
craving and you just have to get something really fast” (Jaana, RU, DG7).
Placing pleasure as an integral part of healthfulness bears resemblance to Backett’s et al. (1994)
depiction of unhealthy or risky habits of individuals as ‘life-enhancing’ as distinct from the ‘healthenhancing’ behaviours. The social aspects and bodily pleasures of eating may well produce wellbeing even though they might not advance health narrowly defined. In the citation of Jaana above,
however, the separation between life-enhancing and health-enhancing disappears. By ‘requiring’
unhealthful food the body transforms ‘bad’ into its opposite, ‘good’. Curiously enough, in several
discussions it was blue cheese that was presented both as the epitome of unhealthful food and as
something that is ‘good for you’. Indulging with blue cheese could be legitimated by physiology as
8
above, but it also symbolized the problem of pleasure and guilt, the entangled nature of indulgence
and bad conscience.
5.4 “What is good for me may be bad for you”
Despite the shared understanding about the principles of healthy it was equally emphatically
observed that in the end, healthfulness is “individual”. The view of a healthy diet as a personal
matter emerged in all discussions. It may, of course, be a way of leveling off impending conflicts: if
somebody tells he/she eats pizzas every week without weight problems, others won’t start lecturing
about the other dangers of fat but rather note that “metabolism is so individual”. However, for the
main part, the discussions about individual variety seemed not to involve potential disagreements
but rather consensus about the fact that the links between food and health are complex and, at the
individual level, also unpredictable.
The shared view of ”individual healthfulness” led to the conclusion that nutrition recommendations,
as universal as they are meant to be, are not universally applicable. Everyone has to find “their own
individually good” diet. From this perspective, the measure of healthfulness of a diet cannot be
found in the food components or eating habits as such but in the ways that the food affects each
individual. At the same time, the everyday categorisations of food into good and bad get blurred. In
the discussions, there were some references to dietary restrictions caused by illnesses, such as
allergies, gout or celiac disease – however, more prevalent was a notion of individuality as
something ‘non-diagnosable’, even mystic. “I guess there are differences between individuals […]
you can’t tell people that ‘no-one will ever eat fatty pork sauce ever again because it’s unhealthful’,
as for some people it’s not unhealthful at all” (Jaana, RU, DG7).
How can one then sort out what’s good for them? It seems that being in good condition is often
enough despite the inevitable insecurity about one’s future health. Some participants believed in
examining their own bodily feelings. “You have to learn to listen to yourself, listen to your body
and what it tells you, whether this [food] suits me or not” (Marita, EU, DG5). Bodily knowledge
and ‘listening to yourself’ can be described as ‘wisdom of the body’ (Lupton & Chapman 1995, see
also Keane 1997), which is essentially experiential and based on ‘self-knowledge’. As an approach
to health it thus differs from the ideas of self-discipline and control that are often portrayed as
integral in the modern relationship to health. In the wisdom of the body the focus is on ‘inner’
knowledge and feelings whereas in self-discipline and control the individual adopts the stance of an
outside observer or regulator.
The individuality of healthfulness extended to ideas concerning functional foods. The discussants
noted that “well you don’t know how they’d [functional foods] affect you personally” (Kirsti, NU,
DG6) and that in the end, it is “a matter of faith”. If one just strongly believes that a food does some
good it probably will – an aspect of individuality that emerged in all discussions but one. It was
remarked that in medical experiments researchers frequently find the “placebo-effect”, i.e. people
taking the placebo feel better and get healthier just by believing that they are taken care of. The
same applies to dietary supplements and various forms of self-medication, so it will probably play a
role in functional foods as well, it was reasoned.
The placebo effect was related to the idea that one can never be sure whether a food marketed as
health-enhancing actually does what it promises. Even in foods with measurable impacts on
markers such as cholesterol or blood pressure the health effects may be ambiguous because there
are always intervening factors that cannot be ruled out. In several discussions, people pondered on
the possibilities of arranging “tests” or “laboratory experiments” of the effects of functional foods
and concluded that when food is concerned, one will not know how things “interact” and what the
decisive factors are. Even some informants who had succeeded in getting their cholesterol levels
9
down with functional spreads wondered whether this might have been induced by the increase in
exercise or improvement in other eating habits.
