Factors perceived to influence healthy eating: a systematic review and meta-ethnographic synthesis of the literature

Zorbas, Christina; Palermo, Claire; Chung, Alexandra; Iguacel, Isabel; Peeters, Anna; Bennett, Rebecca J.; Backholer, Kathryn

doi:10.1093/nutrit/nuy043

Cited by 72 publications

(125 citation statements)

References 64 publications

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“…Having limited access to supermarkets and grocery stores can be a significant barrier to the consumption of healthy foods. Also, unsafe neighborhoods can be an obstacle to physical activity ( 43 , 44 ).…”

Section: Classic Ses and Social Disadvantages And Their Consequences mentioning

confidence: 99%

Consideration of Social Disadvantages for Understanding and Preventing Obesity in Children

Ayala-Marín

Iguacel

Miguel-Etayo

et al. 2020

Front. Public Health

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Addressing social disadvantages that lead to obesity should be a public health priority. Obesity prevalence among children and adolescents has reached a plateau in countries with high income but it continues rising in low-income and middle-income countries. In high-income countries, an elevated prevalence of obesity is found among racial and ethnic minority groups and individuals from disadvantaged socioeconomic backgrounds. In addition to classic socioeconomic status (SES) factors, like income, parental education, and occupation, recent publications have linked parental social disadvantages, such as minimal social network, non-traditional family structure, migrant status and unemployment, with obesogenic behaviors and obesity among children. Socio-ecological models of obesity in children can explain the influence of classic SES factors, social disadvantages, culture, and genes on behaviors that could lead to obesity, contributing to the elevated prevalence of obesity. Obesity is a multifactorial disease in which multilevel interventions seem to be the most effective approach to prevent obesity in children, but previous meta-analyses have found that multilevel interventions had poor or inconsistent results. Despite these results, some multilevel interventions addressing specific disadvantaged social groups have shown beneficial effects on children's weight and energy balance-related behaviors, while other interventions have benefited children from both disadvantaged and non-disadvantaged backgrounds. Considering obesity as a worldwide problem, the World Health Organization, the European Commission, and the National Institutes of Health recommend the implementation of obesity prevention programs, but the implementation of such programs without taking into consideration social disadvantages may be an unsuccessful approach. Therefore, the present publication consists of a review of the pertinent literature related to social disadvantage and its consequences for behaviors that could lead to childhood obesity. In addition, we will discuss the relationship between social disadvantages and the socio-ecological model of obesity in children. Finally, we will summarize the relevant aspects of multilevel intervention programs aiming to prevent obesity in children and provide recommendations for future research and intervention approaches to improve weight status in children with social disadvantages.

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Section: Classic Ses and Social Disadvantages And Their Consequences mentioning

confidence: 99%

Consideration of Social Disadvantages for Understanding and Preventing Obesity in Children

Ayala-Marín

Iguacel

Miguel-Etayo

et al. 2020

Front. Public Health

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“…Commonly reported influences on young adults' food choices include a lack of time to plan, shop, prepare and cook healthy foods, cost and the preferred taste and convenience of unhealthy foods [5,6]. The relevance of these influences may also vary by young adults' demographic characteristics, such as by sex [6,7] and socioeconomic position [5,6].…”

Section: Introductionmentioning

confidence: 99%

Ranking of meal preferences and interactions with demographic characteristics: a discrete choice experiment in young adults

