Does the body speak? Body map of the relationship with food narrated by women in an intervention for food consciousness

Abstracts

The relationship between the body and food has been impacted by the obesogenic environment, a scarce topic in the literature, which affects women and requires in-depth methods. This study aimed to access and explore the recognition of the relationship between the body and food of women participating in an educational intervention for food consciousness using the body map storytelling, a visual methodology. This is qualitative research, conducted with nineteen Brazilian women, who developed the body map individually and analyzed considering visual and narrative representations. Forms of self-denomination were recognized by themes that demonstrated how aspects of identity defined or intensified the relationship between the body and food. This study contributed to a strategy for educational food and nutrition programs to strengthen women’s health.

Keywords Qualitative research; Eating behavior; Women; Visual methods; Consciousness

A relação com o corpo e com a alimentação tem sido impactada pelo ambiente obesogênico, tema escasso na literatura que afeta mulheres e necessita de métodos de investigação em profundidade. O objetivo deste estudo foi acessar e explorar o reconhecimento da relação com o corpo e a alimentação de mulheres participantes de uma intervenção educativa para a consciência alimentar por meio do mapa corporal narrado, uma metodologia visual. Trata-se de uma pesquisa qualitativa, conduzida com 19 mulheres brasileiras, que construíram o mapa corporal individualmente, analisado considerando representações visuais e narrativas. Formas de autodenominação foram reconhecidas por temas que demonstraram como aspectos da identidade definiram ou intensificaram a relação com o corpo e a alimentação. Este estudo contribuiu com uma estratégia para programas educativos de alimentação e nutrição para o fortalecimento da saúde de mulheres.

Palavras-chave Pesquisa qualitativa; Comportamento alimentar; Mulheres; Métodos visuais; Mapa corporal

La relación con el cuerpo y con la alimentación se ha visto impactada por el ambiente obesogénico, tema escaso en la literatura, que afecta a las mujeres y necesita métodos en profundidad. El objetivo de este estudio fue tener acceso y explorar el reconocimiento de la relación con el cuerpo y alimentación de mujeres participantes de una intervención educativa para la conciencia alimentaria por medio del mapa corporal narrado, metodología visual. Se trata de una investigación cualitativa, realizada con diecinueve mujeres brasileñas que construyeron el mapa corporal individualmente, analizado en consideración a representaciones visuales y narrativas. Formas de autodeterminación se reconocieron por temas que demostraron cómo aspectos de la identidad definieron o intensificaron la relación con el cuerpo y con la alimentación. Este estudio contribuyó con una estrategia para programas educativos de alimentación y nutrición para el fortalecimiento de la salud de las mujeres.

Palabras clave Investigación cualitativa; Comportamiento alimentario; Mujeres; Métodos visuales; Mapa corporal

Introduction

A personal relationship between the body and food occurs as a product of the contact between the senses and body structures, with the stimuli provided by the environment¹. Food is recognized for building and modulating cultural identity according to the meanings of experiences produced in contact with food^2,3. Despite the relevance of the theme, it has been little explored, especially from the perspective of the involvement of food in the symbolic and cultural construction of the body³.

The obesogenic environment⁴ is characterized by excessive stimulation and easy access to the consumption of food with poor nutritional quality. This food environment has unbalanced the connection and regulation of bodily needs, such as hunger and satiety⁴. Food decision-making taken with reduced time and attention is affected by low reflective capacity, which can contribute to overconsumption⁵. In this scenario, consumption patterns and values related to the body are disseminated under the aegis of modernization, hedonism, individualism, and the idealization of a socially accepted body^3,6, especially for women⁶.

Previous studies have identified that the body plays a fundamental role in experiences with the world⁷, which is known as an embodied(^e) experience, such as the experience produced by the body in contact with food. Food mediates these experiences³, in parallel with the recognition of bodily needs that depend on the level of consciousness and self-knowledge⁸ and are fundamental for the regulation of bodily states⁹. Consciousness actively participates in the person’s relationship with the world, coordinating decision-making and behavior based on the combination of information received in this relationship¹⁰. The embodied experience, on the other hand, can modulate decision-making and behavior, mediate the relationship with social norms, and direct food desires and attitudes^1,11.

Methods that access the symbolic relationship between the body and food to deepen food consciousness are still scarce in the literature and could be strategic for educational programs¹². Approaches that use creative-reflective methods¹³ and encourage food consciousness^5,10 are potent alternatives. Recognizing the difficulty in capturing the meanings of the symbolic relationship between the body and food through verbal communication, these can be represented by the embodied experience through visual representations such as words, objects, and images¹⁴. The embodied experience is characterized by the generation of data from the representation of the body, which allows the perception of experiences from the perspective of what is sensed and experienced by the body¹⁵. This is what body-map storytelling (BMST) proposes, a visual methodology of qualitative research, which has been applied in several contexts¹⁶, however, its use is still scarce in the area of food and nutrition.

