Health-related beliefs and consumer knowledge as determinants of fish consumption

Background: Despite scientific evidence on the positive effects of seafood consumption on human health, the consumption of fish remains below the recommended intake levels for the majority of Europeans. The present study aimed to explore cultural differences in potential determinants of fish consumption: consumers' knowledge and health-related beliefs, as well as the relationship between those variables, socio-demographics and fish consumption frequency, using data from five European countries. Methods: A cross-sectional consumer survey was carried out in 2004 with representative household samples from Belgium, the Netherlands, Denmark, Poland and Spain. The sample consisted of 4786 respondents, aged 18-84 years, who were responsible for food purchasing and cooking in the household. Results: European consumers had a very strong belief that eating fish is healthy. Consumers' belief that eating fish is healthy, their interest in healthy eating and objective fish-related nutrition knowledge, positively, but only weakly, influenced fish consumption frequency. Subjective knowledge was found to be a stronger predictor of fish consumption than the previously noted factors. Age and education contributed, both directly and indirectly through knowledge, to explain fish consumption behaviour. However, the path coefficients in the estimated model were relatively low, which indicates that fish consumption frequency was also determined by factors other than health-related beliefs and consumers' knowledge. Conclusions: The findings of the present study suggest that communication should focus on health-related benefits other than fish consumption alone. Communicating that eating fish is healthy and stressing the health benefits of fish alone, as is still commonly performed (e.g. in generic promotion and other types of public information campaigns) will be insufficient to achieve higher levels of compliance with fish consumption recommendations.