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Heart Health and Todays Consumer
February 12, 2007
7 Min Read
If you live to a ripe age and expire due to cardiovascular disease (CVD), consider yourself lucky. It means you have successfully averted car accidents, Alzheimer’s disease, AIDS and terminal cancer. According to the U.S. Centers for Disease Control, Division for Heart Disease and Stroke Prevention, heart disease and stroke remained the default cause of death in the United States in 2006—the reward for enhanced American longevity created by immunization, antibiotics, better access to health care, health system improvements, and improved consumer self-care. The high prevalence of late-life CVD as a cause of illness and death is, relative to other parts of the world, a success story. Our hearts sustain us without needing much help for a long, long time.
As such, Americans take their hearts and heart health for granted throughout much of their lives, particularly during their habit-forming youthful years, when problems are few. Interestingly enough, as a central mindset, we are collectively out of touch with our heart as an “organ.” The popular representation of the heart (the symmetrical Valentine heart) is only loosely based on its actual image or function. It’s too grisly and eerie to consider our hearts as realities. Perhaps this lack of heart awareness is why many Americans become proactive around heart and cardiovascular health as only a response to a sudden perceived vulnerability or a diagnosed condition. High cholesterol, high blood pressure, heart attacks and the death of loved ones cause us to spring into action. Consumer language in The Hartman Group’s Pulse Report Heart Health from a Consumer Perspective reflects this: Top-of-mind language on the meaning of “heart health” overwhelmingly centers on preventing or minimizing problems, in the lingo of maintenance—words like “keeping,” “preventing,” “making sure,” “taking care” and “watching” are commonly used. Interestingly, language about actually improving the function of the heart or promoting the heart’s capacity to generate vitality, is nearly absent. In fact, consumers struggle to articulate what “heart health” actually is.
Instead, consumers conceptualize the heart as a vague, guarded entity, which functions well enough but is under mild siege from fat intake, cholesterol and the prospect of obesity. Much of this siege is more tangibly envisioned by consumers on the vascular landscape. Consumers strongly associate cholesterol with the notion of heart health: The fixation on cholesterol is a newcomer accompanying the well-known mantra of “eat right and exercise.” With the prospect of having one’s circulatory system blocked or clogged by cholesterol, the enemy becomes clearer to them, and action can be taken. The same goes for blood pressure: Blood pressure “numbers” can be reduced through lifestyle changes and/or medication.
To gain insights into how consumers learn about subjects like lowering cholesterol and blood pressure, and maintaining overall heart health, we asked them in our poll what sources of information and strategies they used.
Info Sources, Strategies
Over half of consumers surveyed seek health information from Internet sources, while over a third read magazines as a health information source. Roughly one-third of consumers use both of these sources specifically for heart health reasons.
On food packaging, the nutrition panel is the most used information source for heart health purposes, followed by the ingredient list (Figure 1). Consumers are less likely to rely on health claims, certifications, and content labels or descriptors. This reflects scrutiny by heart-conscious consumers over the proportions of sodium and fats in products relative to daily value, rather than mere reliance on other messaging.
Two-thirds of consumers who diet, exercise or limit their stress level do so out of concern for cardiovascular health. A key initial line of defense for those concerned about heart health is the alteration of diet to reduce intake of sodium and fat. This parallels the general consumer trend away from high-sodium snack and packaged food categories. Increasingly, consumers are souring on sugar as well. There is heightened awareness among mid-level wellness consumers—those who experiment with a wide range of wellness products and services, compared to core wellness consumers who embrace wellness lifestyles fully—on the harm caused by added sweeteners (i.e., high fructose corn syrup). Sugar and sweetener consumption links to heart health in the consumer’s mind through the prospect of obesity and burdening one’s physical mobility (i.e., heart racing and becoming winded after climbing stairs).
Walking on a regular basis is the key physical activity reported by consumers for improving cardiovascular health. Recent Hartman Group research finds sustained periods of moderate physical movement are considered to be part of living a balanced lifestyle among those in the age 40 to 60 set. Long walks, recreational biking, dance lessons, yoga and short hikes were routinely prioritized into the busiest of lifestyles; these active occasions often are centered upon opportunities taken to socialize or to spend quality time with family. Bearing witness to parents and older relatives succumbing to heart disease and stroke is a key driver to pursue more active lifestyle than the preceding generation.
Based on unaided, top-of-mind results, fruits and vegetables are considered by consumers to be the best foods for promoting heart health. Surprisingly, water is the next most mentioned product, followed by red wine and whole grains. These findings are also supported by survey results, which show similar rankings of foods and beverages believed to be heart healthy (Figure 2).
Associations of brands with heart health revealed that cereal brands are the most closely associated with heart health (Quaker Oatmeal, Cheerios, Kashi), with juices a distant second (V8, POM), followed even more distantly by spreads like Take Control.
When examined in relation to heart health, what characteristics do these seemingly diverse products have in common in the context of promoting heart health?
Purity. Most of the heart health product categories and even the brands are relatively uncomplicated by long ingredient lists. Their quality and “pure” form is easy to personally evaluate. They are attractive to many consumers as flavorful foods without a downside, as they sense these “whole forms” maximize nutrition benefits, offering cardiologic strength and energy.
Alive. Closely related to purity, as whole grains and fruits and vegetables are easy to imagine in their original, pristine context. Highly proactive wellness consumers, such as those in the “core,” state ingesting raw foods that were recently rooted in the earth provides them with a sense of intimacy with the earth’s regenerative capacity. This is in symbolic service to the regenerative capacities of the cardiovascular system itself.
Cleansing. When consumers ingest fruits, vegetables or whole grains, they describe a sense of “breaking up” blockage within their digestive systems. Their cleansing power in the digestive system acts as a metaphor for consumers as to what might be occurring in the cardiovascular system as well.
Permeation. Consumers find that complex flavor, the physical experience of hydration, and warm, rich colors all possess permeating qualities—through the senses and through the physical body itself. This “radiating effect” lends credibility to the perceived health efficacy of the product, in that the experienced physical sensation also acts as a metaphor to consumers for the ability of nutrients and beneficial properties to transcend barriers and become absorbed within the body, including the heart and vascular system.
Consumer notions of heart health are akin to the individualized process of maintaining a familiar and highly regarded power plant that requires protection from the onslaught of both cardio ailments and threats posed by a lack of exercise and poor diet. The fact that the consumer mindset around what “heart health” means focuses on the familiar cultural mindset of “eating right and exercising” (combined with a lesser understood notion of “protecting” this essential organ) signals to manufacturers and retailers that real opportunities exist in assisting consumers with information, products and services that protect the heart and provide increased, unadulterated energy and vitality. Some of these cues are already evident in the types of foods and beverages consumers equate with heart health. These are products best described as pure, raw, whole ingredients that are viewed positively, as they assimilate healthfully into the digestive and vascular system.
Rob Fredericksen is an ethnographic analyst with The Hartman Group (www.hartman-group.com). He is completing his doctorate at Boston University, has worked as a qualitative researcher and consultant on domestic and international public health projects, and has a range of research interests, including the relationship between future orientation and health behavior; increasing the cultural relevance of disease prevention and treatment initiatives for marginalized groups; and meanings of mental health and illness across culture.
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