Abstract
Objectives
To examine the participant experiences regarding perceived barriers and facilitators which impact on consuming the Mediterranean diet in the East of England.
Design
Qualitative methodology with focus groups.
Setting
A healthy, middle-aged population situated in the East of England. Intervention: An 8-week Mediterranean dietary intervention trial.
Participants
Eleven participants (including three co-habiting partners) in three focus groups, ranging between 50-65yrs with a mean age of 54.3yrs (±4.0)
Results
Thematic analysis from the focus groups revealed that participants considered that the MD intervention had introduced a better quality of food, widening the food-horizon and allowed them to re-define cultural eating habits. They also reported several physical benefits from adapting to this diet and found the experience as positive. Whilst claiming that the MD was an enjoyable and pleasurable, the participants did express difficulty adapting to the eating pattern, finding difficulty in purchasing food items, an increase in food costs and found work, stress and time pressures undermining adherence.
Conclusion
The participants’ experiences suggested that the MD was an encouraging dietary change with a middle aged non-Mediterranean based population group. Future MD interventions should tailor interventions and support participants closely, particularly with the necessary planning, organisation and purchasing involved with implementing this diet in non-Mediterranean countries. Secondly, researchers should also challenge any erroneous assumptions regarding the consumption of Mediterranean food, which may hinder implementation.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Chiva-Blanch G, Badimon L, Estruch, R. Latest Evidence of the Effects of the Mediterranean Diet in Prevention of Cardiovascular Disease. Curr Atheroscler Rep 2014;16:1–7
Estruch R, Ros E, Salas-Salvadó J et al. Primary prevention of cardiovascular disease with a Mediterranean diet. New Eng J Med 2013;368:1279–1290
Kopel E, Sidi Y, Kivity S, Estruch R, Ros E, Salas-Salvado J. Mediterranean diet for primary prevention of cardiovascular disease. New Eng J Med 2013;369:672–672
Sofi F, Abbate R, Gensini GF, Casini A. Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. Am J Clin Nutr 2010;92:1189–96
Trichopoulou A, Martínez-González MA, Tong TY et al. Definitions and potential health benefits of the Mediterranean diet: views from experts around the world. BMC Med 2014;12:112–128
Bach-Faig A, Berry E, Lairon D et al. Mediterranean diet pyramid today. Science and cultural updates. Pub Health Nutr 2011;14:2274–2284
NHS Choices. What is a Mediterranean diet? http://www.nhs.uk/Livewell/Goodfood/ Pages/what-is-a-Mediterranean-diet.aspx. Accessed 28 Oct 2014
Patient.co.uk. How to Follow the Mediterranean Diet. http://www.patient.co.uk/ health/how-to-follow-the-mediterranean-diet. Accessed 28 Oct 2014
Klonizakis M, Alkhatib A, Middleton G, Smith MF. Mediterranean diet-and exercise-induced improvement in age-dependent vascular activity. Clin Sci 2013;124:579–587
Klonizakis M, Alkhatib A, Middleton G. Long-term effects of an exercise and Mediterranean diet intervention in the vascular function of an older, healthy population. Microvasc Res 2014;95:103–107
Swift JA, Tischler V. Qualitative research in nutrition and dietetics: getting started. J Hum Nutr Diet 2010;23:559–566
Krueger R, Casey M. Focus Groups: A Practical Guide for Applied Research. 4th edn. Sage, London, 2009
Fade SA, Swift JA. Qualitative research in nutrition and dietetics: data analysis issues. J Hum Nutr Diet 2011;24:106–114
Bryman A. Social Research Methods, 3rd edn. Oxford University Press: Maidenhead, 2008
Strauss A. Qualitative Analysis for Social Scientists. Cambridge University Press, Cambridge, 1987
Tesch R. Qualitative Research Analysis Types and Software Tools. Falmer Press, New York, USA, 1990
Strauss A, Corbin J. Basics of qualitative research: Grounded Theory, Procedures and Techniques. 3rd edn. Sage, London, 2008
Lincoln Y, Guba E. Naturalistic Inquiry. Sage, London, 1985
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006;3:77–101.
Cohen L, Manion L, Morrison K. Research Methods in Education. 5th edn. Routledge, London, 2000
Harris JE, Gleason PM, Sheean PM, Boushey C, Beto JA, Bruemmer B. An introduction to qualitative research for food and nutrition professionals. J Am Diet Assoc 2009;109:80–90
Hoffman R, Gerber, M. Evaluating and adapting the Mediterranean diet for non-Mediterranean populations: a critical appraisal. Nut Rev 2013;71:573–584
Gardener H, Wright CB, Gu Y et al. Mediterranean-style diet and risk of ischemic stroke, myocardial infarction, and vascular death: The Northern Manhattan Study. Am J Clin Nutr 2011;94:1458–1464
Rumawas ME, Meigs JB, Dwyer JT et al. Mediterranean-style dietary pattern, reduced risk of metabolic syndrome traits, and incidence in the Framingham Offspring Cohort. Am J Clin Nutr 2009;90:1608–1614
Knoops KT, de Groot LC, Kromhout D, et al. Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: The HALE project. JAMA 2004;292:1433–1439
Goulet J, Lamarche B, Nadeau G, Lemieux S. Effect of a nutritional intervention promoting the Mediterranean food pattern on plasma lipids, lipoproteins and body weight in healthy French-Canadian women. Atherosclerosis 2003;170:115–124.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
This article is published under an open access license. Please check the 'Copyright Information' section either on this page or in the PDF for details of this license and what re-use is permitted. If your intended use exceeds what is permitted by the license or if you are unable to locate the licence and re-use information, please contact the Rights and Permissions team.
About this article
Cite this article
Middleton, G., Keegan, R., Smith, M.F. et al. Implementing a Mediterranean diet intervention into a RCT: Lessons learned from a non-Mediterranean based country. J Nutr Health Aging 19, 1019–1022 (2015). https://doi.org/10.1007/s12603-015-0663-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12603-015-0663-0