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Title: Understanding the barriers and facilitators to dietary guidelines adherence: The HEALTH study

item NICKLAS, THERESA - Children'S Nutrition Research Center (CNRC)
item Jahns, Lisa
item Bogle, Margaret
item Chester, Deirdra
item Giovanni, Maria
item Klurfeld, David
item Laugero, Kevin
item LIU, YAN - Children'S Nutrition Research Center (CNRC)
item PETERSEN, STEPHANIE JO - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item Tucker, Katherine

Submitted to: Journal of the Academy of Nutrition and Dietetics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/2/2013
Publication Date: N/A
Citation: N/A

Interpretive Summary: Specific barriers to meeting dietary recommendations for consumption of dairy, whole grains, fruit, and vegetables can be categorized under two overarching psychosocial dimensions: personal/behavioral barriers and environmental barriers. Lack of parental food preparation skills; preferences and picky eaters; perceived food aesthetics; cost; competing foods; inconvenience and time constraints; lack of concern about health; tradition and cultural issues; misperceptions about foods; and physical intolerance or allergy were the behavioral and personal barriers reported by caregivers or children. A major environmental barrier was lack of knowledge regarding dietary recommendations, health benefits, and identification of whole grain or dairy products. Quantities recommended for these foods were perceived as excessive. Other environmental barriers included cost, availability, accessibility, concern about spoilage, and lack of variety. The overarching facilitators that were reported for several of the food groups included: emphasizing the health benefits and recommendations; increasing availability and accessibility; affordability; minimizing spoilage; and offering more food choices and guidance on preparation. These facilitators can be used by health professionals in designing educational programs or even tailored intervention programs. Similarly, food companies can use this information for marketing their products and for consumer messaging.

Technical Abstract: The majority of the U.S. population does not meet recommendations for consumption of dairy, whole grain, fruit, and vegetables. The goal of this study was to understand barriers and facilitators to adherence to the Dietary Guidelines for Americans for four nutrient-rich food groups in fifth grade children and adults across six sites in a multi-state study. A total of 281 adults and 321 children participated in 97 Nominal Group Technique sessions. The core barriers specific to adults were lack of meal preparation skills or recipes; did not grow up eating the foods; spoilage/ripeness and cost; cultural issues; and health reasons, e.g., lactose intolerance. Specific to children, the core barriers were competing foods, i.e., junk foods/fast foods, and lack of exposure or availability. The core barriers common to both children and adults included disliking the taste and lack of knowledge on food sources/health benefits/portion sizes. For both adults and children, reported facilitators closely coincided with the barriers and highlighted modifiable conditions that could help individuals to meet the DG.