In the scenario of excessive food stimuli that make human health vulnerable by impacting people’s relationship between the body and food, the importance of recognizing body needs is identified for the balance of decision-making and eating behaviors, especially for women. Therefore, this study aimed to access and explore the recognition of the relationship between the body and food in women as a synthesis of an educational intervention for food consciousness through BMST. We sought to answer the following research question: “How is the relationship between the body and food recognized by women from the perspective of experiences proposed in an educational intervention for food consciousness?”.

Methods

Context

The study was developed and applied as part of the Food and Nutrition Education Program with Sensory and Cognitive Exercises (PESC), a Brazilian educational intervention to promote food consciousness¹⁷. The food consciousness approach was based on the Triple Aspect Monism (TAM) theory of consciousness¹⁰, as described above. The PESC aims to strengthen women’s perception of the stimuli provided by the obesogenic environment for food consumption. The intervention consisted of 6 meetings, being 2 for evaluation and 4 for workshops, in which themes such as food desire (workshop 1), food pleasure (workshop 2), and body signs of hunger and satiety (workshop 3) were explored, ending with the record of eating experiences in the body (workshop 4). Details on the development and application of the PESC have been previously published¹⁷.

Qualitative and theoretical approaches

This study used the BMST with a qualitative research design¹⁵ and was cross-sectional. This is because it refers to the fourth workshop of the PESC¹⁷, a moment for the synthesis of the intervention and a means for recording the consciousness of the eating experiences explored in the intervention on the representation of the body. The means for recording these experiences was by the representation of the food identity and the relationship with food in the BMST. The BMST generation is based on mapping lived experiences of the body through artistic processes¹⁸. Therefore, stimulates the generation of narratives and the construction of visual representations, doing this through the attribution of meanings¹⁵. The theoretical framework, TAM¹⁰, considers consciousness as a person’s recognition of an experience lived in the world perceived from what it produces in the body, such as sensations (for example body states, such as hunger, and thirst), emotional, cognitive, or perceptual content, or even an event evaluation.

The combination of the BMST and the TAM theoretical framework is useful because the BMST allows the recognition of experiences using the representation of the body¹⁵, a condition considered fundamental by the TAM for raising consciousness as a product of the interaction with the world¹⁰. Previously¹⁹ the application of the BMST demonstrated its ability to access food consciousness as it was a means of expression and reflection on eating experiences.

Researchers’ positionality and reflexivity

We are a research group formed by Brazilian women that studies the theoretical-methodological interfaces between social and biological sciences in the field of food and nutrition. In this study, the subjectivity of the relationship of women between food and body was accessed and communicated through the production of the narratives by a visual and participatory methodology, the BMST.

Participants

The participant’s recruitment consisted of¹⁷ (i) the propagation of the research on social media, website, and e-mail related to the Faculty of Medicine of Ribeirão Preto from the University of São Paulo (FMRP-USP); (ii) a telephone interview was conducted with the interesting participants for the application of the eligibility criteria and clarifications about the procedures of the study. From September 2019 to November 2020, nineteen Brazilian women participated in the PESC, comprising the study population recruited based on the PESC eligibility criteria¹⁷. Women with difficulty managing body weight (weight gain greater than 5% in the previous year) who reported a desire to improve their relationship with food were selected. Other inclusion criteria were age between 20 and 59 years²⁰ and Body Mass Index (BMI) values between 18.5 and 34.9 kg/m² (classification of eutrophy to obesity grade I)²¹. Women who used cigarettes, pregnant women, those with dietary restrictions such as celiac disease or diabetes, those using psychotropic medications, and nutrition students or professionals were excluded. The age range and BMI were justified as the purpose of the intervention was to work with food consciousness.

Gender, race, ethnicity, and biological indicators were not considered, because this study aimed to understand the food consciousness of women as an individual experience, accessed by the BMST in the PESC context. Specifically, to understand how the obesogenic environment stimulus for food consumption is lived and internally processed by the participants of the study.

All the women gave Informed Consent for inclusion before participating in the study. Provisions related to consent, confidentiality, and ethical aspects were ensured in all procedures of the study²².

Data generation

Socioeconomic profile data (age, marital status, education, per capita income)²³, and anthropometric measures such as weight and height, to calculate the BMI (kg/m²), were gathered. Weight was measured using a digital scale (Wiso®), and height was registered using a portable stadiometer (Cescorf®).

