Defining Healthy Food: Consumer Perspecitives

Background: Interventions to promote healthy eating often rest on a assumed priorities related to healthful food.  In a evaluation designed to inform Philadelphia Department of Public Health’s Healthy Supermarket Pledge we examined concepts of healthy food among participants in a low-income urban setting.  Methods: Eight focus groups (FG), with 76 participants (> 18yrs) were held in community settings.  All FGs were audio recorded and transcribed verbatim.  The study team developed a codebook, analysis was facilitated by NVivo10 software and all transcripts were double coded. Results: Participants were asked to describe and define healthy foods.  These conversations often began with a discussion of “good quality,” “clean,” and “fresh,” food. Respondents explained that packaged foods are often the healthier option in supermarkets were “fresh” fruits, vegetables and meats are often rotten, close to rotten, or exposed to rodent droppings. Occasionally, respondents share misunderstandings of healthy foods, for example identifying gelatin based fruit snacks or sugar-sweetened ice-tea as healthy. However most participants accurately identified healthy food products including: gluten-free, low-glycemic, low sodium, and fresh fruits and vegetables, reporting, however that they were often not true options where they live. Conclusions: Respondents’ reported concerns related to disparate access to quality foods, sharing a belief that basic standards of cleanliness and freshness of foods are not adhered to in their communities. Canned, frozen, packaged foods are often considered the healthier option because the quality, freshness and cleanliness are easily assessed. We found that participants’ operational definition of healthful foods was adapted to their context.