Review articleEffect of ambience on food intake and food choice
Introduction
People's eating behavior has a decisive effect on health. Obesity, for instance, is one of today's most visible public health problems. It is a significant risk factor for serious diseases, including cardiovascular diseases, hypertension and stroke, diabetes mellitus, and various forms of cancer. In developed countries, the global prevalence of obesity was 20.4% among adults in 2000.1 In addition, the development of nutrition-related chronic diseases, such as obesity, cardiovascular disease, type 2 diabetes, and cancer, appears to have increased in children and adolescents.2, 3, 4, 5 It is widely recognized that a lack of physical activity without a commensurate decrease in food intake is the primary reason for recent increasing rates of obesity.
However, why intake has not decreased to match the decreased expenditure is not understood. It is possible that environmental factors such as where, when, and with whom food consumption takes place might be, at least in part, responsible. Environmental factors such as the presence of other people, time of consumption, smell, colors, or physical setting might influence food intake and food choice, resulting in a lack of appropriate adaptations in intake. As Meiselman argued, there is a sufficient amount of research investigating sensory and internal physiologic mechanisms in control of food intake, but the possibility of other situational and social factors has been largely ignored.6, 7
In consumer research, the study of the atmospherics surrounding the consumer-related place is well established. The term ambience is used most often in customer and marketing service research examining store atmospherics.8 It seems that the ambience of the location is sometimes more important than the product.9 Also, the individual's expectations about the product can be as important as the product.10 Systematic exposure to a particular ambience is used to influence consumers' and buyers' purchasing behavior. One way of describing ambience is that it consists of “parts of the environment that are hard to localize and that surround the organism integrally like temperature, sound, smell and so on” with “potential for impinging upon human functioning at nearly all levels—physiology, motivation, mood, behavior, cognition and social interaction.”11, 12 In addition, ambience, described as the atmosphere of the environment, can serve as an effect-creating medium and a surrounding influence. The main sensory channels affected by the environment are visual, auditory, olfactory, and textual. Colors, sounds, smell, and textures in the environment may directly arouse visceral reactions that contribute favorably to eating behavior. The conceptualization of ambience includes not only environmental stimuli but also food-related sensory stimuli. Both factors are considered as ambient factors with a direct effect on food intake. Various components of ambience can trigger sensations in the consumer that might increase or decrease food intake; in other words, these situational and sensory factors might help convert behavioral intentions into actual eating behavior.
Hence, the review examines environmental factors including social variables, general surroundings, color and lighting, and ambient temperature and variables such as color, temperature, and odor of the food that are associated with the immediate environment of eating. The term ambience as used in this review connotes the external conditions present as opposed to internal stimuli such as hunger, physiologic states, and psychological thoughts or moods.
We are aware of more societal factors influencing food intake such as the media and advertisement, cultural norms, distribution system, and food supply. But the consumer is mainly exposed to these variables well before consumption occurs. This review is limited to the immediate context of eating. For a review including food supply, food advertising, and food pricing see French et al.2 We review the effects of external stimuli such as social variables, the room setting, color, light, sound, smell, temperature, and time-related factors on food intake and food choice because the two are inexorably intertwined.
Eating behavior is mostly studied in controlled laboratory settings or in the natural environment with self-report surveys. It is studied by specialists in a large number of disciplines, including psychology, sociology, physiology, medicine, neuroscience, nutritional science, architecture, marketing, and biochemistry. We concentrate on human behavior, although we are aware of the extensive research with non-human animals. Observations of humans eating in laboratories are very useful but often not indicative of real-world eating behavior.13 Hence, the current review presents laboratory and real-world studies with experimental and epidemiologic data. Further, this review focuses on the behavior observed in Western culture (European and North American populations) because most studies have been performed within Western society. However, it should be pointed out that observations of Asian culture have indicated the importance of cultural background on ambience-related food intake. The presentation of dishes, coordination of colors, and room arrangements, i.e., Feng Shui, a Chinese lifestyle enhancement through creating a harmonic environment by placing and arranging objects, are essential parts of daily eating behavior in Asia.