The BMST was adapted compared to the traditional application¹⁵, according to a specific protocol¹⁹. The application of the body map lasted 2 hours and was carried out in small groups of up to 6 participants; however, the construction of the body map was individual. Four researchers were trained for the application and helped the participants with guidance and encouragement for reflection throughout the process. The research team also observed the mapping development for the data analysis. The body map was applied in a large and reserved place, providing adequate space for its development.

Initially, the participants performed a relaxation exercise to connect with the body sensations, received guidance on the activity, clarified any questions, and signed the Consent Form. Based on the first body map construction exercise - body tracing and food identity -, they developed maps based on their body identity and recognition of their relationship with food through embodied representations. Starting from the representation of the body silhouette, in the scaled size of an A3 sheet (297 by 420 mm), the participants were invited to draw their own body in the position that most represented them, to decorate the outline of this body and to assign a pseudonym as a title to represent the body map considering their relationship with food. Next, they were instructed to add physical characteristics of their bodies that allow them to relate to food as a representation of the relationship between the body and food.

Taking the representation of the body as a starting point, the participants initially represented these issues visually through artistic processes (for example, drawings, paintings, and texts), using identical art material kits. Subsequently, these questions were narrated by audio recording using personal cell phones and sent to a private conversation platform with the main researcher using a messaging application (WhatsApp). These narratives were accounted for in minutes based on average for participant’s narratives characterization. Furthermore, they gave meaning to the context represented in the body map and to the visually constructed representations.

Data analysis

The organization and processing of the data were carried out soon after the application of the BMST. The nineteen maps were photographed, and the audio recordings were transcribed. Using the qualitative data analysis software (Atlas.ti, version 9.0; scientific software development GmbH, Berlin, Germany), the images of the photographed maps were inserted, as were the transcripts. The material was filed as visual and narrative representations, respectively. For each participant, a document was created containing the description of the visual representations with the meanings provided by the narrative representations. This process was considered as a first step of analysis by approaching the data generated. Considering that they are different types of communication, although constructed together, the visual and narrative representations were analyzed in an integrated way, using different techniques.

The analysis of the visual representations was inspired by semiology. To understand communication patterns, semiology aims to access the symbols of images based on their meanings^8,24. To analyze the narrative representations, content analysis was used, in the reflective thematic modality^25,26, which uses the generation of themes to understand patterns of meanings. Table 1 presents a summary of the integration of the analyses and describes how the processes were performed. The analyses were developed by 2 researchers involved in the study who compared, discussed, and synthesized all the analysis processes.

Table 1
Description of how the analyses were performed.

Terms that directed the analyses	What the terms represent	How the analyses were carried out
		Visual analysis	Narrative analysis
Mapped elements	Visual and narrative representations distinguished by mapped element: position outline pseudonym physical characteristics of their bodies that represented the relationship between the body and food
Codes	Description of the meanings of the communication patterns.	Identification of the meanings communicated by the image: subdivided by “what is represented?” and “what it represents?” (using the narrative as a basis).	Successive readings of the narratives for familiarization, followed by notes. Identification of main ideas.
Subthemes	Elaboration of categories that characterized the communication patterns.		The codes were grouped and refined to a synthesis of initial meaning patterns.
Themes	Definition of communication standards.	Systematization of meanings seeking communication patterns.	Refined and revised, seeking the central meaning of the communication.

• Based on^24-26. Source: The authors.

The study was approved by the Human Research Ethics Committee of the Hospital das Clínicas of FMRP-USP with the National Research Ethics Commission (CONEP), protocol number 09850919.6.0000.5440.

Results

The median age of participants was 37 years; 47% were single; 79% had completed higher education; and the economic classification was compatible with low income (58%)²³. Concerning physical activity, 74% practiced regularly. Regarding the anthropometric profile and according to the BMI classification²¹, 2 participants were eutrophic (median BMI=22.35kg/m²), 12 were overweight (median BMI=27.20kg/m²), and 5 were obese grade I (median BMI= 31.20kg/m²). The audio recordings lasted for an average of 11 minutes per participant.

Table 2 presents the results of the analysis of the representations, according to the themes, subthemes, and codes generated. They were generated by the data communicated meaning patterns as a representation of the BMST exercises (food identity and recognition of the relationship with food). They are presented by level of complexity, from the least to most complex, and represent the recognition of the relationship between the body and food based on forms of self-denomination.

Table 2
Participants’ forms of self-denomination regarding their relationships between the body and food according to the elements mapped in the body-map storytelling.

