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«Saoussen LAKHDAR Assistante contractuelle, ISCAE Tunis, Tunisie Doctorante en marketing, Faculté des Sciences Economiques et de Gestion, Tunis, ...»

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While consumers in other studies favoured cues like “freshness” and “unprocessed”, Tunisian respondents favoured cues like “natural”, “nutritious” and “low fat”.

Moreover, word and image association highlighted the motives that can drive participants to choose healthy foods. As it has been shown above, the healthiness dimension is a credence characteristic in food products as consumer cannot perceive healthiness directly in the food but expects that this food will have in short or long term positive effects on his or her health if he or she ingests the food. The most frequently mentioned motives are related to (1) daily and future health enhancement (physical performance, intellectual performance, and energy), (2) illness control (cancer, heart disease, high blood pressure, cholesterol, and intestinal problems), (3) weigh control, (4) well-being and (5) appearance improvement (skin, hair, nails, developed muscles).

Finally, this projective technique reveals that as shown by literature (Van Trijp and Steenkamp, 1992; Hanse, 1994; Worsley and Skrzypiec, 1998; Verbeke, 2005; Carels, Konrad and Harper, 2007; Köster and Mojet, 2007; Rozin, 2007), perceived healthiness can be influenced by demographic characteristics and personality traits. The respondents perceived healthy foods as foods addressed to women (n=31) more than men, older than younger (n=27), well educated individual (n=18) and individual with higher socio-economic situation (n=13). Moreover, perceived healthiness can be influenced by personality traits like health beliefs (perceived susceptibility to a considered illness, perceived severity of a considered illness, perceived benefits like preventing illness or improving health (Rosenstock, 1974), (n=32); “health concern” (or value) (n=16); food involvement (n=11) and variety seeking (n=8).

Attitudes toward functional foods While some functional foods (e.g. foods enriched with Omega 3, foods enriched with vitamins and minerals or functional ingredients (e.g. antioxidants, Probiotics, Bifidus,) were mentioned by participants, the term “functional foods” did not appear spontaneously in focus groups and in-depth interviews. This fact is due to the confusion in the designation of this term. As the majority of Tunisians are French speakers, participants used the term healthy foods to describe all foods that promise health benefits including functional foods as functional foods are generally called “health foods” in French language (aliments santé).

Besides, there is an important ambiguity of what are functional foods in comparison to organic foods, dietetic foods, local foods, light foods, etc. and what are the meaning of the different health claims. To avoid this confusion, participants were provided with the French definition of functional foods (Roberfroid, 2008). The pictures of functional foods presented in the association exercise also help to distinguish functional foods from other healthy foods.

Once the term functional foods enlightened, the participants used the term “aliments fonctionnels” to refer to functional foods and “aliments santé” to refer to what are widely known as healthy foods.

The findings of projective techniques mainly reveal that the general attitude toward functional foods seems positive toward certain functional ingredients such as “Omega 3” and “fiber”.

This result was not expected because functional foods are emergent products in the Tunisian market. The major reason for functional food acceptation can be the fact that this new category of product meets Tunisian consumers demand for healthy life and healthy eating. In other words, participants perceived certain rewards in these food products such as well-being in the case of fortified foods with vitamins and minerals or enriched foods with fiber and avoiding illness in the case of Omega 3 foods.

Besides, some participants with current health problems such as cholesterol, diabetes, cardio vascular disease, digestion problems consider functional foods as a necessity. They attested that they purchase regularly functional foods to treat or control their health problems.

Other participants referred to the fact that consuming functional foods participate in maintaining their “healthy lifestyle”. They stated that there are several ways to live a healthy life such as not smoking, exercising, having a healthy weigh but above all eating healthy.

Although the discussions included many positive statements concerning the fact that functional foods are perceived as a necessity, as a part of healthy life or a mean to obtain benefits like well being, maintaining or improving health, projective techniques particularly story completion reveal complex and sometimes contradictory impressions toward functional foods.

Health claims and scientific discourses on functional foods do not necessarily produce reassurance and confidence in the respondents mind. The questions of trustworthiness on the health claims shown on functional foods were evident in the discussions. Terms related to confidence (trust, confidence, true, etc.) were largely evocated during the interviews (n=52).

The majority of participants seemed sceptical about the efficacy of the promised health effects of functional foods. They attested that they do not trust functional food marketing and stated that they were wary about the fact that they cannot verify whether functional ingredients are really present in the food and in case of the presence of these functional ingredients how to be sure that the information on health effects of these ingredients are true.

Moreover, studies showed that recent food scandals, particularly Bovine Spongiform Encephalopathy (BSE), commonly known as mad-cow disease and Genetically Modified (GM) food have clearly increased perceived risk in food and food neophobia (negative response to novel foods). Data provided from focus groups and in-depth interviews was concordant with these statements. Respondents seemed suspicious about the safety of functional foods. The term “risk” was evocated many times by participants (n=36) who seemed afraid of unknown effects that functional foods as novel and “modified” food may have on health.

Finally, similarly to literature, there is almost always a dilemma between health and pleasure (Niva, 2007). According to some respondents, sensory properties may decrease willingness to try functional foods. Many young participants contested the fact that health is the most important motive for food choice and attested that they prefer conventional foods because they are tastier than functional foods.

As it has been shown above, the large quantity of ideas generated from projective techniques reveals that general attitude toward functional foods can be merged into six dimensions (Table. 2). For a better understanding of the categorization of Urala and Lähteenmäki (2004) and to verify that Tunisian consumers have the same attitude’s dimensions toward functional foods, the findings of focus groups and literature (Urala and Lähteenmäki, 2004) were used as input for story completion technique involved in in-depth interviews. Some extracts of indepth interviews and focus groups related to each dimension are presented in Table 2.

