The Importance of Sociocultural Context When Choosing to Eat Healthier

OBJECTIVE

To explore how working women in metropolitan Malaysia make food decisions.

DESIGN

A grounded theory approach and semistructured interviews.

SETTING

A large university in metropolitan Malaysia.

PARTICIPANTS

Twenty-four female employees purposively recruited to vary in ethnicity, body mass index, age, and marital status via convenience sampling.

PHENOMENON OF INTEREST

Perceptions of sociocultural influences on healthy eating behavior among working women.

ANALYSIS

Researchers audio-recorded interviews and analyzed verbatim transcripts.

RESULTS

Working women shared a desire to eat a healthier, more balanced diet by reducing processed food consumption through home-cooked meals. Participants described aspects of their living situations and cultural values about food that made it seem impossible to change their diets. Living with other people limited their ability to cook the food they wanted to eat. In addition, unspoken rules about communal eating in Malaysia, such as not refusing food and not wasting food, prevented working women from practicing healthy eating.

CONCLUSIONS AND IMPLICATIONS

In this population of working women in metropolitan Malaysia, experiences of time scarcity and limited sociocultural support for behavior change were major barriers to healthy eating. Interventions could prioritize leveraging these realities about food to facilitate environments in which women feel like they have control of their own food intake.

Development and Validation of a Sustainable Diet Index among Malaysian Adults: Protocol

Adopting a sustainable diet is an alternative to address the pandemics of obesity, undernutrition and climate change that are threatening human health. Sustainable diet considers the health aspect as well as the environmental impact of diets. There is a scarcity of research on sustainable diet and lack validated tools for its measurement. This article aimed to describe the protocol on the development and validation of a Sustainable Diet Index (SDI) among Malaysian adults. A Sustainable Diet Index (SDI) was developed based on previous studies and available dietary guidelines on sustainable diet. Five indicators (rice, animal-based food, plant-based food, food waste and packaging) were included in the SDI. The index will be validated among Malaysian adults using mobile food record as the dietary assessment tool. The index has the potential to measure the level of healthy and sustainable diet behaviour of an individual. The use of mobile food record provides images of each eating occasion for the evaluation of serving size and the information on waste management. Health and environmental impacts from the diet can be evaluated through the integration of all indicators in the SDI. The index developed is novel and expected to provide a feasible measurement to assess the level of sustainable diet of an individual.

Critical Social and Cultural Influences on Eating in a Multiethnic Population of Working Women: It's Hard to Practice What You Know (P10-024-19)

Objectives

Malaysia is currently experiencing the nutrition transition, with an increased consumption of refined carbohydrates and fats paralleling an increase in prevalence of obesity and chronic disease. These dietary changes have occurred despite 90% of urban women reporting awareness of the health risks posed by obesity. This study sought to characterize how working women, an understudied population at risk for diet-related chronic disease, navigate food decisions. As Malaysia is a multiethnic nation, we aimed to explore the sociocultural determinants of eating behavior in this unique population.

Methods

A purposive design in combination with a convenience sampling approach was used to recruit 24 women ages 26 to 55 of Malay, Indian, and Chinese descent across 15 university departments in Kuala Lumpur, Malaysia. Audio recordings of the individual semi-structured interviews were transcribed and analyzed using grounded theory.

Results

Women identified two important life transitions, getting married and having children, as particularly influential in changing eating behavior. Women reported a desire to eat healthier that was in tension with pressures to cater to the taste preferences of their household members and to accommodate their work schedules. Persistent social norms of eating in group settings and difficulty in accessing foods perceived as nutritious were reported as barriers to changing individual eating behavior. Regardless of education level and marital status, women agreed that the act of eating was closely connected with cultural values and embodied important meanings that took precedence over eating as a health-promoting behavior. While all participants expressed a desire to eat healthier, many reported limited confidence in their ability to consistently give up familiar and tasty foods for healthier alternatives. Shifts in eating behavior such as trying new healthy recipes and adopting a more restrictive diet were reported as most feasible and personally applicable after learning about a family member's declining health.

Conclusions

In this urban, multiethnic population, increasing the accessibility of nutritious foods and changing cultural perceptions of the relationship between food and nutrition may be important for enabling healthy eating behaviors.

Funding Sources

Yale Sustainable Food Program, Yale School of Public Health.