Change search
ReferencesLink to record
Permanent link

Direct link
Implementing and sustaining dietary change in the context of social relationships
Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
Institutionen för kostvetenskap, Uppsala Universitet.
2011 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 3, 583-590 p.Article in journal (Refereed) Published
Abstract [en]

Background: Changing to healthier dietary habits is quite difficult to implement and even more difficult to sustain. As the majority of people have some or all their meals with others, it is likely that their social relationships influence the dietary change process and its sustainability. Thus, the aim of this research was to explore and describe experiences of dietary change and its sustainability in the context of an individual’s social relationships.Methods: Semi-structured interviews were conducted individually with fourteen individuals who had previously been participants in a 3-month dietary intervention study using a Mediterranean diet. Thematic analysis was used on verbatim transcripts of the interviews. Results: Social relationships were the main barrier to sustainability – in particular social relationships within the household where various coping strategies were needed on an everyday basis. Social relationships outside the household were also difficult to manage as dietary change challenged existing traditions and norms of what to eat. The changer was thereby forced to risk social disapprova lor to deviate from the diet. Conclusions: Social relationships within and outside the household complicated the accomplishment of healthy dietary changes. Hence, it is important to acknowledge the social context of the changer when dietary change is to be implemented.

Place, publisher, year, edition, pages
Wiley , 2011. Vol. 25, no 3, 583-590 p.
Keyword [en]
dietary change, social relationship, sustainability, barriers, qualitative interviews
National Category
Food Science Nursing
Research subject
Food and Nutrition
URN: urn:nbn:se:umu:diva-39358DOI: 10.1111/j.1471-6712.2010.00867.xOAI: diva2:393793
Article first published online: 19 JAN 2011Available from: 2011-02-01 Created: 2011-01-25 Last updated: 2011-08-26Bibliographically approved
In thesis
1. Toward an understanding of the barriers to and facilitators of dietary change:
Open this publication in new window or tab >>Toward an understanding of the barriers to and facilitators of dietary change:
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Faktorer som underlättar respektive försvårar kostförändring :
Abstract [en]

Healthy dietary changes would be beneficial for society, as the economic burden of diet-related diseases is massive, and for the individual, who would reduce their risk of ill health. However, it is not easy to change dietary habits. Therefore, the aim of this thesis was to better understand dietary change, focusing on the barriers to and facilitators of healthy dietary change by i) examining changes in food choices when dietary change is imposed by a medical diagnosis, ii) examining experiences related to dietary change and its sustainability after participation in a study where healthy dietary changes were required, and iii) examining diet cost in relation to healthiness of the diet.

Methods Eighty children aged 13 who were diagnosed with celiac disease (CD) by a screening study reported their food intake in a food frequency questionnaire before and 1,5 years after commencing a gluten-free diet. Changes in food intake and the healthiness of the diet were examined, controlling for societal changes through the use of an age- and sex-matched control group. Diet healthiness was assessed using the National Food Administration’s (NFA) food index and the Diet Quality Index-Swedish Nutritional Recommendations. Qualitative interviews were conducted with 14 individuals who participated in an intervention study five years earlier where they had been randomly selected to adhere to a Mediterranean-like diet for three months. Analyses of the transcribed interviews focused on their experiences of barriers to and facilitators of dietary change and its sustainability. The costs related to healthy diets were examined by comparing consumer food prices with dietary intake data collected in two separate studies. The first study collected dietary intake data through a diet history interview with participants who had been randomized to either a Mediterranean-like diet or to continue their normal diet. The second study collected dietary intake data from 4-, 8-, and 11-year-old children by means of food diaries and was conducted by the NFA. Diet healthiness was assessed using the Healthy Eating Index 2005.

Results The screened CD group made relatively few changes to their diets. They decreased their intake of certain gluten-containing products, including pizza, chicken nuggets, fish sticks, and pastries. There were no changes in the healthiness of their diet. The narratives of the individuals changing their diets showed that social relationships were the main barrier to sustainability. Social relationships within the household were especially troublesome, and various coping strategies were required on an everyday basis. Dietary change also increased the burden of food work (e.g., planning, shopping, cooking), which was another major barrier to dietary change. Comparisons between consumer costs of healthy and less healthy diets showed that those consuming the healthier diets also had consumed more expensive diets.

Conclusion More barriers to healthy dietary changes were found than facilitators of these transitions. For instance, the impact of social relationships on sustainability of dietary change was found to be high, indicating the importance of participation of other household members when dietary changes are implemented. The higher cost of the healthier diets may be another barrier for healthy dietary changes, especially for those with limited resources. Even though it is possible to eat healthily at a lower cost, such a diet would likely require both cooking skills and time, thus making the task more difficult. However, the finding that children diagnosed with CD only made minor changes in their consumption of, for instance, bread and pasta, indicates that one way of increasing the healthiness of a diet is to substitute healthier alternatives within the same food group for less healthy food items.

Place, publisher, year, edition, pages
Umeå: Kostvetenskap, 2011. 89 p.
Dietary change, Healthy eating, Barriers, Facilitators, Dietary indexes, Diet cost, Food prices, Social relationships, Qualitative interviews, Mediterranean diet, Celiac disease, Children
National Category
Food Science
Research subject
Food and Nutrition
urn:nbn:se:umu:diva-43769 (URN)978-91-7459-189-7 (ISBN)
Public defence
2011-06-03, Hörsal C, Samhällsvetarhuset, Umeå Universitet, Umeå, 13:00 (Swedish)
Available from: 2011-05-13 Created: 2011-05-09 Last updated: 2011-05-11Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Rydén, Petra
By organisation
Department of Food and Nutrition
In the same journal
Scandinavian Journal of Caring Sciences
Food ScienceNursing

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 194 hits
ReferencesLink to record
Permanent link

Direct link