The reviewed studies employ a broad range of methodologies, including laboratory experiments, field experiments, survey methods, diet diaries, observations, and intervention studies (the Appendix summarizes the studies and their methodologies). Observational research approaches have the advantage of viewing real-life eating behavior but may have difficulties with reliability and validity. Inter-rater reliabilities have been established in only a few studies.14, 15, 16 In addition, some observational studies, to leave the individual undisturbed, have calculated the subject's food intake by guessing based on cursory observation or photographs.14, 17, 18 The accuracy of the real-meal size measurement is questionable. Other observational approaches have used surveys. Social modeling effects and television viewing habits, especially when examining children's food intake, are based mostly on parents' reports19, 20 or retrospective questionnaires filled out by teenagers.21, 22 It is impossible to ascertain the accuracy of these data. It can be affected by memory lapses and the parents may not be observing all of the actual behavior of their children. In addition, most observational and survey studies are correlational in nature and as a result do not allow for causal interpretations.
Causation can be explored in field experiments in which the setting and different components of food intake are varied and compared within certain settings.23, 24 Many of these field experiments were carried out in institutional settings, such as military facilities and student cafeterias.25, 26, 27, 28, 29, 30 Both appear to be chosen for their easy access and availability. School and military cafeterias offer a good opportunity to observe food intake in a situation where it is relatively easy to manipulate factors such as food accessibility and presentation. But the results of research using these settings and samples might not be generalizable to real-world behavior in the general population.
Laboratory studies afford another opportunity to explore causation because in highly controlled settings each influential factor's impact can be assessed separately. With observational and field experiment approaches, it is very difficult to isolate each ambient factor from the overall ambience of the environment. However, laboratory research examines mainly students31, 32, 33 whose behavior may not be representative of the population. Moreover, laboratory studies,31, 33, 34, 35 due to reactivity, can produce behavior that does not reflect the usual behavior that people demonstrate outside the experimental setting.
The diet diary approach requires a detailed self-report of participants' food intake in their normal everyday environments.36, 37 This has the advantage of relative ease in collecting large quantities of detailed data about real-world influences on intake. However, this procedure almost always underestimates actual food intake as a result of reactivity and under-reporting. It is possible to take underestimation into consideration when analyzing obtained data by employing within-subject analyses.38 The underestimation can become problematic when comparing between subjects or groups and when accurate estimates of the absolute levels of intake are required. In addition, the analyses using diet diaries are correlational in nature and causation cannot be established. It is also important to consider that many of the measurements involve subjective rating on the part of the participants. There are most often no objective measures available to verify the reports. For instance, the lighting or temperature in a certain situation might be bright and cold but the subject does not perceive it that way.
Although each of these approaches has weaknesses, the flaw in one type of research is often a strength in another. Hence, the application of multiple approaches to understanding the influence of an ambient factor is optimum. If different methodologic approaches produce similar results, then it is likely that the results are not artifactual but may be considered as reliable findings that may have future health implications.
Section snippets
Social facilitation
The presence of other people during food consumption can have a profound effect on intake; this effect is called social facilitation. Klesges et al. demonstrated that men and women eat more when they are with others than when eating alone.39 Observations of people in restaurants and coffee shops showed a positive relation between meal duration and group size.17, 40, 41 Social facilitation of spontaneous meal size was mediated by meal duration in all three studies. De Castro presented an
Conclusion
The present review suggests that the impact of ambience on food intake may be underestimated. As Rozin and Tuorila concluded: “to ignore contextual influences (on food choice and intake) is to risk misinterpreting the meaning and significance of human food choice.”232 Ambience appears to affect the amount and patterns of eating and the food choices and preferences.
Eating-related health issues such as obesity have increased in importance over recent years.233 The data suggest that environmental
Acknowledgements
This review article originates from a research scholarship supported by the Dr. Rainer Wild-Stiftung, Heidelberg, Germany. The authors express their special thanks to Gesa Schoenberger and Dr. Rainer Wild.
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