Livingstone

Lamb

Abbott

et al. 2020

Int J Behav Nutr Phys Act

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Background The diet of young adults is poor, yet little is known about the relative importance of influences on healthy eating in a decision-making context. The aim of this exploratory study was to understand the relative ranking of influences on meal choices in young adults and to investigate interactions between meal preferences and demographic and health characteristics. Methods Adults aged 18–30 years (n = 92, mean age: 23.9 (SD 3.4) years) completed an online discrete choice experiment. Participants were presented with 12 choice sets reflecting a typical weekday meal and were asked to choose between four meal options. Each meal consisted of a combination of five meal attributes (preparation time, cost, taste, familiarity and nutrition content) that each had three attribute levels. Data were analysed using conditional logit models. Subgroup analyses were performed by sex, education, income, weight status and meeting fruit and vegetable recommendations. Results Comparing the highest and lowest attribute levels, meal preferences were higher for better taste (B = 0.38; 95% CI: 0.12, 0.63), familiarity (B = 0.37; 95% CI: 0.21, 0.54) and nutrition content (B = 1.11; 95% CI: 0.81, 1.41) and lower for increased preparation times (B = −0.33; 95% CI: − 0.53, − 0.12) and cost (B = −0.50; 95% CI: − 0.75, − 0.24). Nutrition content was the most important influence on meal choice. Cost was the second most important, followed by taste, familiarity and preparation time. Compared to males, females had a higher preference for better nutrition content, taste and familiarity and a lower preference for increased cost. Higher educated participants had a higher preference for better nutrition content, familiarity and taste compared to lower educated participants. Young adults who met recommendations for fruit and vegetable intake had a higher preference for better nutrition content compared to participants who did not meet recommendations. Conclusion Nutrition content was the most important influence on young adults’ meal choices, followed by cost, taste, familiarity and preparation time. Preferences varied by demographics and health characteristics, suggesting that the focus of dietary interventions may benefit from being tailored to specific young adult groups.

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“…Food price is a key determinant of food choice and population diets (1,2) , particularly for those with limited food budgets (3,4) . The perceived higher price of healthy foods, relative to unhealthy foods, has been identified as a key barrier to healthy eating (1) . However, recent evidence examining the affordability of diets challenges this idea (2,5) .…”

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confidence: 99%

Streamlined data-gathering techniques to estimate the price and affordability of healthy and unhealthy diets under different pricing scenarios

Zorbas

Lee

Peeters

et al. 2020

Public Health Nutr.

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Objective: To determine the reliability of streamlined data-gathering techniques for examining the price and affordability of a healthy (recommended) and unhealthy (current) diet. We additionally estimated the price and affordability of diets across socio-economic areas and quantified the influence of different pricing scenarios. Design: Following the Healthy Diets Australian Standardised Affordability and Pricing (ASAP) protocol, we compared a cross-sectional sample of food and beverage pricing data collected using online data and phone calls (lower-resource streamlined techniques) with data collected in-store from the same retailers. Setting: Food and beverage prices were collected from major supermarkets, fast food and alcohol retailers in eight conveniently sampled areas in Victoria, Australia (n 72 stores), stratified by area-level deprivation and remoteness. Participants: This study did not involve human participants. Results: The biweekly price of a healthy diet was on average 21 % cheaper ($596) than an unhealthy diet ($721) for a four-person family using the streamlined techniques, which was comparable with estimates using in-store data (healthy: $594, unhealthy: $731). The diet price differential did not vary considerably across geographical areas (range: 18–23 %). Both diets were estimated to be unaffordable for families living on indicative low disposable household incomes and below the poverty line. The inclusion of generic brands notably reduced the prices of healthy and unhealthy diets (≥20 %), rendering both affordable against indicative low disposable household incomes. Inclusion of discounted prices marginally reduced diet prices (3 %). Conclusions: Streamlined data-gathering techniques are a reliable method for regular, flexible and widespread monitoring of the price and affordability of population diets in areas where supermarkets have an online presence.

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Factors perceived to influence healthy eating: a systematic review and meta-ethnographic synthesis of the literature

Abstract: Actions to improve population diets should mitigate the barriers to healthy eating to create environments that support healthy eating across the socioeconomic gradient. Systematic Review Registration: PROSPERO registration number CRD42017065243.

Cited by 72 publications

References 64 publications

Consideration of Social Disadvantages for Understanding and Preventing Obesity in Children

Consideration of Social Disadvantages for Understanding and Preventing Obesity in Children

Ranking of meal preferences and interactions with demographic characteristics: a discrete choice experiment in young adults

Streamlined data-gathering techniques to estimate the price and affordability of healthy and unhealthy diets under different pricing scenarios

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