Themes	Mapped elements	Subthemes	Codes
Identity	Pseudonym I	Attributes: (I) transcendent and (II) morals	(I) Spirituality, (a) desire for change II, and connection with elements that are essential for human life (Sun). (II) Perseverance and freedom.
		Personal references	People’s names, idols, mother’s influence on food and body relationship, and family memories.
		Self-representation	Age, level of satisfaction with body image, and reflections about the body shape.
	Position	Embodied life experiences III	Standing, upright, and fronting (types of behavior such as steadfastness, seriousness, uprightness); standing (in movement and energetic); sitting (rest and work); (b) standing and fronting (body self-analysis) II.
	Outline (drawing)	Transcending attributes	(c) Life values (spirituality, hope, transformation, happiness), expressed by vibrant colors (green, yellow, purple, and orange) II.
		Physical appearance	(d) Appearance characteristics II, body structure and shape II.
Person-world relationship	Outline and pseudonym I	Relationship toward person	Life values, self-representation forms (age, body shape), and perceptions about the relationship with food.
	All IV	Relationship toward world	Body posture, personal references, and systemic relationship with an element (Sun).
Temporality	All IV	Past	Memories.
		Present	How do I view myself?
		Future	Idealizations.
Synthesis: identity and embodied III relationship with food	All IV	Mapping Style	Dissatisfaction, identity, transcending, and reflection.
		Embodied representations III about the relationship with food	(e) Mind V, (f) organs and physical health V, (g) sensory aspects V, embodied III subjective experience.

• ^I
  The pseudonym associated with the narratives below refers to the body maps’ title.
• ^II
  The letters a to d refer to Figure 1.
• ^III
  Used when the generation of data occurs from the representation of the body.
• ^IV
  A set of elements mapped (choice of position, path used to draw the body, assignment of a pseudonym, and physical characteristics of their bodies that represented the relationship between the body and food).
• ^V
  The letters e to g refer to Figure 2.
• Source: The authors.

The participants’ narratives, as presented below, are identified with the fantasy name, in parentheses, in reference to the name that each participant self-assigned to represent their BMST.

Theme 1. Identity

For the first theme, identity, the participants expressed the recognition of personal values and personal body characteristics (examples: qualities, how they see themselves from the body shape, references, and relationships that inspired and identified them) using a pseudonym, as well as, how they identified with life experiences according to body posture (examples: ways of positioning themselves, dynamics adopted in life, activities performed and appreciation of qualities). In particular, the color chosen for the outline of the body was a striking form of expression to communicate meaning (Figure 1).

Figure 1
Violet´s body map.

Violet´s body map, representing theme 1, Identity, by codes and respective narratives (see the letters a to d in Table 2): (a) desire for change: “I think the colors purple and violet represent transformation and the desire to change”; (b) standing and fronting: body self-analysis: “I made the outline upright to make it easier to fill in the drawing”; (c) life values, expressed by vibrant colors: “I put glitter around it because I think my mood today is a little more wanting to represent transformation and desire for change, so I put a little bit of purple glitter to show this idea”; (d) appearance characteristics, body structure, and shape: "I made the body contour a little asymmetrical, and the top a little wider because I have broader shoulders; the leg is a little smaller because I have one leg slightly shorter. The elements I put on were hair, eyes, eyebrows, eyelashes, and a little blush, because sometimes I’m a little vain, I like makeup, these things, mainly to identify myself. (Violet)"

Theme 2. Person-world relationship

This theme was represented by the women’s ways of relating to the world, based on their experience with the body and food. This relationship could be directed towards the person, as narrated by the participant who title her body map: Suddenly wide body, slumped shoulders:

I didn’t draw anything on the face when I was supposed to draw my body. I didn’t make a mouth, I just drew the eyes, as if that’s what I was really representing, what I see I want to eat. I don’t have a mouth, because maybe I don’t feel happy to draw a smile.

(Suddenly wide body, slumped shoulders)

She gave meaning to her eating experience based on her subjective relationship with her body – dissatisfaction -, marked by food desire and a body expression – not having a mouth – to express sadness and discontent. The women’s relationship with the world could also be directed toward the world:

I made my body stand up, more upright, it has a steeping floor so I’m not floating, and I did it in this position because I’m more active because I believe I have goals, I go after them, not just through the body. So, I did it in that more energetic position.

(Eth, body and health)

She gave meaning to the choice of body posture by the way she moves in life, that is, her experience in the world: attentive and sustained by reality, represented by the experience with the body and the steeping floor.

Theme 3. Temporality

The recognition of the relationship between the body and food was also marked by the period of life. The past, marked by memories, was exemplified by the narrative: “I chose Margarida [body map´s title] because as the representation is about me, I remembered that my mother called me ‘margarida’ when I was a child”. (Margarida)

The present revealed the participants´ views about themselves: “Me for me [body map’s title] is how I see myself, it’s not how I think people see me or how I would like to be seen.” (Tica).

