'A Food Culture in Transition'. Perceptions of Healthy Eating and Reasoning in Food Choices - A Grounded Theory Study of Young Mothers in South Tarawa, Kiribati

Abstract: The recent shift towards energy-dense and nutrient-poor diets has led to an increase of diseases such as obesity, diabetes and cardio-vascular disease. Due to poverty, geographical remoteness and lack of cultivable land, Kiribati experiences a double burden of malnutrition with high levels of NCDs among adults, and undernourishment among children. Since mothers are generally responsible for choosing food, it is of public health relevance to carry out research on their perceptions of healthy eating and food choices. The study at hand explores these issues in urban Tarawa. The aim was to explore perceptions and attitudes towards healthy eating and food choices among young mothers in South Tarawa, Kiribati. Using a Glaserian approach to Grounded Theory, the study used focus group discussions and in-depth interviews as the main source of data. The data was coded in three stages; open coding, focused coding and theoretical coding. This led to the construction of a conceptual model. ‘A food culture in transition’ was chosen as the core category based on the findings. The mothers felt they were dependent on imports and had trouble accessing food because of the increasing lack of cultivable land. They were used to eating without variety, but dreamed of trying new interesting food. While balancing old knowledge from family and peer-influence with new requirements from nutrition interventions, the mothers had various understandings of healthy eating. They also faced expectations of being a good mother, while wanting to do activities for themselves. Engaging in activities often meant mitigating healthy eating and peaceful relationships. The findings indicate that sustainable change will not be achieved if variety of food is not provided. Mothers need to be empowered with nutritional literacy and supported in their food choices so that they can take ownership of changing their health behaviour. Interventions need to have coherent follow-up systems of activities and involve mothers in the planning and implementation.