Even more convincing evidence of the individually variable effects of functional foods was
presented by two informants (in separate discussions) whose cholesterol levels had actually gone up
after starting the use of cholesterol-lowering margarine. Subsequently, both of them were somewhat
critical towards the concept of functional foods and stressed the importance of healthy diets and
“natural” foods. However, neither of them condemned cholesterol-lowering foods as such. They
had reasoned that these kinds of foods just didn’t suit them personally. This is how Aili (EU, DG6)
explained her experience:
“[W]ell when this Benecol margarine came, some ten years ago, well I was of course very eager because my
total cholesterol was seven then. But because my build is kind of slender and my LDL was really low and HDL
was really high and then these triglycerides really good, low, as they should be. Then someone said that you
should eat this functional margarine so that you get your total cholesterol down. Because of that it rose up to
eight point five, and then I quit it quickly because even the doctor said that ‘now you won’t eat any of this any
longer’. So that’s my experience of the functional margarine.”
In Aili’s account, the reason for the failure of functional margarine was the fact that apart from the
total cholesterol her other cholesterol values were perfect. Because of this original inner balance the
functional margarine would not work as it was meant to but ended up in unexpected results. In a
similar vein, Marita (EU, DG5) had reasoned that the margarine didn’t work for her because earlier
she hadn’t used any spread on bread at all and “it [Benecol margarine] is fat, after all”. Because of
the extra fat, Benecol had raised the total cholesterol. Her doctor had just commented that “well it
doesn’t suit you then”.
5.5 Can you prevent diseases by eating?
Based on the discussions, the answer to the question in the heading is both yes and no. On one
hand, despite much discussion about the ‘individual’ aspects of healthfulness, it seemed self-evident
that one “should” eat a wholesome and balanced diet. Indeed, the tone in informants’ accounts of
healthy eating was often notably moralistic. While the comments on one’s own and other
participants’ eating habits were permissive and tolerant as to treats and indulgence, there was a
general concern about the eating of other people. Own practices deviating from the norm of
healthfulness were presented as rational and well-grounded whereas other people’s pleasure seeking
eating habits were depicted as a neglect and indifference of health.
Still, in all discussions the deliberations over the relationship between eating and the state of health
concluded in an unanimous view that not even a person eating properly can be sure that they “get to
grave in good health” (Marita, EU, DG5) because “people die of something anyway”, as Paula (NU,
DG3) somewhat laconically noted. However, we could not detect a strong sense of fatalism
concerning health that has been found in some other studies (Davison et al. 1991, Lupton 1996).
Our informants did not employ terms such as fate, bad luck or chance in their reasonings of health
and illness. Besides food, there were lengthy discussions of other lifestyle factors, heredity, and
cultural and social conditions that all make a difference for health.
Davison et al. (1991) have termed lay interpretations of the causes and consequences of health and
illness as ’lay epidemiologies’. Our informants were adept lay epidemiologists. In the light of the
experiences of one’s relatives and friends they evaluated the significance of risk factors such as
cholesterol in the development of heart disease: “And cholesterol won’t tell you anything. My
mother’s cholesterol level is nine [mmol/L] and she lives on, and my father died of heart attack at
the fifty-four and his cholesterol was three point three” (Asta, NU, DG6). In this and similar
anecdotes we meet two ideal types contradicting modern health messages: on one end, the long10
lived and healthy relatives who have eaten lard and smoked cigarettes all their lives, and on the
other, acquaintances leading an extremely healthy life and dying of cancer at young age. Through
these stories the informants demonstrated the essential feature of lay knowledge: assessing
information in the context of other knowledge and their own experiences. They did not claim
cholesterol levels to be irrelevant as to cardiovascular diseases, but they did problematise a
simplistic causal relationship between a risk factor and an illness. This perspective might effectively
question the usefulness of eating cholesterol-lowering foods. However, the products were not
directly challenged from this perspective. This had to do with fact that high cholesterol level was
considered a problem that needs to be tackled. Even though it might not cause them a heart attack
our informants did not seem willing to take the risk.