The future was marked by idealizations of how a person should be: “I chose the standing, up-right body position because it is to exemplify how I see myself: a person who needs to have posture needs to be straight and needs to be more serious in certain situations.” (Cristal).

Theme 4. Synthesis: identity and embodied relationship with food

The order of construction of the mapped elements (position – outline – pseudonym), defined the style of the body map, that is, it synthesized the striking aspect to be communicated by it. For example, the body map style that synthesized dissatisfaction had a tone of expression in the body map for excesses, disproportions, and asymmetries of body shape, characterized by the perception of suffering with the body perception. The style directed towards identity was visually highlighted by elements of personal experience and personality. In the style of transcendence, vibrant colors were represented in the drawing without delimiting contours (for example there is no representation of hands and feet), re-producing the expansion of the meanings of life. The body map in Figure 2 exemplifies the reflective style, expressed by the narrative:

Figure 2
Fernanda’s body map.

I made my drawing with my eyes closed as if it were a meditation as if I had to think a little more when I go to eat. At any time.

(Fernanda)

She represented the need for connection with herself through her body posture, reproducing the way of relating to food. Figure 2 also shows embodied representations of the relationship with food. The centrality occupied by the mind in the regulation of bodily functions was represented (Figure 2, letter e). Manifestations from organs (Figure 2, letter f) referred to vitality by maintaining bodily functions through food. They also referred to the process of food entrance into the body, as narrated by this participant: “I circled the neck more towards the throat. Because it is through there [throat] that food comes in contact with my body, externally to internally, right?!” (Tica).

Sensory aspects manifested the strength of sensory appeals for food desire and pleasure: “I eat with my eyes. The first reaction I have when I see a favorite dish is my eyes start shining [emphasis], that feeling of my mouth watering. And I have a feeling of pleasure, you know?!” (Margarida).

Nevertheless, some participants focused on the moment when the person contact with food before starting eating: “The eyes, because first I believe that we eat a lot with our eyes. First attraction, then smell, then taste” (Eth, body and health).

Others highlighted the contact with food as the flavor through taste (Figure 2, letter g): “The mouth because it’s the way we eat” (Alice).

The participants also integrated the expectations before eating with the experience of eating: “I prepare food with my hands and with them put it in my mouth” (Maturity).

The aspects before eating were marked by sight and smell; and those of contact, by taste, touch, and hearing. Finally, the subjective relationship with the body identified meanings about weight: “Being a little overweight, right?! It shows that I have had a good relationship with food, that I have been eating a lot” (The liberty).

Also, about the systemic emotional state: “I used a smiling mouth to represent my relationship with food. Because I consider myself a happy person. Food for me is something that brings me a lot of joy, a lot of satisfaction, a lot of pleasure” (Human).

Fernanda’s body map, representing theme 4, synthesis: identity and embodied relationship with food, through codes and respective narratives (see the letters e to g in Table 2): (e) mind: "The brain is what controls all the functions, all the organs, and that sends you the feeling of satiety [...] and that has everything to do with your relationship with food, what you think about food, your emotions [...] that’s why I made it right in the center and with glitter to draw more attention. (Fernanda)". (f) organs, and physical health: "I also drew attention to the stomach with the sequins, because it is very important, it has everything to do with food, digestion, and feelings of satiety and hunger. (Fernanda)". (g) sensory aspects: the narrative was exemplified in the text.

Discussion

The BMST effectively accessed and represented the recognition of the relationship between the body and food of women by forms of self-denomination, integrating personal experiences with those experienced in the intervention, the PESC. Nuances were represented regarding desires and needs, limitations, how they identified themselves through body shape and posture, as well as food demands. The participants reflected on what inspired them and what was important, including lessons learned with the PESC workshops. Therefore, the BMST allowed access to self-consciousness and the implications of conscious aspects in the relationship between the body and food in the interaction of women with the world.

The participant’s socioeconomic characteristics, represented by a high level of education and a social class with lower economic power, could be explained by the means utilized by this study for participant recruitment in the context of a University (FMRP-USP).

The integration between forms of self-denomination and experiences in the world was marked by the active participation of the body in the unfolding of the relationship with food. We propose that there was the encouragement of somatic representation¹¹, which assumes the participation of the body as a central element in the development of the senses involved in the lived experiences, and, therefore, in the repercussion of behaviors that involve sensations, emotions, and perceptions²⁷. Regarding the theoretical framework applied, TAM¹⁰, consciousness is produced when the person identifies the meanings of experiences lived in the world through the body, influenced by the sociocultural context²⁸.

