Concepts of Healthy Diet Among Urban, Low-Income, African Americans

We sought to explore concepts of healthy diet and to elicit recommendations to support healthier eating among urban, low-income,
African Americans. We conducted semi-structured interviews with 33 self-identified African American adults (18–81 years of
age, 15 male participants) from a low-income neighborhood in west Philadelphia, PA, during summer and fall 2008. Our qualitative
approach was continuous, iterative and thematic considering gender, age category, and participants’ “mentions” of fast-food
and fruit-and-vegetable intake from the preceding day. We found that participants shared concepts about broad nutritional
principles consistent with national dietary recommendations, but disagreed about the healthfulness of specific foods—e.g.
meat. On average—with little variation—participants reported eating >2 “mentions” more of fast foods the preceding day than
fruits and vegetables (P < 0.001). Suggested strategies to help promote eating more produce included increasing exposure, advertising, affordability,
and local availability (vice versa to limit fast-food consumption), and more education on the health effects of diet and how
to find and prepare healthy foods. Women’s ideas reflected their roles in food shopping and food preparation; otherwise, participants’
ideas did not differ appreciably by gender or age. Overall, participants generally expressed sufficient understanding of nutritional
principles to eat healthfully, but disagreed about the healthfulness of specific foods and described largely unhealthy dietary
consumption from the preceding day. If poor dietary intake results from barriers to recognizing, purchasing, and preparing
healthy foods, then participants’ suggestions to increase education and modify the environment may lead to improved diets
and better health in the community.