Exploring barriers and facilitators to eating the Mediterranean diet in England: a qualitative study

Abstract

Scientific guidelines and recommendations strongly encourage a Mediterranean-like dietary pattern for primary and secondary pre-vention of major chronic diseases (1) . In the United Kingdom (UK), several credible sources of dietary information have recommended consumption to the public (NHS Choices and Patient UK). The concept of how British citizens incorporate a Mediterranean diet (MD) into daily life (e.g. food availability, cost, personal preferences and preparation) has remained unexplored. Little is known on the pragmatic and cultural perspectives of adopting the MD in the UK. This study aimed to highlight the barriers and facilitators to eating the MD from a sample of participants who had recently attempted to implement the diet in the north-east of England. The investigation recruited a sample (n 11) of adult (50–65yrs) participants (n 8) that had previously enrolled on an 8-week MD intervention study (2) . They were encouraged to attend this investigation with their co-habiting partner (n 3). Semi-structured focus groups (3) were digitally recorded and transcribed verbatim; these allowed participants to discuss their experiences regarding 'barriers' and 'facilitators' whilst attempting the MD intervention. Additional field notes supported data collection. Data were analysed through a process of thematic content analysis from the concept-driven design (3) . Key themes highlighted that participants enjoyed the pleasurable experience, reporting several physical benefits from adapting to this diet. Furthermore, they felt that the diet introduced a better quality of food, widened the food-horizon and allowed them to redefine cultural eating habits. Participants expressed difficulty in accommodating the diet with work and stress undermining adherence along with the pressures of time and family. They also suggested that it is difficult to purchase food items and regarded the British cul-ture as non-conducive to this pattern of eating. The table illustrates views on how adherence to the MD could be improved: The data collected displayed the perceived enabling factors and apparent challenges when attempting to adhere this diet. This pro-vides cultural information for the future development of appropriate and effective MD interventions with UK based participants.