Looking for a Taste of Home: A Qualitative Study of the Health Implications of the Diets of Australian - Based Southeast Asian Students

A Multi-Stage Dyadic Qualitative Analysis to Disentangle How Dietary Behaviors of Asian American Young Adults are Influenced by Family

The dietary behaviors of Asian American (AA) young adults, who face a growing non-communicable disease burden, are impacted by complex socio-ecological forces. Family plays a crucial role in the lifestyle behaviors of AA young adults; however, little is known on the methods, contributors, and impact of familial dietary influence. This study aims to deconstruct the mechanisms of AA young adult familial dietary influence through a multi-perspective qualitative assessment. A five-phase method of dyadic analysis adapted from past research was employed to extract nuanced insights from dyadic interviews with AA young adults and family members, and ground findings in behavioral theory (the Social Cognitive Theory, SCT). 37 interviews were conducted: 18 young adults, comprising 10 different AA ethnic subgroups, and 19 family members (10 parents, 9 siblings). Participants described dietary influences that were both active (facilitating, shaping, and restricting) and passive (e.g., sharing foods or environment, mirroring food behaviors). Influences connected strongly with multiple SCT constructs (e.g., behavioral capacity, reinforcements for active influences, and expectations, observational learning for passive influences). Familial influence contributed to changes in the total amount, variety, and healthfulness of foods consumed. Intra-family dynamics were crucial; family members often leveraged each other's persuasiveness or food skills to collaboratively influence diet. AA family-based interventions should consider incorporating both passive and active forms of dietary influence within a family unit, involve multiple family members, and allow for individualization to the unique dynamics and dietary behaviors within each family unit.

International tertiary education students experienced difficulties in dietary transitions in Australia: A qualitative study

ISSUE ADDRESSED

More attention to the diet and nutritional status of international students in Australian universities is indicated. This qualitative research aimed to provide an in-depth understanding of dietary changes among international students after they arrived in Australia.

METHODS

Semi-structured interviews were conducted with international students from China and India who were studying at a large urban Australian university. An approach of interpretative phenomenological analysis was employed for coding and data analysis.

RESULTS

A total of 14 interviews were included. International students were able to consume more international foods, dairy products and animal proteins in Australia as a result of increased exposure to a larger variety of these foods compared with their home countries. However, they experienced some difficulties in eating vegetables and authentic traditional foods due to limited availability and higher prices in Australia. It was challenging for these students to live independently and cook for themselves for the first time and with a limited food budget and time, but many students improved their cooking skills over time. Less frequent main meals with more snacking sessions were reported. Weight fluctuations were commonly experienced and craving for traditional foods no longer accessible may negatively impact mental health.

CONCLUSIONS

International students adapted to the Australian food environment but believed the food choices available did not meet their food preferences or perhaps nutritional requirements.

SO WHAT

Some intervention from universities and/or government may be needed to ease the barriers to consumption of affordable and desirable meals in a time-saving manner for international students.

Perceptions of dietary intake amongst Black, Asian and other minority ethnic groups in high-income countries: a systematic review of qualitative literature

BACKGROUND

Minority ethnic groups are a fast-growing population in many high-income countries, partly due to the increasing population of immigrants and second-generation migrants. The dietary practices of some of these minority ethnic groups might make them to be disproportionately affected by obesity and increase their risks of developing non-communicable diseases. Population-specific interventions and strategies are vital to addressing poor nutritional practices among this population. Thus, this study systematically reviewed the perceptions of dietary intake amongst Black, Asian and other minority ethnic groups in high-income countries.

METHODS

This systematic review was conducted in line with the guidelines of the Joanna Briggs Institute (JBI) methodology for systematic reviews, using a meta-aggregative design. This systematic review identified and synthesised qualitative literature on the perceptions of dietary intake amongst BlackAsian and other minority  ethnic groups in high-income countries. An extensive and comprehensive database search was conducted between January 2000 - May 2022 and included twenty (20) studies that met the eligibility criteria from six countries. The included studies were assessed for quality using the JBI qualitative assessment and review instrument. The JBI data extraction tools were used to retrieve relevant data from included articles, and the data were thematically analysed.

RESULTS

We identified eight major themes across this database: (1) "Social and Cultural Factors," (2) "Availability and Accessibility," (3) "Family and Community Influences," (4) "Food Preferences", (5) "Home Country Food Versus Host Country Food" (6) "Dietary Acculturation" (7) "Health and Healthy Eating" (8) "Perception of Nutritional Information."

CONCLUSION

Overall, Black, Asian, and other minority ethnic groups individuals were found to be aware of the effects of unhealthy eating on their health, and some of them have nutritional knowledge, but social and cultural factors, including structural factors, were deterrents to their healthy eating behaviours. An important finding from this review is that some participants believed that nutritional information, based on bio-medical science, was intended for only White population groups and that it was antagonistic to their cultural and community well-being.

