What is the difference between intended and unintended consequences

One reason for the difference in significance between fruits and vegetables is likely linked to the barriers participants noted in preparing foods with FVs; fruits can generally be eaten without preparation whereas vegetables generally require preparation for desirable consumption.

Future research is called for to examine if improvements in dietary quality are sustainable for the long-term beyond the intervention duration, particularly in the context of the challenges that participants noted with regards to adhering to the intervention.

The improvements in dietary quality with the implementation of Eat Fresh were aligned to positive influences on multiple self-reported and perceived parameters of well-being including improvements in perceived overall well-being, mood, optimism, mental alertness, energy, feelings regarding weight, and skin.

Almost all participants agreed that the FVs provided by the Eat Fresh intervention made them feel good or very good about their health as well as made them feel happy or very happy. These findings are in line with previous studies that provide evidence on the linkage of FV consumption with perceptions of happiness, life satisfaction, and well-being within a 2-year period While the physiological health benefits of healthy eating accrue and are felt decades later, the perceived well-being improvements from increased consumption of FVs are closer to immediate In addition to perceived well-being improvements, previous studies have shown significant short-term improvements to participant's psychological well-being within a day period on the basis of provisioning of FVs to young adults The self-reported health measures point to the importance for food and nutrition interventions to evaluate participant perceptions of health in addition to anthropometric measures in order to capture the multi-dimensionality of well-being.

While Eat Fresh met its goal for enhancing FV consumption, multiple barriers were noted by participants in preparing and consuming meals with FVs and adhering to healthy diets which can provide important lessons for designing future dietary interventions in low-income, rural, and tribal communities. Overall, participants found Eat Fresh moderately challenging to adhere to with the main barriers being access to ingredients in recipes, time constraints to cook, lack of financial resources to procure ingredients, cooking knowledge, and cooking skills.

These challenges are expected to be exacerbated outside of the duration of the intervention when participants are not provided weekly provisioning of fresh fruits and vegetables. Future intervention design should take into account these barriers including providing simpler recipes with fewer and more accessible ingredients that require less time and cooking skills to prepare. However, these recipes should be tested in the community to meet local taste preferences while having accessible ingredients; the majority of participants reported intervention recipes met taste preferences which likely supported the enhancements in FV consumption.

The community-engaged approach of designing the intervention through focus group meetings with a Community Advisory Board of food and nutrition stakeholders played a key role in supporting the desirability of the provided foods and recipes among participants. In meeting local taste preferences, future FV interventions should take a place-based approach such as incorporating indigenous foods in tribal communities including wild game, fish, and edible plants into interventions should be considered Training on prioritizing time and scheduling on procuring and preparing meals can further increase the capacity to prepare healthy meals from scratch For example, meal planning has been shown to be a promising tool to offset time scarcity and lead to healthier diets and less obesity Low income is another critical barrier to supporting healthy diets; lower income is associated with cheaper and more energy-dense food choices Diet optimization techniques that are sensitive to cost and social norms can help overcome this barrier by identifying affordable, desirable, and nutrient-rich foods At the same time, there is a need for systemic change that support livelihoods in addition to programs and policies focused on healthy and sustainable food environments and diets.

While Eat Fresh led to intended consequences during the intervention period, it did result in several unintended consequences including the increase in BMI and blood pressure for several participants. The increase in BMI and blood pressure can be attributed to focus on Eat Fresh in promoting the increased consumption of FVs within healthy diets rather than a whole-diets approach where portions sizes and the consumption of unhealthy foods were restricted.

While the consumption of unhealthy foods and portion size were touched upon during the in-person classes, these topics were not the focus of the Eat Fresh nor was the consumption of unhealthy foods restricted during the intervention. Multiple participants shared that the recipes with the provided FVs did not satiate their appetite and thus they ate additional snack foods or meals. Future interventions that promote the consumption of FVs should thus consider dietary restrictions or recommendations on consumption of unhealthy foods in ways that are culturally appropriate.

Previous studies have highlighted that interventions to promote healthy eating as a way to achieve and maintain healthy weights do not work for most people and in cases, have been linked to negative unintended consequences including social, psychological and economic costs 54 , 55 such as loss of self-efficacy, self-esteem issues, the ability to cope with barriers to healthy eating, body dissatisfaction and social stigma, self-blame, discouragement, discomfort eating with others including attending community events, and issues with household budgets In addition, previous work has highlighted the potential harm of simple dietary recommendations in having negative unintended consequences and the need and power of creative ways to extend nutrition advice that is actionable, balanced and avoids unintended and unhealthy consequences while sustaining health over the long term Based on findings from this pilot study, the research team and members of the Community Advisory Board have co-designed a more holistic dietary intervention, Healthy and Sustainable Diets for All, to follow Eat Fresh that takes a place-based approach incorporating themes of sustainable diets and indigenous food systems to support both human and planetary health As part of this on-going intervention, the study team is incorporating dietary restrictions and education about unhealthy foods including limiting the consumption of ultra-processed foods.

This pilot study had multiple limitations which can be addressed in designing future community-based interventions. Two major limitations are the small sample size of 19 participants as well as the short duration of the intervention of 6 weeks.

The small sample size of the study does not allow us to expand the findings beyond the participants of the study and may further have had an impact on the relative magnitude of unintended consequences in the study.

Additional limitations of this pilot study include the use of self-reported dietary recall data for two single days at pre- and post-intervention which may not reflect actual behaviors or the variation that occurs in diets day-to-day as well as at different seasons or times of the month. Future research is called for that builds on the results illuminated through the Eat Fresh pilot study using a larger sample size and a longer duration intervention.

