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Food availability, perceived food environment and social norm perceptions of healthy and vegetarian food consumption at a public music festival in the Netherlands: a cross-sectional study


Introduction

Municipalities worldwide are seeking to create healthy and sustainable living environments to improve public and planetary health, as they have a responsibility to enhance and protect their community’s well-being.1 With festivals becoming more popular in the past decade,2 municipalities in the Netherlands are exploring the potential of public policies to improve the food availability at planned events (eg, festivals). So far, public policies for planned events have mainly focused on economic development, place marketing and tourism.3 While some local governments have sought ways to restrict alcohol and drug use at festivals through public policies,4–6 improving the availability and accessibility of healthy and sustainable food remains largely unaddressed. Sustainable, environmentally friendly diets can be achieved by lowering the intake of animal-based proteins, through the consumption of vegetarian food for instance.7 One of the challenges hindering the development of food policies for festivals is the lack of a comprehensive understanding by municipalities of the extent to which unhealthy and unsustainable foods are prevalent and how visitors perceive this. Besides, the pathways through which festival food environments (FEs) could shape food consumption on site remain unclear.

While festival FEs have been understudied, other out-of-home settings are known to offer mainly unhealthy food8 and have been associated with unhealthy and unsustainable food consumption.9–15 A Swedish music festival successfully banned meat, which reduced the festival’s ecological footprint by 40%.16 Another study found that the majority of visitors to an Australian music festival declared having consumed unhealthy food, regardless of healthy eating intentions.17 Yet, to the best of our knowledge, only one study has evaluated the food availability at a planned event. This study showed that the 2016 Rio Olympic games offered mostly unhealthy food and beverages, despite ‘healthy choice’ claims in the Rio 2016 policy.18

There is also a lack of studies regarding visitors’ perceptions about the physical FE. Besides, physical FEs may shape the social FE (eg, social norms, SNs), which may shape food consumption.19 20 These data are important for the design, implementation and evaluation of FE policies and are highly valued by policy and key decisions-makers.21 They allow for the exploration of people’s experiences and perceptions of physical and social FEs, which enriches our understanding of the way people interact with their FE. This can ultimately provide insights into ways to design effective policies for improved nutrition.22

The first aim of this study was to gain insight into the food availability at a yearly public music festival in Wageningen, the Netherlands. The second aim was to gain insight into visitors’ perceptions of the FE, identify their SN perceptions of healthy and vegetarian food consumption at the festival, and test for the association between perceptions of the FE and of SNs.

Discussion

The majority of the food and beverages available at the festival were unhealthy. Vegetarian food was available but consisted mostly of fries. Overall, participants perceived the FE as unsupportive of healthy food consumption while their perception of the FE for vegetarian food consumption was more neutral. Participants had weak descriptive and injunctive SN perceptions of healthy and vegetarian food consumption. Still, they perceived stronger injunctive than descriptive SNs for healthy and vegetarian food consumption. They perceived stronger descriptive and injunctive norms for vegetarian compared with healthy food consumption. Last, participants who found the perceived FE more supportive of healthy and vegetarian food consumption also found it more common (descriptive SN) and appropriate (injunctive SN) to consume these foods.

The availability of healthy food and beverages at the festival was very low (7.6%). These findings match the literature on food availability and consumption in out-of-home settings.9–15 18 There was a better availability of vegetarian food (46.4%) compared with healthy food at the festival, but it could be improved by increasing the diversity and healthiness of vegetarian options, which were mostly unhealthy (fries, sweet pastries, fried savoury snacks).27 This could contribute to the protein transition as FEs with large varieties of vegetarian dishes contribute to reducing meat consumption.32 While this study evaluated the healthiness and sustainability of the food available at a public music festival, it should be noted that food consumed at festivals constitutes an occasional event, as opposed to food consumed on a daily basis. Hence, the impact of the food offered and consumed during festivals on the overall diet of people may be limited. Also, these results should ideally be compared with other studies on food at planned events or in out-of-home settings.