A simple causal relation between using functional foods and state of health was further undermined
by the concerns relating to the safety of the novel products. Not only those having bad experiences
of functional foods or those generally critical towards all “modified” foods, but also active users of
cholesterol-lowering spreads were sometimes doubtful as regards the safety of the products they
used. In one discussion (DG7), in which all participants were regular users of cholesterol-lowering
spreads, there was agreement that functional foods are ”over-advertised” and that ”ordinary proper
food is as healthful” or “even more healthful” than functional foods – a perspective not unfamiliar
in other discussions either. As Sini (RU, DG7) said: “Well in my family we certainly don’t use
other [functional foods] apart from this spread, I think it’s totally unnecessary to buy any other of
these. We eat rye bread and vegetables and such, and they are functional as well”. Ossi agreed, and
Sini added that “the spread is the only one I believe in”.
However, a bit later, Sini mentioned that she’d “been wondering what’s in them [functional foods]
and if they could actually be harmful to health”. This inspired a discussion over the potential
“interactions” between the substances in functional foods and the fact that it is not rare for studies to
prove something that was earlier considered “healthful” to be actually almost “poisonous”. After
this, the suspicion started to extend to the very products that the participants used themselves. They
had all been happy users of cholesterol-lowering spreads until now, but when the moderator asked
whether they believed that using the product will benefit their future health as well, they hesitated.
Elli (RU, DG7) concluded that “of course you wonder what additives you get from it, so maybe
you’ll get rid of cholesterol but what if you’ll get a cancer or something in return”. Still, they all
agreed that they were going to continue using the product because “if there’s no news coming
saying that it’s dangerous then you’ll just keep going, as it’s a familiar product after all” (Jaana,
RU, DG7).
In the previous discussion, the functional margarine is in a sense first ‘distanced’ from all other
functional foods and treated as a special, trusted case for which there is both need and evidence of
its beneficial effects. In contrast, other functional foods are deemed unnecessary and untrustworthy.
After some contemplation, however, even this product receives a shadow of doubt: one might not
be sure of its long-term side effects after all. For a users’ discussion, the one depicted above is
extraordinary in it’s doubtful tone towards cholesterol-lowering foods. However, it shows that
consumers’ reasonings and everyday practices are indeed multilayered. Functional foods may be
appropriated on a ‘use level’ and constitute a habitualised part of everyday eating, but at the same
time, consumers take notice of the imperfections of scientific knowledge concerning nutrition.
However, at least for products that have been widely studied, that have established their position on
the market and that own experience proves good, users seem willing to put their qualms aside –
until research shows them true.
11
6 Between foods and medicine
Some informants would take all the uncertainty regarding food, health and the substantiation of
health effects as an argument against using any functional foods. The products are expensive, and as
long as health effects are not guaranteed there is no point succumbing to various novelties and be
“victims of advertising”. As noted above, the usefulness of targeted functional foods was evaluated
against the backdrop of ‘healthy eating’. Another baseline for functional foods lies in their place on
the ‘borderline’ (Lehenkari 2003) between foods and medicine. This was touched upon in all
discussions when the participants were making sense of the mutual places of conventional foods,
functional foods, supplements and medicine. On one hand, functional foods were differentiated
from ordinary foods by noting their “medicinal” or “targeted” effects. They were considered proper
to use in cases of specific need or medical conditions. There may be situations in which even
current non-users could imagine themselves resorting to functional products, especially in cases of
high cholesterol or blood pressure. Ideally, however, this should proceed in hierarchical steps: first,
one should adopt “lifestyle changes”, such as modifying eating habits and taking more exercise.
Only if that didn’t work, could one add some functional foods.
The position of functional foods between foods and drugs is problematic in the sense that they seem
by definition always subordinate to either of them. Compared to ‘inherently’ healthy foods,
functional foods always seem to ‘lose’ due to the incredibly strong image of ‘proper food’ and
‘balanced diets’ as the cornerstones in advancing health. On the other hand, medicines are trusted
more than functional foods as “they are at least medically tested” (Sinikka, NU, DG6) – unlike most
foods marketed as health-promoting. When functional foods are accorded the image of quackery,
medicine remains the first option in battling diseases. Medicines were seen as effective, tested and
safe, whereas functional foods were located nearer to the realm of supplements, as a potentially
dangerous form of self-care. However, when stressing “natural” ways of advancing health,
functional foods may be a “healthier” and “more natural” option to medicines as the latter may have
side-effects and cause “other health problems”. This ambiguous relationship of functional foods to
foods and medicine originates from the very basic nature of functional foods as something that
takes the form of food but acts like a medicine or is at the very least marketed as doing precisely
that.
