Exploring the relationship between perceived barriers to healthy eating and dietary behaviours in European adults
Exploring the relationship between perceived barriers to healthy eating and dietary behaviours in European adults
M. G. M. Pinho 0 1 2 3 4 5 6 7
J. D. Mackenbach 0 1 2 3 4 5 6 7
H. Charreire 0 1 2 3 4 5 6 7
J.‑M. Oppert 0 1 2 3 4 5 6 7
J. W. J. Beulens 0 1 2 3 4 5 6 7
J. Brug 0 1 2 3 4 5 6 7
J. Lakerveld 0 1 2 3 4 5 6 7
0 Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center , De Boelelaan 1089a, 1081 HV Amsterdam , The Netherlands
1 Amsterdam School of Communication Research (ASCoR), University of Amsterdam , Nieuwe Achtergracht 166, 1018 WV Amsterdam , The Netherlands
2 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht , Huispost Str. 6.131, PO Box 85500, 3508 GA Utrecht , The Netherlands
3 Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University , Watersportlaan 2, 9000 Ghent , Belgium
4 ECOHOST-The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine , 15-17 Tavistock Place, London WC1H 9SH , UK
5 Sorbonne Universités, Université Pierre et Marie Curie, Université Paris 06; Institute of Cardiometabolism and Nutrition, Department of Nutrition, Pitié-Salpêtrière Hospital , 47-83 Boulevard de l'Hôpital, 75013 Paris , France
6 Lab-Urba, Paris Est University , 61 Avenue du Général de Gaulle, 94010 Créteil , France
7 Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, Université Paris 13 , 74 Rue Marcel Cachin, 93017 Bobigny , France
Purpose Dietary behaviours may be influenced by perceptions of barriers to healthy eating. Using data from a large cross-European study (N = 5900), we explored associations between various perceived barriers to healthy eating and dietary behaviours among adults from urban regions in five European countries and examined whether associations differed across regions and socio-demographic backgrounds. Methods Frequency of consumption of fruit, vegetables, fish, fast food, sugar-sweetened beverages, sweets, breakfast and home-cooked meals were split by the median into higher and lower consumption. We tested associations between barriers (irregular working hours; giving up preferred foods; busy lifestyle; lack of willpower; price of healthy food; taste preferences of family and friends; lack of healthy options and unappealing foods) and dietary variables using multilevel logistic regression models. We explored whether associations differed by age, sex, education, urban region, weight status, household composition or employment. Results Respondents who perceived any barrier were less likely to report higher consumption of healthier foods and more likely to report higher consumption of fast food. 'Lack of willpower', 'time constraints' and 'taste preferences' were most consistently associated with consumption. For example, those perceiving lack of willpower ate less fruit [odds ratio (OR) 0.57; 95% confidence interval (CI) 0.50-0.64], and those with a busy lifestyle ate less vegetables (OR 0.54; 95% CI 0.47-0.62). Many associations
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differed in size, but not in direction, by region, sex, age and
household composition.
Conclusion Perceived ‘lack of willpower’, ‘time
constraints’ and ‘taste preferences’ were barriers most strongly
related to dietary behaviours, but the association between
various barriers and lower intake of fruit and vegetables
was somewhat more pronounced among younger
participants and women.
Maintaining healthy dietary behaviours (e.g. diet that is
rich in fruit and vegetables and low consumption of foods
that are high in saturated fat and sugar) is crucial for
population health and the prevention of non-communicable
disease [1–7]. Both contextual (‘midstream’ and ‘upstream’)
and individual (‘downstream’) factors can influence
dietary behaviours [8]. We recently studied the interactions
between neighbourhood characteristics and the number of
individual perceived barriers with obesity-related
behaviour [9]. Perceived barriers to healthy eating are an
important individual-level factor [10, 11] and people who
perceive a greater number of barriers are more likely to report
to consume less healthy diets [12]. As suggested by health
behaviour theories (i.e. Social Cognitive Theory and the
Theory of Planned Behaviour), individuals who perceive
more barriers have lower motivation, lower levels of
selfefficacy and possibly lower behavioural control required to
maintain a healthy diet [13, 14]. Across studies, the most
frequently reported barriers to healthy eating relate to time
constraints, taste preferences and monetary costs [15–18].
The majority of previous studies were conducted within
specific populations [12, 16, 18–22], from which we have
learned that these barriers may differ across subgroups. For
instance, older women are more likely to report that heal (...truncated)