While the vast majority of food and beverages at the festival were unhealthy (92.4%), participants’ perceptions were mixed. Some perceived healthy food as sufficiently available (33.1%) while others did not (37.8%). This discrepancy could be attributed to several factors. First, participants may have had a different understanding of healthy food. Second, participants were not asked what their expectations were regarding the FE at the festival (eg, with low expectations, the actual situation may seem satisfying). Third, participants were not asked about their reference point when evaluating their perceptions of the FE. Fourth, not all participants may have been aware of the food available at the festival or may have obtained food elsewhere. Finally, researchers approached visitors at different locations. The direct surroundings of a participant when filling in the survey may have impacted their perceptions of the FE.33

Participants perceived weak descriptive SNs for healthy and vegetarian food, with the perceived descriptive SNs for healthy food being weaker than those for vegetarian food consumption. This suggests that they did not see other visitors consuming vegetarian food and even less healthy food. This is probably a reflection of the direct FE, which most likely hampered visitors to display healthy or vegetarian food consumption. These findings are in line with prior findings indicating that SNs on food consumption may be steered by the FE.19 20 33 34 Empirical evidence has shown that SNs are physically embedded in FEs and might influence food consumption.20 In another study, participants living in neighbourhoods with more fast-food outlets reported stronger descriptive and injunctive SNs about fast-food consumption, which were associated with higher fast-food intake.19

Participants perceived stronger injunctive than descriptive SNs endorsing healthy and vegetarian food consumption. Nonetheless, their perception of injunctive SNs for healthy food consumption remained weak (mean=2.93; SD=0.78), suggesting that they still thought it was rather inappropriate to eat healthy food at the festival. They might be used to eating unhealthy food in out-of-home settings9–15 18 or might associate festivals with the consumption of unhealthy food. Enjoying a special occasion (eg, a party) was identified as the most important reason for people to enjoy unhealthy snacks.35

Their perception of the injunctive SNs for vegetarian food consumption was stronger (mean: 3.14) than for healthy food, indicating that vegetarian food consumption was seen as more appropriate. This may be due to age, gender and education level. Prior studies reported more vegetarians and flexitarians among younger adults36 and highly educated women.37 While 11% of participants identified as vegetarian, a larger proportion may have been flexitarian. Besides, 55% of participants were female, 40.5% were young adults and 53% were highly educated.

Participants who perceived the FE as more supportive of healthy and vegetarian food consumption also perceived stronger descriptive and injunctive SNs for healthy and vegetarian food consumption. This could indicate that their perception of the FE influenced their SN perceptions or vice versa. Both measures may influence food consumption. Previous studies have found associations between perceptions of an unhealthy FE and fast-food consumption,38 and associations between vegetarian food consumption and perceived SNs.39

Recommendations for policy and research

The findings from this study can serve as input to develop public policies for improved food availability at festivals (eg, guidelines for proportion of healthy/unhealthy food and types of food providers). Inspiration can be taken by what has been done to restrict alcohol and drugs at festivals.4–6 40 Besides, the majority of festival visitors perceived a low availability and accessibility of affordable healthy food, which may encourage policy makers to take initiatives.41

Additional research on the availability of healthy and vegetarian food at festivals is needed to validate current findings. More research is also needed to determine how the availability of healthy and vegetarian food at festivals influences consumption on site and daily food consumption in the future.40 Besides, future research could examine the association between the perceived FE and perceived SNs for healthy and vegetarian food consumption, and their eventual influence on actual food consumption at festivals. Similar studies have been conducted to examine the association between FEs, SNs and food consumption.19 20 More research is needed to evaluate the impacts of public policies for festivals targeting food.18 This study can serve as a baseline to evaluate the implementation and effectiveness of such policies.

Strengths and limitations

This study had notable strengths. It is, to the best of our knowledge, the first study measuring the festival FE objectively and subjectively, including social aspects. Food availability was audited by researchers, rather than relying on self-reported outcomes of participants or food providers. Last, the food availability and surveys were completed on-site, reducing chances of recall bias.

This study also had limitations. There were internet connection problems given the large number of visitors, which explains the uncompleted surveys. This could be resolved by using tablets to fill in the surveys offline. Next, the researchers covered the whole site to invite participants to participate so the particular context in which participants completed the survey may have differed. Moreover, we did not account for the duration that participants spent at the festival before filling in the survey, which may have caused participants to perceive the FE and SNs differently.33 Also, participants were not asked whether they had already visited food stands or bought food, which may have caused differences in their perception of the FE. The food stands’ menus were used to evaluate the food available, which did not always provide enough information to evaluate healthiness. Last, participants were given succinct definitions of what constitutes healthy and vegetarian diets, similar to previous research,29 and with the aim of increasing the validity of their responses. These definitions may have influenced participants’ responses, by making participants more critical about their perceived FE for instance.



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