School of Health and Social Development, Deakin University, Geelong, Victoria, Australia.
Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia.
Nutr Rev. 2018 Dec 1;76(12):861-874. doi: 10.1093/nutrit/nuy043.
Dietary risks are leading contributors to global morbidity and mortality and disproportionately burden individuals of lower socioeconomic positions.
The aim of this review is to understand, holistically, what factors are perceived to influence healthy eating and to determine whether perceived factors differ when comparing the general population with lower socioeconomic subgroups.
Four academic databases (MEDLINE, CINAHL, PsycINFO, Cochrane Library) and 3 gray literature databases were searched systematically, along with reference lists.
Studies were included if they were qualitative and were conducted with community-dwelling adults in high-income countries and if they focused specifically on healthy eating. Eligibility was determined through author consensus.
Thirty-nine eligible studies (of 11 641 records screened) were identified. Study characteristics were extracted using a standard template, and quality appraisal was conducted using the Critical Appraisal Skills Program tool. Data synthesis was conducted using meta-ethnography, with themes categorized according to the socioecological model.
Factors across the individual, social, lived, and food environments were perceived to influence healthy eating. Meta-ethnography revealed that multiple environmental and social factors were frequently reported as barriers to healthy eating. While factors were largely generalizable, diet affordability and the lower availability of stores offering healthy food appeared to be more salient barriers for lower socioeconomic groups.
Actions to improve population diets should mitigate the barriers to healthy eating to create environments that support healthy eating across the socioeconomic gradient. Systematic Review Registration: PROSPERO registration number CRD42017065243.
饮食风险是导致全球发病率和死亡率的主要因素，并且不成比例地给社会经济地位较低的个人带来负担。
本综述旨在全面了解哪些因素被认为会影响健康饮食，并确定在比较一般人群和社会经济地位较低的亚组时，感知到的因素是否存在差异。
系统地搜索了四个学术数据库（MEDLINE、CINAHL、PsycINFO、Cochrane Library）和三个灰色文献数据库，并查阅了参考文献列表。
如果研究是定性的，并且是在高收入国家的社区居住成年人中进行的，并且专门关注健康饮食，则将其纳入研究。通过作者共识确定合格性。
从 11641 条记录中筛选出 39 项符合条件的研究（符合条件的研究）。使用标准模板提取研究特征，并使用批判性评估技能计划工具进行质量评估。使用元民族学进行数据综合，根据社会生态学模型对主题进行分类。
个体、社会、生活和食物环境中的因素被认为会影响健康饮食。元民族学表明，多种环境和社会因素经常被报告为健康饮食的障碍。虽然这些因素在很大程度上具有普遍性，但饮食的可负担性以及提供健康食品的商店的可用性较低，似乎是社会经济地位较低的群体面临的更突出障碍。
改善人群饮食的行动应减轻健康饮食的障碍，为整个社会经济梯度创造支持健康饮食的环境。系统评价注册：PROSPERO 注册号 CRD42017065243。