Food Habits and Forms of Food Insecurity among International University Students in Oslo: A Qualitative Study

A growing number of studies indicate that university students and especially international students are prone to experiencing food insecurity (FI). Still, few studies have investigated forms of FI among international students in Europe. Thus, this qualitative study aims to explore experiences regarding FI among international university students in Oslo. Sixteen semi-structured interviews were conducted between May and June 2022 and analyzed using a thematic approach. The sustainable livelihood approach (SLA) was used as a framework for analyzing and interpreting the data. The students experienced food prices as being high and found food variety at the grocery stores to be low, resulting in struggles to fulfil their food preferences and keep a varied diet. Particularly, social aspects of eating were affected due to high dining prices or inadequate cooking facilities in student homes. However, no student openly reported skipping meals and many mentioned attention for healthy eating. Considering our results, it seems of importance to give more attention to cultural and social aspects related to FI when assessing FI among international students. As the number of international students is increasing, knowing more about this phenomenon can support the promotion of initiatives addressing FI in this population.

Food environment interactions after migration: a scoping review on low- and middle-income country immigrants in high-income countries

Objective:

To map and characterise the interactions between the food environment and immigrant populations from low- and middle-income countries living in high-income countries.

Design:

A scoping review was carried out following the framework outlined by Arksey and O’Malley, as well as Levac et al. Peer-reviewed studies in English published between 2007 and 2021 were included. Two reviewers screened and selected the papers according to predefined inclusion criteria and reporting of results follows the PRISMA-ScR guidelines. A ‘Best fit’ framework synthesis was carried out using the Analysis Grid for Environments Linked to Obesity (ANGELO) framework.

Setting:

High-income countries.

Participants:

Immigrants from low- and middle-income countries.

Results:

A total of sixty-eight articles were included, primarily based in the USA, as well as Canada, Australia and Europe, with immigrants originating from five regions of the globe. The analysis identified three overarching themes that interconnected different aspects of the food environment in addition to the four themes of the ANGELO framework. They demonstrate that in valuing fresh, healthy and traditional foods, immigrants were compelled to surpass barriers in order to acquire these, though children’s demands, low incomes, time scarcity and mobility influenced the healthiness of the foods acquired.

Conclusion:

This study brought together evidence on interactions between immigrant populations and the food environment. Immigrants attempted to access fresh, traditional, healthier food, though they faced structural and family-level barriers that impacted the healthiness of the food they acquired. Understanding the food environment and interactions therein is key to proposing interventions and policies that can potentially impact the most vulnerable.

Food access, dietary acculturation, and food insecurity among international tertiary education students: A scoping review

The number of international students within tertiary education facilities continues to increase globally, but the challenges for this population in achieving a healthy diet in an unfamiliar environment receives insufficient attention. This scoping review aimed to synthesize current literature that investigated dietary changes and food security status of this student population. We followed a five-stage methodological framework developed by Arksey and O'Malley. Six electronic databases were searched. All types of research methods, including qualitative, quantitative, and mixed methods, were considered for inclusion. This review included 30 articles reporting dietary changes and 12 articles reporting food insecurity in international students. The students were able to explore novel foods in their host country without totally abandoning their original diet, thus developing a hybrid diet. Dietary habits oscillated between the new and traditional dietary cultures with many students consuming foods from their new food environment but less so in the long term. Changes in diet may contribute to weight change and some negative health impacts, but none of the included studies investigated the effects on academic performance. Additionally, international students appeared to be more vulnerable to food insecurity, but the contributing factors and impacts of this issue were insufficiently researched. International students often experienced dietary acculturation and faced more challenges in food security than their domestic peers. More specific support should be provided by tertiary institutions and governments to international students including regular culturally appropriate nutrition education programs.

"That is an Awful Lot of Fruit and Veg to Be Eating". Focus Group Study on Motivations for the Consumption of 5 a Day in British Young Men

Young men do not consume enough fruit and vegetables, increasing their risk for future ill health. To understand what motivates their food choice, a novel conceptual framework that included key concepts from the theory of planned behavior and risk theory was developed. Thirty-four British men (18-24 years) took part in focus groups, where innovative visual qualitative methods provided insight into participants' motivations for fruit and vegetable consumption. Based on information from food diaries, participants were described as high (4+ portions) or low (up to 3 portions) consumers. Interviews were coded thematically into concepts and characteristics of the conceptual framework. Young men were generally unaware of the UK government's recommendation to consume 5 portions of fruit and vegetable a day and chronic health risks associated with low consumption. High consumers were motivated by perceived risk, perceived behavioral control, and health-conscious self-identity. They held internalized, holistic beliefs about diet and health, whereas low consumers' beliefs were externalized, based on physical appearances. Low consumers were driven by social influences to consume cheap, easily available convenience foods. The conceptual framework differentiated levels of fruit and vegetable consumption between the two groups and provided new information about young men's motivations for fruit and vegetable consumption.