Hunter Emma, Stone Rebecca A, Brown Adrian, Hardman Charlotte A, Johnstone Alexandra M, Greatwood Hannah C, Dineva Mariana, Douglas Flora
School of Health, Robert Gordon University, Aberdeen, AB10 7QE, UK.
Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK.
Appetite. 2025 Jan 1;205:107794. doi: 10.1016/j.appet.2024.107794. Epub 2024 Nov 28.
The high prevalence of food insecurity in the United Kingdom has been exacerbated by the cost-of-living crisis. In high-income countries, those experiencing food insecurity struggle to buy and consume foods that meet Government healthy eating recommendations, and are at increased risk of obesity, linked to poor diet quality. Individuals in high-income countries purchase most of their food to consume at home from supermarkets, making this an important context within which healthier and environmentally sustainable food purchasing should be supported. However, the lived experience of supermarket food purchasing in people living with obesity and food insecurity has not been explored in depth. Adults, living in England and Scotland, who self-identified as living with obesity and food insecurity and looking to reduce their weight, were recruited to take part in semi-structured interviews (n = 25) or focus groups (n = 8) to explore their experience of shopping for food in the supermarket. Using thematic analysis, four main themes were generated: 1) the Restricted Consumer; restrictions around the type of food purchased, where food can be purchased and the resulting emotional toll, 2) the Conscious Consumer; decision making and effortful practices both in preparation of and during the shopping trip, 3) Mitigating the Rising Cost of Food; agency and actions taken to mitigate high food prices, 4) Stigma; instances of perceived and/or experienced weight and poverty-related stigma and the physical actions and cognitive social comparisons used to minimise stigma. Findings provide insights for evidence-based policy on the need for upstream changes within the wider food system to address the social determinants of health and support people living with obesity and food insecurity to eat healthier and more sustainable diets.
生活成本危机加剧了英国粮食不安全问题的高发生率。在高收入国家,经历粮食不安全的人们难以购买和食用符合政府健康饮食建议的食物,且肥胖风险增加,这与不良的饮食质量有关。高收入国家的个人大多从超市购买在家食用的食物,因此这是一个应支持购买更健康且环境可持续食物的重要背景。然而,肥胖和粮食不安全人群在超市购买食物的实际体验尚未得到深入探讨。招募了居住在英格兰和苏格兰、自我认定有肥胖和粮食不安全问题且希望减重的成年人,让他们参与半结构化访谈(n = 25)或焦点小组讨论(n = 8),以探究他们在超市购买食物的体验。通过主题分析,得出了四个主要主题:1)受限消费者;在购买食物的种类、购买地点方面的限制以及由此产生的情感代价;2)有意识的消费者;在购物前准备和购物过程中的决策及费力行为;3)缓解食品价格上涨;为缓解高食品价格所采取的行动和措施;4)耻辱感;感知到的和/或经历过的与体重和贫困相关的耻辱感事例,以及为尽量减少耻辱感而采取的身体行动和认知社会比较。研究结果为基于证据的政策提供了见解,表明需要在更广泛的食品系统中进行上游变革,以解决健康的社会决定因素,并支持肥胖和粮食不安全人群食用更健康、更可持续的饮食。