Cross-cultural comparison of perspectives on healthy eating among Chinese and American young adults.

Objective: Understanding views about what constitutes a healthy diet in diverse populations may inform design of culturally tailored behavior change interventions. While previous studies have examined views on healthy eating using qualitative methods, few studies have sought to compare these views in distinct groups of young adults. This study aimed to describe perspectives on healthy eating among Chinese and American undergraduate students and identify similarities and differences between the two groups. Methods: Chinese (n=55) and American (n=57) participants composed one- to two-paragraph responses to the following prompt: “What does the phrase ‘a healthy diet’ mean to you?” Content analysis using qualitative data analysis software was applied to identify predominant themes. Three researchers independently coded each essay and then grouped codes with similar content. Themes representing the main messages conveyed in the essays were identified and then rearranged based on discussion among researchers. Results: American students most commonly described healthy eating in terms of balance, both with regards to balancing food groups and balancing consumption with exercise. Physical activity was very often cited as an essential component of a healthy diet. While not as commonly reported, healthy eating was also said to be important for mental and spiritual health. Chinese students generally described a healthy diet as yielding desirable physical outcomes, such as maintaining immunity and preventing digestive problems. Other outcomes were also mentioned, such as feeling good and being happy as a result of healthy eating. Timing of eating was considered important, with regular meals emphasized, as well as larger quantities of food during the day than at night. Conclusions: While both groups described healthy eating in terms of principles guiding current nutrition recommendations, several other themes also emerged, such as those relating healthy eating to psychosocial outcomes. Future studies may further examine themes that may not typically be addressed in nutrition education programs in diverse populations of young adults. Gaining greater knowledge of the ways in which healthy eating is viewed will allow for development of interventions that are sensitive to the traditional values and predominant views of health in various groups