7 Discussion
Consumers in the group discussions displayed knowing the principles of healthy eating. They
mastered the vocabulary of nutrition recommendations, focusing on balance, variety and energy
consumption as well as noting the harmful effects of especially fat, but also salt and sugar. Healthy
eating is about favouring wholesome foods traditionally known to be good for you: vegetables,
fruit, berries, mushroom, not to mention the Finnish pride, rye bread. Foods specially designed to
promote health seem not to have earned a place in the descriptions of either healthy foods or healthy
eating. The focus on the whole of diet effectively excludes any single foods from the definition of
healthy eating; and the focus on naturalness excludes processed and designed products from the
definition of healthy foods.
Despite the basic simplicity of the principles of healthy eating, the discussions indicated that the
perspectives on the practices of healthy eating are many. As ‘lay epidemiologists’ consumers
acknowledge the fact that health is not only a product of one’s eating but is affected by a number of
factors only some which one can influence themselves. Despite personal efforts, health cannot
always be controlled or predicted. At the same time, people should not forget their ‘natural’
relationship to food. Food is not only for health, it is also for enjoyment and indulgence, to be
shared with family and friends. Even so, healthy eating is loaded with notions of responsibility and
12
control. People should eat healthily and prepare wholesome meals for their families, if only for their
children’s sake. And still, healthy eating is an individual matter. What advances my health may be
detrimental for you.
In the discussions, the informants alternated between these approaches, emphasizing one at a time
but easily moving to another. This diversity represents the complexities of healthy eating:
uncertainties regarding scientific knowledge, the moral undertones governing what is defined as
acceptable eating, and the symbolic significance of food as an inextricably social matter. In the end,
what became evident was a certain reflexivity of eating. Depending on the perspective, eating may
be defined as ‘wholesome’ or ‘unwholesome’ or even both at the same time. Even so, it seems
conscious and deliberated. To rephrase Holm (2003), not only eating, but also healthy eating, is
characterised by a number of alternative rationalities.
The findings suggest that in current consumer discourse, foods with targeted ‘functional’ effects are
evaluated against ideas concerning healthy foods and healthy eating. In these ideas, conventionally
healthy foods with their ‘authenticity’ and ‘naturalness’ are understood as being inherently healthpromoting. This may partly explain why designed functional foods are in many accounts deemed as
unnecessary – at least for healthy people. The usefulness of designed functional foods is limited to
special cases, people with specific conditions or illnesses.
We can also conclude that each functional food represents a special case for its user. Having
appropriated a product as part of the daily routine doesn’t imply adoption of other functional foods.
The ‘need-orientation’, such as an effort to lower cholesterol level, may justify the use of one
functional food, but other functional foods with other or even similar effects may never be even
considered. For the users, cholesterol-lowering foods were a substitute or a complement to
medicines, used only because of the problem. The products were rarely discussed in terms of their
role in the diet as a whole, neither did the discussant ponder on whether using the products had
changed the planning or preparation of meals or affected the eating habits of their families. The
taste of cholesterol-lowering foods was occasionally commented but usually not in a very positive
tone. The products can thus be described as ‘medicines within a diet’, as a necessity one would
rather do without. Hence, it remains uncertain whether there had occurred appropriation in the
strong sense of the word so that the products would form such an integral part of life that they
would go ‘unnoticed’. In contrast, this kind of appropriation had apparently happened with xylitol,
which had taken such a strong presence in the everyday life that it could be totally forgotten. The
difference between these products, of course, lies in the nature of their functionality: one is for a
diagnosed and measurable health problem (cholesterol), the other for preventing less serious future
problems (caries).
