Qualitative exploration of food choice in older Irish adults

1. 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)

2. Overview of Presentation • Introduction to research and life course perspective • Preliminary Qualitative Study • Methodology • Initial findings • Conclusions • Next steps

3. Understanding Food Choice • Adversetrends 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

4. 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)

5. 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 • 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

6. Objective To explore influences across the life course on the food choices of older Irish adults

7. Preliminary Exploratory Qualitative Study Methodology • In-depth semi-structured interviews with 32 older adults *Sub-sample of participants (n=700) participating in epidemiological health survey, UCC

8. 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

9. Results: Key Contextual Influences

10. 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

11. 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 • Changes for Health: • A minority motivated by prevention/ maintaining good health in older age • More likely if salient health threats experienced • Ageing: Declining appetite/more difficult digestion

12. 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

13. 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

14. 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 industry-relayed information

15. 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

16. Next Steps: Future Research Plan Nationally representative quantitative survey on food choice (HRB Centre for Health & Diet Research) 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

17. 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