The importance of explaining the meanings of the position, outline, and pseudonym chosen by the participants referred to the constitution of women’s identity. The elements mapped in the BMST are recognized for setting limits between the public (world) and private (person) space²⁹. Authors propose that the skin is an expression of the body defining the relationship with the world^30,31. The throat is considered a means of an inside entry of food into the body, which reveals the intimacy of the food-body relationship as food becomes viscerally part of the body³². Other authors³³, described that food manifests people’s identity through the symbolic content it acquires throughout life. We suggest, therefore, that the elements built in the BMST probably performed these functions, for example, representing how their postures expressed how they see themselves in the world, and how the experiences lived in the context of their lives awakened continuous and insatiable desires associated with body dissatisfaction.

The role of individual factors in the process of changing lifestyle, particularly in promoting health-oriented eating practices, has been explored by other studies^34,35. These studies highlighted the impact of environmental factors, such as cost, time, and publicity, on people’s dilemma between succumbing to desires and/or pleasures versus alignment with health practices. In our study, we observed these same dilemmas such as the recognition of how these factors became part of the person (processed and internalized by them), whether by surrendering to appeals and desires or by suffering their contradictions with other aspects. The consciousness of the influences surrounding food choice^5,36 can represent an alternative for the prevention and treatment of obesity, in food and nutrition interventions based on lifestyle changes.

Temporality, another finding of this study, indicated the recognition of the relationship between the body and the food according to the period of life, as future projections in favor of changes, as narrated by a participant when mentioning her posture. Some authors³⁷ defined temporal orientation as a health influencer, as it is a sign of what is recognized and valued, aspects emphasized by the participants of our study. These authors³⁷ associated future projections with health practices as the person will be anticipating potential consequences. Conversely, the association with current projections is related to the need for momentary satisfaction, regardless of health consequences. It seems to us, therefore, that projections can help the identification of health influences related to food through the recognition of what is recognized and valued by the person.

The participants also recognized the key aspects that synthesized the body’s and food’s relationship. They demonstrated how an aspect of identity (for example dissatisfaction with the body) intensified the way of relating to food (for example seeking desire and pleasure in food) or defined it (for example meditation as an indication of a connection with herself and food awareness). It is suggested that the individual’s perceptive and cognitive development is integrated with bodily experiences^7,30. Furthermore, the communication of these experiences requires the development of content based on the expressions of the representation of the body, to integrate individual identity through body experiences¹³. Therefore, how the participants in this study recognized, from the representation of the body, getting in touch, internalizing, and giving meaning to food experiences that are present in the world, may indicate that food can be an expression of this relationship with the body.

The sensory and metabolic aspects in the process of food choice and consumption from a biological perspective are well described in the literature³⁸. However, little is known about the sensorial and metabolic aspects from the subjective and embodied perspective^3,7. The present study demonstrated the participants’ recognition of these aspects, from forms of detection by the senses as initial contact with food, through processing by the organs, to the subjective elaboration of the relationship between the body and the food. We reinforce the possibility of the representation of conscious aspects¹⁰ considering the recognition of experiences from the perspective of how the women experience and recognize the constructed phenomena. The present study demonstrated that the BMST was an efficient tool for the recognition of the relationship between the body and the food of these participants and, therefore, enabled reflection to deepen food consciousness, from the perspective of the educational intervention along the lines of the PESC¹⁷.

We considered as limitations of the study (i) homogeneous population, which may not reflect the sociocultural reality of the population groups; (ii) not include other social indicators for a better understanding of the population of the study. We emphasize the necessity of other studies to analyze the subjective dimension in specific social groups, and also, the need to apply this study in other contexts, such as other regions of Brazil and other countries, as well as in other population groups, whether due to different health conditions, gender, age, and sociocultural aspects.

Conclusions

This study was able to access and explore the recognition of the relationship between the body and the food of women by forms of self-denomination as a synthesis of an educational intervention based on food consciousness. Through body-map storytelling, aspects of identity, person-world relationship, temporality, and synthesis of identity and embodied relationship with food, marked the conscious recognition of the relationship between body and food. Body-map storytelling is an innovative and effective tool to access and communicate the involvement of food in the symbolic construction of the body. This study contributed as a strategy for educational programs that seek to strengthen women’s reflection and health on how the obesogenic environment can affect the relationship between the body and food.

• (e)
  Term used in international literature.

Acknowledgment

The authors would like to thank institutions that supported the research and people who collaborated with the study but did not meet the authorship criteria: we thank Dr. Alfredo Pereira Junior, Gabriela Batista Ribeiro Mendonça, and Homero Munaretti, for their contributions to the study and all women who participated in the study. We also thank the Postgraduate Program in Internal Medicine at the Faculty of Medicine of Ribeirão Preto at the University of São Paulo (FMRP/USP) for their support in translating the article into English. BEL thanks the National Council for Scientific and Technological Development (CNPq) for the study grant [grant number 168801/2018-3]. RWDG and LM thank CNPq for the productivity grants [grant number 303194/2018-9 and 303037/2018-0].