On the other hand, bad experience of a functional food easily leads to ‘disappropriation’ (cf. Lie &
Sørensen 1996): the product is discarded and friends are told about the experience. As a result, also
other functional foods may be treated with suspicion. However, a bad experience may well be
explained in terms of ‘individual effects’. Here the point is that functional foods may be useful for
some people, but one should be careful and not take beneficial effects for granted.
Despite the proliferation of health concerns in the current discourse on food, in lay discussions
health is not necessarily the predominant approach to eating. In our discussions this was evident in
the ways that other realms of eating were constantly brought into the discussion, either as
alternative approaches to eating or as ‘extensions’ of healthy eating, a case in point of which was
the depiction of craving as a bodily need. These integrations of the other rationalities of eating into
the very notion of healthiness may, of course, be seen as signalling the enormous strength of the
health paradigm in the modern discourse around food.
13
References
Atkinson, Paul (1983). Eating virtue. In: Murcott, Anne (ed.). The sociology of food and eating. Aldershot, Hants:
Gower Publishing Company.
Backett, Kathryn, Davison, Charlie & Mullen, Kenneth (1994). Lay evaluation of health and healthy lifestyles: evidence
of three studies. British Journal of General Practice 44: 277–280.
Bunton, Robin & Burrows, Roger (1995). Consumption and health in the ‘epidemiological’ clinic of late modern
medicine. In: Bunton, Robin, Nettleton, Sarah & Burrows, Roger (eds.). The sociology of health promotion. Critical
analyses of consumption, lifestyle and risk. London: Routledge, 206–222.
Coveney, John & Bunton, Robin (2003). In pursuit of the study of pleasure: implications for health research and
practice. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 7 (2): 161–179.
Dant, Tim & Martin, Peter J. (2001). By car: carrying modern society. In: Gronow, Jukka & Warde, Alan (eds.).
Ordinary consumption. London: Routledge, 143–157.
Davison, Charlie, Davey Smith, George & Frankel, Stephen (1991). Lay epidemiology and the prevention paradox: the
implications of coronary candidacy for health education. Sociology of Health & Illness 13 (1): 1–19.
Diplock, A.T., Aggett, P.J., Ashwell, M., Bornet, F., Fern, E.B. & Roberfroid, M. B. (1999). Scientific concepts of
functional foods in Europe: Consensus document. British Journal of Nutrition 81 (Suppl.1): S1–S27.
Heasman, Michael & Mellentin, Julian (2001). The functional foods revolution. Healthy people, healthy profits?
London: Earthscan Publications.
Heinonen, Visa, Kortti, Jukka & Pantzar, Mika (2003). How lifestyle products became rooted in the Finnish consumer
market – domestication of jeans, chewing gum, sunglasses and cigarettes. NCRC Working papers 80/2003. Helsinki:
National Consumer Research Centre.
Holm, Lotte (2003). Food health policies and ethics: lay perspectives on functional foods. Journal of Agricultural and
Environmental Ethics 16: 531–544.
IEFS (1996a). A Pan-European survey of consumer attitudes to food, nutrition and health. Report number three.
Definitions of healthy eating, barriers to healthy eating and benefits of healthy eating. Dublin: Institute of European
Food Studies.
IEFS (1996b). A Pan-European survey of consumer attitudes to food, nutrition and health. Report number four. Dietary
changes. Dublin: Institute of European Food Studies.
Ilmonen, Kaj (2004). The use of and commitment to goods. Journal of Consume Culture, 4 (1): 27–50.
Keane, Anne (1997). Too hard to swallow? The palatability of healthy eating advice. In: Caplan, Pat (ed.) Food, health
and identity. Routledge. London and New York, 172–192.
Korhonen, Hannu (2005). Terveysvaikutteiset elintarvikkeet – kohti optimaalista ravitsemusta. [Functional foods –
towards optimal nutrition. In Finnish]. Elintarvike ja Terveys -lehti 19 (1): 8–21.
Lawrence, Mark & Germov, John (1999). Future food: The politics of functional foods and health claims. In: Germov,
John & Williams, Lauren (eds.). A sociology of food and nutrition. The social appetite. South Melbourne: Oxford
University Press, 54–76.
Lehenkari, Janne (2003). On the borderline of food and drug: Constructing credibility and markets for a functional food
product. Science as culture 12 (4): 499–525.