Attitudes toward functional foods Extracts of interviews Perceived values in functional foods: F1-3-F-42 “… I pay attention to my son’s Functional foods with their specific health breakfast... I give him milk with added effects could represent a perceived benefit or vitamin so he can be in a good form for value such as well-being, avoiding illness, school…” improving health and performance. I8-F-22 “I have gone on a diet during the last year to lose weigh... when I take a coke or juice, I look if it is sugar free. I always watch out for that” Confidence in functional foods: I7-H-43 “...organic milk... how do you know This dimension describes consumers’ beliefs that it is really organic?” in the promised health effects. I1-F-49 “Firms do everything to sell their products,... we cannot verify if it is true...” Necessity for functional foods : F4-22-H-52 “you know with all the diseases This dimension describes how essential I have, cholesterol... high pressure blood... I consumers think that functional foods are for think that I have to buy omega 3 spread” them. I2-F-53 “I have digestion problems, you know not really serious... I think that I cannot digest milk... a friend recommended me to try “Candia milk”...” Functional foods as a party of healthy diet: I2-F-53: “I’m absolutely riveted by healthy The use of functional foods is a part of a lifestyle. All these stars who tell you that healthy diet. they stay young because they have healthy life. It' hard not to get caught up in it...

s functional foods help give me the nutrients that are needed to live a long, healthy life.” Absence of nutritional risks in functional F1-4-F-42 “10 vitamins and 4 trace foods : elements... It is overdosed of components...

Functional foods may have harmful effects that’s not really good for health” Health effects vs. taste : F2-11-H-31 “... It facilitates digestion but Health benefit can be a determinant of this juice is off-flavor...” willingness to compromise on taste F3-16-H-29 “all these products don’t have good taste...” Table 2. Attitudes toward functional foods CONCLUSION In recent years, some chronic diseases including obesity, diabetes, cardiovascular diseases and cancer have increasingly affected both developed and developing countries. To reduce the incidence of these diet related-diseases, governments, media and food industry have played a major role in creating consumer healthy diet awareness. The first key objective of this study was to assess the importance Tunisian consumers attach to health dimension in food choice in order to verify if a real awareness on health issues exists among Tunisians. Moreover and according to literature, food healthiness perception varies considerably among different cultures. Consumers may use different cues to infer food healthiness. A further objective of this study was to gain insight into how Tunisian consumers make sense of food’s healthiness and to identify the most determinant cues Tunisian consumers consider in food healthiness evaluation. Finally, this paper aimed to determine to what extent perceived healthiness can influence attitude toward functional foods and purchase intention. This category of food was chosen as it is marketed with health-related claims. Thus, it was considered interesting to explore Tunisian consumers’ attitude toward different functional foods with different health promoting ingredients and claims.

Word and image associations, analogy and story completion were useful projective tools to shed light on these issues. In the three projective techniques, respondents were provided with various verbal and visual stimuli and situations to reveal their unconscious feelings and attitudes toward health dimension in foods in general and functional foods in particular.

Findings reveal that the majority of participants were aware of the importance of healthful food choice to reduce risk of disease or to promote health. However, positive attitudes toward healthy eating do not necessarily lead to healthy eating choices. Many participants attested that they are not ready to compromise other food choice motives such as taste, convenience, price, mood, familiarity or ethical concern for health benefits in making food-related decisions. Besides, results show that healthiness is perceived by intrinsic and extrinsic food cues, nutritional information and production methods in particular. Dimensions such us “natural”, “nutritious”, “vitamin and mineral”, “low fat”, “fresh”, and “organic” are used to judge food’s healthfulness. Moreover, results show that personal characteristics influence perceived healthiness. Gender has a clear predictive value in health perception. Similarly to literature women report being more health conscious and reveal that they read nutrition labels more often than men. Personality traits can also be cognitive predictors of health behaviors.

Respondents associate “healthy foods” to personal characteristics such us health value, selfefficacy and health beliefs. Finally, when defining functional foods and presenting a set of pictures of different functional foods with different health claims as stimulus to participants, various impressions emerged. As the concept of functional foods still unclear because of the large variety of products marketed under this designation and as it is hard for consumer to verify the promised health effects, many contradictory attitudes emerged from the discussions. While functional foods were perceived as necessary, as a part of a healthy diet and as food products that offer health rewards, several mistrustful and suspicious statements were made concerning the safety of these foods, the confidence in their promised health effects and the possibility that they may be inferior in taste. Consequently, six attitude’s dimensions toward functional foods were discerned in focus groups and in-depth interviews including perceived reward from using functional foods, confidence in functional foods, necessity for functional foods, functional foods as a part of healthy diet, risk effects of functional foods and taste of functional foods in comparison to conventional foods.

Implications to theory, management practice and policy Understanding consumers’ perception of healthiness and attitude toward functional foods is likely to have significant impacts to theory, management practice and policy.

The theoretical framework presents a rich overview on health dimension in food products.

Because of the complexity of food choice, an interdisciplinary approach was adopted. The contributions of cognitive psychology, sociology, consumer research, nutrition science and food technology were examined to understand food healthiness perception and evaluation and to assess the importance of this dimension versus other food dimensions in food choice. The literature review suggests products characteristics and consumer’s background as factors that may influence how healthiness of food is perceived. Product characteristics are related to intrinsic cues such as appearance, color, structure, shape and size and extrinsic cues such as price, brand, country of origin, store, nutritional information and production information.

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