Healthy Diet Perceptions of Pregnant Women from Sub-Saharan Africa Residing in the U.S

Concepts of healthy and environmentally sustainable diets clash with a life in transition - Findings from a qualitative study in urban Burkina Faso

BACKGROUND

Sub-Saharan African countries like Burkina Faso face a dietary transition and are experiencing a shift in disease burden.

OBJECTIVE

We explored perceptions of healthy and environmentally sustainable dietary habits in urban Burkina Faso in order to tailor nutritional interventions to the local population and ultimately improve public and planetary health.

METHODS

We conducted an exploratory qualitative study with semi-structured face-to-face interviews in three informal and two formal neighborhoods of Ouagadougou. The sample comprised 36 adult participants. The interviews were conducted in Mooré and French, audio-recorded, and transcribed verbatim. Data were analysed inductively, using thematic analysis.

RESULTS

Participants described their ideal healthy and environmentally sustainable diet as traditional, local, natural, pure, organic, and transparent in terms of food production, processing, and preparation. Perceived barriers to achieve such diets were: limited financial resources, reduced availability of products and limited time for food preparation. Furthermore, participants highlighted discordant food preferences in the family, and a lack of understanding around the interconnection between nutrition, health and the environment as barriers. Most of these barriers were aggravated by the experience of a life in transition due to modernizing lifestyles, globalizing food systems, and a changing environment.

CONCLUSIONS

Participants' ideal of a healthy and environmentally sustainable diet clashed with a life in transition. To improve public and planetary health, interventions should aim to empower individuals, alleviate financial constraints, and shape global and local food environments.

Eating Behaviors and Dietary Patterns of Women during Pregnancy: Optimizing the Universal 'Teachable Moment'

Understanding women's perceptions of eating behaviors and dietary patterns can inform the 'teachable moment' model of pregnancy. Our objectives were to describe eating behaviors and dietary patterns in pregnancy. This was a cross-sectional, national electronic survey. Women were ≥18 years of age, living in the United States, currently pregnant or less than two years postpartum, and had internet access. Age, education, race, and marriage were included as covariates in ordinal and binary logistic regressions (significance p < 0.05). Women (n = 587 eligible) made positive or negative changes to their diets, while others maintained pre-existing eating behaviors. The majority of women did not try (84.9 to 95.1% across diets) and were unwilling to try (66.6 to 81%) specific dietary patterns during pregnancy. Concerns included not eating a balanced diet (60.1 to 65.9%), difficulty in implementation without family (63.2 to 64.8%), and expense (58.7 to 60.1%). Helpful strategies included being provided all meals and snacks (88.1 to 90.6%) and periodic consultations with a dietitian or nutritionist (85 to 86.7%). Responses differed across subgroups of parity, body mass index, and trimester, notably in women with obesity who reported healthier changes to their diet (p < 0.05). Our study underscores the importance of tailoring care early to individual needs, characteristics, and circumstances.