• Funding
  This study was financed in part by the Coordination for the Improvement of Higher Education Personnel (CAPES) [code 001], which was not involved with any procedures or development of the study.
• Leghi BE, Palazzo CC, Magalhães L, Diez-Garcia RW. Does the body speak? Body map of the relationship with food narrated by women in an intervention for food consciousness. Interface (Botucatu). 2024; 28: e240410 https://doi.org/10.1590/interface.240410

References

• ¹ Longhurst R, Johnston L, Ho E. A visceral approach: cooking “at home” with migrant women in Hamilton, New Zealand. Trans Inst Br Geogr. 2009; 34(3):333-45.
• ² Rose G. Researching with visual materials: a brief survey. In: Rose G, organizadora. Visual methodologies: an introduction to researching with visual materials. 4th ed. London: SAGE Publications; 2016. p.1-23.
• ³ Santos LAS. Reflexões sobre a tríade corpo, comer e comida. In: Santos LAS, organizadora. O corpo, o comer e a comida um estudo sobre as práticas corporais alimentares cotidianas a partir da cidade de Salvador - Bahia. Salvador: Editora da Universidade Federal da Bahia; 2008. p. 21-45.
• ⁴ Swinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, et al. The global syndemic of obesity, undernutrition, and climate change: the lancet commission report. Lancet. 2019; 393(10173):791-846.
• ⁵ Provencher V, Jacob R. Impact of perceived healthiness of food on food choices and intake. Curr Obes Rep. 2016; 5(1):65-71.
• ⁶ Quittkat HL, Hartmann AS, Düsing R, Buhlmann U, Vocks S. Body dissatisfaction, importance of appearance, and body appreciation in men and women over the lifespan. Front Psychiatry. 2019; 10:1-12.
• ⁷ McCorquodale L, DeLuca S. You want me to draw what? Body mapping in qualitative research as canadian socio-political commentary. Forum Qual Sozialforsch. 2020; 21(2):1-28. doi: 10.17169/fqs-21.2.3242.
  » https://doi.org/10.17169/fqs-21.2.3242
• ⁸ Craig AD. How do you feel? Interoception: the sense of the physiological condition of the body. Nat Rev Neurosci. 2002; 3(8):655-66.
• ⁹ Herbert BM, Pollatos O. The body in the mind: on the relationship between interoception and embodiment. Top Cogn Sci. 2012; 4(4):692-704.
• ¹⁰ Pereira A Jr. Triple-aspect monism: a conceptual framework for the science of human consciousness. In: Pereira A Jr, Lehmann D, editores. The unity of mind, brain and world. New York: Cambridge University Press; 2013. p. 299-337.
• ¹¹ Hayes-Conroy A. Feeling slow food: visceral fieldwork and empathetic research relations in the alternative food movement. Geoforum. 2010; 41(5):734-42.
• ¹² Hsu T, Forestell CA. Mindfulness, mood, and food: the mediating role of positive affect. Appetite. 2021; 158:105001.
• ¹³ Futch VA, Fine M. Mapping as a method: history and theoretical commitments. Qual Res Psychol. 2014; 11(1):42-59.
• ¹⁴ Figueiredo MD, Silva AO. Expressões alimentares em mulheres com obesidade: facetas simbólicas do complexo do comer. Plur Saude Ment. 2020; 9(2):28-33.
• ¹⁵ Gastaldo D, Magalhães L, Carrasco C, Davy C. Body-map storytelling as research: methodological considerations for telling the stories of undocumented workers through body mapping [Internet]. Toronto: University of Toronto; 2012 [10 Ago 2023]. Disponível em: http://www.migrationhealth.ca/undocumented-workers-ontario/body-mapping
  » http://www.migrationhealth.ca/undocumented-workers-ontario/body-mapping
• ¹⁶ Gastaldo D, Rivas-Quarneti N, Magalhães L. Body-map storytelling as a health research methodology: blurred lines creating clear pictures. Forum Qual Soc Res. 2018; 19(2):1-26. doi: 10.17169/fqs-19.2.2858.
  » https://doi.org/10.17169/fqs-19.2.2858
• ¹⁷ Palazzo CC, Leghi BE, Pereira A Jr, Diez-Garcia RW. Educational intervention for food consciousness: a randomized study protocol. Nutrition Health. 2022; 28(1):123-9.
• ¹⁸ Klein M, Milner RJ. The use of body-mapping in interpretative phenomenological analyses: a methodological discussion. Int J Soc Res Methodol. 2019; 22(5):533-43.
