Transcript Food Choice in older adults

Qualitative exploration of food
choice in older Irish adults
a 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)
Life Course Perspective on Food Choice
 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
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 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
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
Obese
8
8
16
Healthy weight
8
8
16
Married
14
12
26
Widowed
1
3
4
Single/Never married
1
1
2
BMI
Marital status
*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 limited
 Religious 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
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 Changes for Health:
A minority motivated by prevention/ maintaining good health in
older age
More likely if salient health threats experienced
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 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 diet
 Avoidance/reduction-animal fat, red meat,
salt, sugar, processed foods
 Addition-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
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Changing Macro Contexts
 Food Culture and Meaning
 Culture of sharing food in farming community
 Visiting customs – confectionary symbol of generosity
 Central 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 advice
 Multiple concepts of ‘healthy’ eating – traditional views of
sustenance/nourishment vs. modern conceptions
 Greater trust in health professionals than media- and industryrelayed 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
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
Nationally representative quantitative survey on food choice
(HRB Centre for Health & Diet Research)
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