Lehtonen, Turo-Kimmo (2003). The domestication of new technologies as a set of trials. Journal of Consumer Culture 3
(3): 363–385.
Lie, Merete & Sørensen, Knut H.(1996). Making technology our own? In: Lie, Merete & Sørensen, Knut H. (eds.).
Making technology our own? Domesticating technology into everyday life. Oslo: Scandinavian University Press, 1–30.
Lien, Marianne E. (2003). Det naturligste i verden. Konstruksjoner av natur i industriell matproduksjon. In: Jacobsen,
Eivind, Almås, Reidar & Johnsen, Jahn Petter (eds.). Den politiserte maten. Oslo: Abstrakt forlag, 193–212.
Lupton, Deborah (1996). Food, the body and the self. London: SAGE Publications.
Lupton, Deborah & Chapman, Simon (1995). ‘ A healthy lifestyle might be the death of you’: discourses on diet,
cholesterol control and heart disease in the press and among the lay public. Sociology of Health & Illness 17 (4): 477–
494.
Miller, Daniel (1997). Consumption and its consequences. In Mackay, Hugh (ed.) (1997). Consumption and everyday
life. London: Sage Publications, 13–50.
14
Mäkelä, Johanna (2002). Syömisen rakenne ja kulttuurinen vaihtelu. [The structure of eating and cultural variation.
Dissertation, in Finnish]. Helsinki: National Consumer Research Centre.
Nestle, Marion (2002). Food politics. How the food industry influences nutrition and health. Berkeley: University of
California Press.
Niva, Mari & Jauho, Mikko (1999). Ruoan ja lääkkeen välimaastossa. Funktionaalisia elintarvikkeita koskevat
käsitykset ja julkinen keskustelu. [In between foods and drugs - views and public debate on functional foods. In
Finnish]. NCRC Publications 2/1999. Helsinki: National Consumer Research Centre.
Niva, Mari, Mäkelä, Johanna & Piiroinen, Sanna (2003). Kotimaisia marjoja ja kasvistanoleja. Terveysvaikutteisten
elintarvikkeiden hyväksyttävyys Suomessa. [Domestic berries and plant stanols. Acceptability of functional foods in
Finland. In Finnish]. NCRC Publications 9/2003. Helsinki: National Consumer Research Centre.
Niva, Mari & Piiroinen, Sanna (2005). “Kohtuudella kaikkea”. Maallikot ja asiantuntijat terveellisestä syömisestä.
[”Everything in moderation”. Lay and expert notions of healthy eating. In Finnish]. Forthcoming in the Yearbook of the
National Consumer Research Centre. Helsinki.
Silverstone, Roger, Hirsch, Eric & Morley, David (1992). Information and communication technologies and the moral
economy of the household. In: Silverstone, Roger & Hirsch, Eric (eds.). Consuming technologies? Media and
information in domestic spaces. Routledge: London and New York, 15–31.
Warde, Alan (1997). Consumption, food and taste. Culinary antinomies and commodity culture. London: SAGE
Publications.
Weststrate, J. A., van Poppel, G. & Verschuren, P. M. (2002). Functional foods, trends and future. British Journal of
Nutrition 88 (Suppl. 2): S133-S138.
1
In Japan, a regulatory approval system for so called FOSHU (foods for specified health uses) products was established
as early as 1991 (Heasman & Mellentin 2001).
2
The project is carried out in 2004–2006 and is financed by the of Ministry of Agriculture and Forestry. The
coordinating partner is VTT Biotechnology and the other partners are Department of Psychology at the University of
Helsinki, MTT Agrifood Research Finland, National Consumer Research Centre (NCRC), and National Veterinary and
Food Research Institute of Finland (EELA).
3
For simplicity, in this text (including the citations) I use the term ‘functional’ even though ‘health-affecting’ would be
a more accurate expression bearing in mind the Finnish term.
4
The citations from the group discussions are placed within quotation marks. In longer citations, informants’ names
(which are not real) are shown. Acronym NU stands for non-user, OU for occasional user, EU for ex-user and RU for
regular user of cholesterol-lowering foods. ‘DG’ refers to the discussion group in which the speaker participated.
15