Dietary cacophony (Fischler, 1993) is the confusing and often contradictory and overwhelming ‘noise’ one reads or hears from multiple sources about what and how they should eat or what and how they should feed their families or their loved one who is sick. Emphasis is on should.

This noise becomes louder and more complicated when one lives with a health condition that affects what, when, where, and how to eat. 

Dietary cacophony arises from two sources:

  1. from outside oneself (e.g., family, friends, neighbours, health professionals, celebrities, magazines, internet sources and so on)
  2. from within oneself and could include:
  • thoughts about trying to be a better person by eating ‘better’ (whatever that means to the individual)
  • bargaining (e.g., if I eat this way, I will be rewarded and whatever I am hoping for will happen (e.g., being cured, becoming thinner or gaining weight, surviving)
  • related to guilt or internalized negative messaging about eating one has received throughout their life
  • more ‘shoulds’ and ‘shouldn’ts’ related to beliefs about eating including rewarding or punishing oneself, celebration, appropriate foods to eat when sick or recovering, and more (e.g., “I deserve this donut because I have had a tough day” or “I shouldn’t drink coffee or eat chocolate; when I do, it reveals that I am weak willed”, or “Of course we will have desserts; it’s your birthday!” or “soup is healthful for people who are sick”.

Many people living with changed health status find that when news gets out about their condition, a lot of people (family, friends, neighbours, coworkers, etc.) offer food and nutrition advice. While well meaning and conveying caring and concern, these messages can add to the confusion (the dietary cacophony).

Adding to the confusion is that not only are there messages of what one ‘should do’, there are sometimes (not so subtle) messages of social and moral responsibility to eat according to the advice given. If one does not, they are somehow deficient, defiant, ‘not following the rules’, or not willing to do what it will take to be or get well. In the case of caregivers or supporters, not following the advice that is offered can be interpreted as not caring enough for their loved one. Recall from the blog post, ‘It feels hard because it is’, coping with dietary cacophony adds to the hardship and (di)stress.

Dietary cacophony and living with illness/taking care of a loved one

For much of life, when most people experience hunger, they decide what they want to eat from the options available, and then eat it. For many (not for all), eating is a satisfying multi-sensory experience of tastes, aromas, colours, and textures. Very often, eating takes place with others, so there is social pleasure as well. And when one is part way through eating, there is the pleasant sensation of no longer feeling hungry. When experiencing changed health status or illness, there are so many should messages about what, how, and when to eat depending on the condition, the age of the person, the prognosis, and other factors, that the process of eating often becomes a source of worry rather than pleasure.

As a dietitian working in clinics and hospitals, I came to see that my job was to help individuals and families sort through dietary cacophony to develop personalized plans to enhance their quality of life, and their relationships with and through food. This included identifying and reducing sources of dietary cacophony by weeding out the messages that were not relevant or helpful. This helped to reduce confusion and anxiety about what was ‘best’ given their situation.

Dietary cacophony may be contributing to your confusion or concerns about feeding your loved one who is sick. I hope that in learning about this term, dietary cacophony, you will notice the sources of dietary cacophony that are present for you. Then, consider if there are messages you can ignore (and gratefully remove them from your list of things to think about).  Not only is there a lack of reliable information on the Internet about what to feed loved ones who are sick, much of it is far too general and unlikely to apply in your situation. By removing some of the sources from your list, the most appropriate feeding approaches to take will become clearer. I am in Canada so writing from the Canadian context. There are dietitians working in every hospital and health unit in Canada, and there are many private practice dietitians with whom you can consult. Dietitians of Canada has a ‘Find a Dietitian’ feature at the bottom of this webpage:

Wishing you all the best.