Perceptions Regarding Healthy Eating, and Individual and Interpersonal Facilitators to Healthy Food Choices of Middle-Aged Central American Men: A Qualitative Study

Objectives: This study explored middle-age, overweight or obese Central American men's perceptions of healthy eating and facilitators to healthy food choices. Methods: In fall 2020 and spring 2021, 25 in-depth, qualitative individual interviews were conducted with participants who met the following criteria: first generation Central American immigrant men residing in Washington, D.C., BMI ≥25 kg/m2, low income, not following a diet due to a medical condition, and married or partnered. Men were interviewed about their perceptions on the meaning of healthy eating, factors that influence their decisions to eat healthy foods, things they do since coming to the U.S. that helped them to eat healthy foods, and family influences on eating habits. Audio-recorded interviews were transcribed and then reviewed by two primary coders who developed the codebook. Transcripts were coded independently by the coders using NVivo v.12 and then reviewed by a third researcher. Coded transcripts were analyzed for themes both within and across codes. Results: Participants had a mean age of 51.4±6.6 years. They perceived healthy eating as: (1) having a balanced diet (e.g., incorporating all food groups in their meals), (2) preparing homemade meals, (3) eating foods low in fat, added sugar, and sodium, and (4) not having diseases. Individual-level facilitators included: (1) eating self-regulation, and (2) healthy food choices derived from their home-country. Interpersonal-level facilitators included: (1) wife/partner as a catalyst for healthy food choices, and (2) other family members social support for healthy food choices. Conclusions: Overweight or obese Central American men had a good understanding of what healthy eating was and linked healthy eating to absence of disease. Reducing food portion sizes and preferring to consume culturally traditional healthy foods in the U.S. were discussed as examples of individual-level facilitators of healthy eating. Wives/partners played a leading role in facilitating men's healthy food choices. Weight management interventions to promote healthy eating should capitalize on men's understanding of healthy eating. Interventions should also integrate spousal involvement given their perceived influence on men's food behaviors.