• ¹⁹ Leghi BE, Palazzo CC, Magalhães L, Diez-Garcia RW. Using body-map storytelling for accessing insights in an educational intervention for food consciousness. Int J Qual Methods. 2022, 21:1-15.
• ²⁰ World Health Organization. Women and health: today’s evidence tomorrow’s agenda [Internet]. Geneva: WHO; 2009 [citado 10 Ago 2023]. Disponível em: https://iris.who.int/handle/10665/44168
  » https://iris.who.int/handle/10665/44168
• ²¹ World Health Organization. Obesity: preventing and managing the global epidemic [Internet]. Geneva: WHO; 2000 [citado 10 Ago 2023]. Disponível em: https://iris.who.int/handle/10665/42330
  » https://iris.who.int/handle/10665/42330
• ²² Guillemin M, Drew S. Questions of process in participant-generated visual methodologies. Vis Stud. 2010; 25(2):175-88.
• ²³ Associação Brasileira de Empresas de Pesquisa. Critério Brasil [Internet]. São Paulo: ABEP; 2021 [citado 10 Ago 2023]. Disponível em: https://www.abep.org/criterio-brasil
  » https://www.abep.org/criterio-brasil
• ²⁴ Rose G. Semiology: laying bare the prejudices beneath the smooth surface of the visible. In: Rose G, organizadora. Visual methodologies: an introduction to researching with visual materials. 4a ed. London: SAGE publications; 2016. p. 106-46.
• ²⁵ Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006; 3(2):77-101.
• ²⁶ Braun V, Clarke V. Reflecting on reflexive thematic analysis. Qual Res Sport Exerc Heal. 2019; 11(4):589-97.
• ²⁷ Anderson B. Becoming and being hopeful: towards a theory of affect. Environ Plan D Soc Space. 2006; 24(5):733-52.
• ²⁸ Carvalho MCVS, Luz MT. Práticas de saúde, sentidos e significados construídos: instrumentos teóricos para sua interpretação. Interface (Botucatu). 2009; 13(29):313-26. doi: 10.1590/S1414-32832009000200006.
  » https://doi.org/10.1590/S1414-32832009000200006
• ²⁹ Sweet EL, Escalante SO. Bringing bodies into planning: visceral methods, fear and gender violence. URBAN Stud. 2015; 52(10):1826-45.
• ³⁰ Ferreira FR. A produção de sentidos sobre a imagem do corpo. Interface (Botucatu). 2008; 12(26):471-83. doi: 10.1590/S1414-32832008000300002.
  » https://doi.org/10.1590/S1414-32832008000300002
• ³¹ Lupton D. Theoretical perspectives on food and eating. In: Lupton D, organizadora. Food, the body and the self. 2a ed. London: SAGE Publications; 1998. p. 6-36.
• ³² Counihan CM. The body as voice of desire and connection in Florence, Italy. In: Counihan CM, organizadora. The anthropology of food and body: gender, meaning, and power. Nova York: Taylor & Francis; 1999. p. 178-94.
• ³³ Guiné RPF, Ferrão AC, Ferreira M, Correia P, Cardoso AP, Duarte J, et al. The motivations that define eating patterns in some Mediterranean countries. Nutr Food Sci. 2019; 49(6):1126-41.
• ³⁴ Brennan L, Klassen K, Weng E, Chin S, Molenaar A, Reid M, et al. A social marketing perspective of young adults’ concepts of eating for health: is it a question of morality? Int J Behav Nutr Phys Act. 2020; 17(1):44.
• ³⁵ Morgan C, Wildt G, Prado RBR, Thanikachalam N, Virmond M, Riley R. Views and experiences of adults who are overweight and obese on the barriers and facilitators to weight loss in southeast Brazil: a qualitative study. Int J Qual Stud Health Well-being. 2020; 15(1):1-14.
• ³⁶ Palazzo CC, Leghi BE, Diez-Garcia RW. Food consciousness intervention improves interoceptive sensitivity and expression of exteroception in women. Nutrients. 2022; 14(3):1-12.
• ³⁷ Mantau A, Hattula S, Bornemann T. Individual determinants of emotional eating: a simultaneous investigation. Appetite. 2018; 130:93-103.
• ³⁸ Boesveldt S, Graaf K. The differential role of smell and taste for eating behavior. Perception. 2017; 46(3/4):307-19.

Edited by

• Editor
  Antonio Pithon Cyrino
  Associated editor
  Micheli Dantas Soares

Publication Dates

• Publication in this collection
  28 Oct 2024
• Date of issue
  2024

History

• Received
  11 Aug 2023
• Accepted
  05 Aug 2024