Situation-specific cognitive behavioural self-therapy for erroneously suspected allergy or intolerance to a food. A short self-assessment tool

Why Do People Misdiagnose Themselves with Food Hypersensitivity? An Exploration of the Role of Biopsychosocial Factors

Up to 35% of people self-diagnose food allergy or intolerance (food hypersensitivity [FH]), or diagnose it in their child, and self-manage the condition rather than seek a clinical diagnosis. This is much higher than the latest FH prevalence rate, estimated to affect 2–5% of the general population. The actual prevalence rate may be underestimated due to the lack of diagnostic services; however, this can only account for a small proportion of the discrepancy because only a small percentage of self-reported FH can be clinically confirmed. Many people are therefore misdiagnosing their or their child’s symptoms as FH and needlessly removing foods from their or their child’s diet. There are a number of possible reasons for this misdiagnosis, which can be considered from a biopsychosocial perspective. Psychological factors include a confusion over the diagnosis, coincidental pairing of food and symptom, psychological or psychosomatic reactions, and taste aversions. There are also biological mechanisms that have not been fully considered in food allergy research that may be relevant, such as conditioning of the immune system or stress responses. A social context pertains to a greater awareness of FH due to media coverage and changes in food labelling laws. Any of these theories are plausible, but the research to date has a number of methodological issues. Most studies report on small self-selected samples recruited from clinics and there is a lack of general population data. Studies also tend to be cross-sectional, which does not allow cause and effect to be established. Future research needs to include longitudinal designs that incorporate qualitative elements to enable a detailed exploration of reasons why people self and misdiagnose FH.

Why Do People Misdiagnose Themselves with Food Hypersensitivity? An Exploration of the Role of Biopsychosocial Factors

Up to 35% of people self-diagnose food allergy or intolerance (food hypersensitivity [FH]), or diagnose it in their child, and self-manage the condition rather than seek a clinical diagnosis. This is much higher than the latest FH prevalence rate, estimated to affect 2–5% of the general population. The actual prevalence rate may be underestimated due to the lack of diagnostic services; however, this can only account for a small proportion of the discrepancy because only a small percentage of self-reported FH can be clinically confirmed. Many people are therefore misdiagnosing their or their child’s symptoms as FH and needlessly removing foods from their or their child’s diet. There are a number of possible reasons for this misdiagnosis, which can be considered from a biopsychosocial perspective. Psychological factors include a confusion over the diagnosis, coincidental pairing of food and symptom, psychological or psychosomatic reactions, and taste aversions. There are also biological mechanisms that have not been fully considered in food allergy research that may be relevant, such as conditioning of the immune system or stress responses. A social context pertains to a greater awareness of FH due to media coverage and changes in food labelling laws. Any of these theories are plausible, but the research to date has a number of methodological issues. Most studies report on small self-selected samples recruited from clinics and there is a lack of general population data. Studies also tend to be cross-sectional, which does not allow cause and effect to be established. Future research needs to include longitudinal designs that incorporate qualitative elements to enable a detailed exploration of reasons why people self and misdiagnose FH.

Perceived Healthiness of Breakfasts in Women with Overweight or Obesity Match Expert Recommendations

The aim of the present study was to examine the perceived healthiness of breakfasts and the underlying beliefs influencing that perception against expert nutritional evaluation. Women with overweight or obesity (N = 120) were asked to recall the food items they consumed during a recent “healthy” or “unhealthy” breakfast. They also reported why the breakfast was healthy or unhealthy and rated its healthiness. Two nutritionists categorised the beliefs about why the breakfasts were “healthy” or “unhealthy” and evaluated the healthiness of each breakfast following nutrition guidelines. Generally, the meals considered as healthy versus unhealthy breakfasts and related beliefs about why the breakfasts were healthy or unhealthy matched food-based nutrition guidelines. Participants were found to perceive healthy breakfasts as more healthy and unhealthy breakfasts as less healthy than nutritionists did. Participants frequently mentioned the belief that their breakfast was healthy because “it contained fruit” or that their breakfast was unhealthy because “it contained fat.” Such salient healthy or unhealthy food items may guide the perception of breakfast healthiness and could be a target for nutrition counselling.

Meals described as healthy or unhealthy match public health education in England

Dietary guidelines for the general public aim to lower the incidence of nutrition-related diseases by influencing habitual food choices. Yet little is known about how well the guidelines are matched by the actual practices that people regard as healthy or unhealthy. In the present study, British residents were asked in a cognitive interview to write a description of an occasion when either they ate in an unhealthy way or the eating was healthy. The reported foods and drinks, as well as sort of occasion, location, people present and time of day, were categorised by verbal and semantic similarities. The number of mentions of terms in each category was then contrasted between groups in exact probability tests. Perceived unhealthy and healthy eating occasions differed reliably in the sorts of foods and the contexts reported. There was also full agreement with the national guidelines on eating plenty of fruit and vegetables, eating small amounts of foods and drinks high in fat and/or sugar, drinking plenty of water, and cutting down on alcohol. There was a tendency to regard choices of bread, rice, potatoes, pasta and other starchy foods as healthy. Reported healthy and unhealthy eating did not differ in incidences of meat, fish, eggs, beans and other non-dairy sources of protein or of dairy foods and milk. These results indicate that operationally clear recommendations by health professionals are well understood in this culture but members of the public do not make clear distinctions in the case of foods that can be included in moderate amounts in a healthy diet.