Healthy eating and physical activity among Arab Muslim mothers of young children living in the U.S.: Barriers and influences of culture, acculturation and religion

Immigrants to western societies often experience changes in physical activity (PA) levels and diet because of adopting habits, beliefs and values of the new society. The study explored behavior changes of Arab Muslim mothers of young children living in the United States) as a result of acculturation and socio-cultural and religious barriers that may potentially affect diet and engagement in PA. This study used mixed methods to allow a better understanding of the factors that affect the women's ability to eat healthy and perform PA. Mothers (n=13) were recruited by convenience sampling and participated in focus group discussions to explore the socio-cultural and religious barriers to eating healthy and engaging in PA. Discussions were analyzed via direct content analysis and guided by the theory of triadic influences. Ten factors influenced eating habits and behaviors of women. Family size, competing priorities and responsibilities, income, family food preference, snacking, changes in meal times, portion sizing, self-efficacy, lack of family support, and cultural customs were among the emerging themes. Five factors influenced the women's ability to be physically active; low self-efficacy, lack of women only facilities, gender discrimination, cultural perception of women who exercise and modest dress.Women (n=180) participated in an online questionnaire to assess intrapersonal and socio-cultural influences and barriers to healthy eating, acculturation levels and food frequency intake. Cost, feeling hungry and having low self-control, having a negative attitude towards healthy eating, family preference and disorganization were the barriers to healthy eating. Four dietary patterns were identified; 1) Fruits and vegetables; 2) Animal products; 3) Saturated fat foods; and 4) Beverages and grains. Cost of healthy food negatively influenced the participant's consumption of saturated fat foods. Mothers (n=447) identified dress code and negative perception of women who engage in physical activities, lack of motivation and stress, and responsibilities as barriers to performing physical activity. Integration to the western society significantly influenced the women's food patterns and increased their PA. Overall, participants had a positive attitude towards healthy eating and performing PA, however, adoption of these behaviors was halted by intrapersonal and socio-cultural but not religious barriers. This is the first study to investigate barriers to healthy eating and performing PA in this community. Thus, more research is needed to further understand specific obstacles. Understanding the challenges that face Arab Muslim mothers from engaging in PA and to eating healthy will help health educators develop culturally appropriate strategies to accommodate the needs of this community