Qualitative exploration of food choice in older Irish adultsa life course perspective

Mary Delaney and Dr Mary McCarthy, HRB Centre for Health and Diet Research (Dept of Food Business & Development, UCC)

Overview of Presentation

Introduction to research and life course perspective

Preliminary Qualitative Study Methodology Initial findings Conclusions

Next steps

Understanding Food Choice

Adverse trends in consumption and diet-related health

Research on food choice can inform dietary change interventions and policies to promote health

Choosing food is a complex behaviour-many influences

Reductionist vs. inductive approach

Food Choice Process Model (Furst et al, 1996)

Life course: ‘changing personal roles and social, cultural and physical environments that individuals have been exposed to over time’

Food Choice Process Model

Continuity and change across time: Food choice trajectories

Conceptual model of how food choice is shaped by contexts over time to form a food choice trajectory (Devine, 2005; Sobal, 2006)

Interaction of individual development over time in historical context experienced by a particular cohort or generation (Devine, 2005)

Irish Context Social, cultural and economic change in Ireland over the last 80

years

• economic prosperity, agricultural to service economy

• urbanisation, gender equality, multi-culturalism

• secularisation and consumerism

A contextually-grounded exploration of eating behaviour over time may inform tailored approaches to tackling eating behaviour

Older Irish people can provide a unique insight

Life Course Perspective on Food Choice

Objective

To explore influences

across the life course

on the food choices

of older Irish adults

Preliminary Exploratory Qualitative Study

Methodology

In-depth semi-structured interviews with 32 older adults

Participants* Male Female Total

Age 61-79 (Mean 69) 16 16 32

Location

Urban (city) 4 4 8

Urban (suburbs) 4 4 8

Rural (coastal) 4 4 8

Rural (inland) 4 4 8

BMI

Obese 8 8 16

Healthy weight 8 8 16

Marital status

Married 14 12 26

Widowed 1 3 4

Single/Never married 1 1 2

*Sub-sample of participants (n=700) participating in epidemiological health survey, UCC

Analysis

~1 hour Interviews digitally recorded in participants’ homes and transcribed verbatim

Data was analysed using content analysis

Key emergent themes were identified and marked in the text

Relevant transcript passages were then coded by these themes using the qualitative software package NVIVO 8

Results: Key Contextual Influences

Early Food Experiences Formation of preferences and norms for eating

Food growing up ‘basic’ and ‘plain’, ‘little variety’

Scarcity, Home-produced ‘Traditional’ food

• Potatoes, bread, porridge, vegetables, bacon, eggs, dairy produce

• Meat, fruit and confectionery limitedReligious fasting observed

• Salted fish Perceptions of early diet as ‘wholesome/healthy/hearty’

(home-produced, natural) vs. ‘fat diet’ (bacon, dairy produce) offset by physical activity

Changing micro-contexts: creeping processes and deliberate change

Early food experiences – enduring preferences Life transitions: changing social roles and micro-contexts eg work,

marriage, parenthood, retirement

• Exposure to more variety

• Increased affluence

• Social context- accommodating food preferences of others

Changes for Health:

• A minority motivated by prevention/ maintaining good health in older age

• More likely if salient health threats experienced

Ageing: Declining appetite/more difficult digestion

Present consumption

Preference for traditional meals:

“Bacon and cabbage is nearly the staple diet around here…I’d never refuse..... and I could eat the cabbage cold, or hot, or any way” (Male 74)

Greater concern with ‘healthy eating’ -modifying dietAvoidance/reduction-animal fat, red meat,

salt, sugar, processed foodsAddition-fruit & veg, fish, white meat, whole grains

Confectionery/ Snacking - sweet tooth/ temptation/ comfort/ boredom

Changing Macro Contexts

Economic Development

Food System

• Range and availability ‘cosmic’

• Affordability

• Deterioration in taste/ quality

• Concern re food processing and

• additives

• Confectionery - ‘rubbish’ vs. availability & cost

Changing Macro Contexts

Food Culture and Meaning

Culture of sharing food in farming communityVisiting customs – confectionary symbol of generosityCentral role of meat, conflicted attitudes to fish

Nutrition Knowledge, Awareness and Trust

Growing awareness of linking diet to chronic disease Media and personal experience/ health adviceMultiple concepts of ‘healthy’ eating – traditional views of

sustenance/nourishment vs. modern conceptionsGreater trust in health professionals than media- and industry-

relayed information

Conclusions

Present food choice decisions and concepts of healthy eating arise out of cumulative life experiences including the collective cultural and historical experience of a particular generation. Important to consider prior life experiences and diverse meanings attached to food in efforts to address eating behaviour

Greater variety and affordability of food welcome changes. Quality and healthfulness of food perceived to be compromised. Some products harmful yet tempting. Quality simple fresh food desired. Challenge to food industry to provide such food at non-prohibitive cost and to communicate responsibly with consumers

Next Steps: Future Research Plan

Nationally representative quantitative survey on food choice (HRB Centre for Health & Diet Research)

In-depth examination of individual food choice trajectories looking at interplay of life events and social psychological processes across time

Design of a second focused qualitative study

Acknowledgements

We wish to acknowledge support to conduct this research from Prof Ivan Perry, UCC Dept of Epidemiology and the Cork & Kerry Study research team.

Funded by Health Research Board and Dept of Agriculture, Food and Fisheries as part of HRB Centre for Health and Diet Research