Data from such future work should be analyzed on the basis on multiple socio-economic demographics to better understand the social determinants of health. Future research should also measure additional biomarkers to evaluate the impacts of the intervention to supplement the self-reported dietary recall data.

In addition, future research should make not of any unintended consequences such as those reported here that are largely missing from the literature yet have importance for practical and ethical reasons.

Lastly, as a large percentage of the study participants purchased food in addition to the food provided by Eat Fresh and the FDPIR Commodities Program , future research should explore how the amount of funds spent on food impact participant study outcomes. Overall, findings from this pilot study add to the emerging literature on the relationship between FV consumption, dietary quality and well-being in health disparate communities, as well as the small body of literature that reports on the negative unintended consequences of a food and nutrition intervention.

Findings highlight both intended and unintended consequences of a dietary intervention that can be applied to design future community-based programs for improving dietary quality and plant-based diets while addressing health disparities in tribal and rural communities. The unintended consequence of Eat Fresh is primarily attributed to the lack of a systems approach As plant-based diets are increasingly recommended for supporting human and planetary health 28 , several key lessons can be adapted from Eat Fresh to inform the co-design of evidence-based interventions in communities for supporting public health: 1 it is important for dietary interventions to be holistic and focus on the whole diet instead of only focusing on the consumption of healthy foods such as FVs; 2 interventions should measure multiple parameters to assess their effectiveness including both objective dietary and health outcomes as well as subjective measures such as participant perceptions of well-being; 3 it is important to collaborate with a Community Advisory Board of food and nutrition stakeholders in co-designing dietary interventions to help ensure the intervention questions, design, outcomes, analysis, and dissemination are place-based and culturally relevant.

For example, working with a Community Advisory Board and the Delphi Method can help ensure that the foods and recipes provided to participants of a dietary intervention are affordable, accessible, convenient, and desirable including being culturally appropriate; 4 dietary interventions should be co-designed to be multi-phased and target individual, familial, community, and environmental dimensions including existing community infrastructure in order to have long-term effects and sustainable effects for supporting well-being through diets and; 5 in taking a systems approach, dietary interventions should foster greater linkages between local agricultural sources and diets to enhance local food systems.

The datasets generated for this study are available on request to the corresponding author. MT and MR collected data. All authors interpreted data. SA and CB wrote the manuscript with contributions from all authors. All authors contributed to the article and approved the submitted version. The content presented here is solely the responsibility of the authors and does not represent the official views of the National Institutes of Health.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors are grateful to the study participants, members of the project Community Advisory Board, the Tribal Council on the Flathead Reservation, and Emily Salois, for sharing their time, experiences, and insights in the development, implementation, analysis, and dissemination of this co-designed community-based project.

The authors would like to extend gratitude to the research assistants and collaborators at Salish and Kootenai College and the Montana State University Food and Health Lab that supported with this work. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for countries and territories, — a systematic analysis for the Global Burden of Disease Study Global Status Report on Noncommunicable Diseases Ginebra OMS, editor.

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BMC Public Health. Create a free Team What is Teams? Learn more. Compelling example of difference between intended consequences and foreseen but unintended consequences? Ask Question. Asked 3 years, 5 months ago. Active 2 years, 4 months ago. Viewed times. Thanks a lot! Improve this question. Consider serial killer who killed terrorist and saved lives. He will be worse than those who intented to save lives through killing terrorist, because he is potentially dangerous.

And yes, this is consequential mechanism in humans. Yet, intuitive an emotional, I believe. Add a comment. Active Oldest Votes. Improve this answer. Conifold Conifold I predict that even wording of "Fat Man" problem can affect the percentage of people: "Is it right to save 5 people, even if the man on the bridge will need to be sacrificed to save those people" vs "Is it right to push that man from the pridge in order to save 5 people".

Wendy Lobdell Wendy Lobdell 1. If you have references to others who take a similar view this would give the reader a place to go for more information and support the answer. Sign up or log in Sign up using Google. Sign up using Facebook. Sign up using Email and Password. Post as a guest Name. Email Required, but never shown. As the critics see it, unintended consequences can add so much to the costs of some programs that they make the programs unwise even if they achieve their stated goals.

For instance, the U. The quotas do help steel companies. But they also make less of the cheap steel available to U. As a result, the automakers have to pay more for steel than their foreign competitors do. So a policy that protects one industry from foreign competition makes it harder for another industry to compete with imports. Similarly, Social Security has helped alleviate poverty among senior citizens.

Many economists argue, however, that it has carried a cost that goes beyond the payroll taxes levied on workers and employers. If Feldstein and the others are correct, it means that less saving s are available, less investment takes place, and the economy and wages grow more slowly than they would without Social Security.

The law of unintended consequences is at work always and everywhere. People outraged about high prices of plywood in areas devastated by hurricanes, for example, may advocate price controls to keep the prices closer to usual levels. An unintended consequence is that suppliers of plywood from outside the region, who would have been willing to supply plywood quickly at the higher market price, are less willing to do so at the government-controlled price.

Thus results a shortage of a good where it is badly needed. One unintended consequence is that people sometimes do their own electrical work, and, occasionally, one of these amateurs is electrocuted. One final sobering example is the case of the Exxon Valdez oil spill in Afterward, many coastal states enacted laws placing unlimited liability on tanker operators.