“It was an education in portion size”. Experience of eating a healthy diet and barriers to long term dietary change

• Published in: Appetite 2013-12, Vol.71, p.411-419
• Main Authors: Macdiarmid, J.I., Loe, J., Kyle, J., McNeill, G.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Barriers; chocolate; cooking; Diet; Diet Records; dietary recommendations; economics; education; Feeding Behavior - psychology; Female; foods; Health Behavior; Health Knowledge, Attitudes, Practice; healthy diet; Healthy eating; Humans; interviews; issues and policy; Male; Middle Aged; Portion Size; Qualitative research; snacks; Socioeconomic Factors; Surveys and Questionnaires; Time pressures; Value for money; Young Adult
• ISSN: 0195-6663; 1095-8304
• DOI: 10.1016/j.appet.2013.09.012

•A qualitative study of expectations and experience of eating a healthy diet.•Views of portion sizes were distorted but people were not hungry eating smaller portions.•Unhealthy food and junk food was seen as better value for money than healthy eating.•A healthy diet without sweet snacks (e.g. chocolate) was a barrier for many people.•Competing priorities and social pressures were greater barriers than a lack of skills. The aim of the study was to explore the expectations and experience of actually eating a healthy diet and using this experience to identify barriers to healthy eating and sustainable dietary change. Fifty participants (19–63yrs) were provided with a healthy diet (i.e. complied with dietary recommendations) for three consecutive days. Afterwards a semi-structured interview was carried out to explore expectations, experience and barriers to healthy eating. Using a thematic analysis approach eight dominant themes emerged from the interviews. Four related to expectations and experience of healthy eating; realisation of what are appropriate portion sizes, an expectation to feel hungry, surprise that healthy diets comprised normal food, the desire for sweet snacks (e.g. chocolate). This demonstrated there are some misconception about healthy eating and distorted views of portion size. Four more themes emerged relating to barriers to healthy eating; competing priorities, social, peer and time pressure, importance of value for money, a lack of desire to cook. Poor knowledge of healthy eating or a lack of cooking skills were the least common barrier, suggesting that future interventions and policy to improve dietary intakes need to focus on social, cultural and economic issues rather than on lack of knowledge or skills.