Piloting a food photo sorting activity in Samoa to assess maternal beliefs and their role in child diet

Abstract

Eating habits begin forming early in life when parental beliefs and behaviours often play a major role in shaping dietary intake. We aimed to assess maternal beliefs about the cost, social status, and nutritional value of foods in Samoa—a setting with an alarming burden of childhood obesity—and to determine how those beliefs may be related to child dietary intake. Samoan mothers (n = 44) sorted photographs of 26 foods commonly consumed in children in Samoa by cost, social status, and nutritional value (healthfulness). Responses were then assessed for their association with child dietary intake (reported using a food frequency questionnaire) using Pearson correlations. Mothers indicated that traditional Samoan foods were healthier, of higher social status, and lower cost compared with non‐traditional/imported food items. Compared with nutritional experts and a market survey of food prices, mothers demonstrated strong nutritional (r = .87, 95% CI [0.68, 0.95], p < .001) and consumer (r = .84, 95% CI [0.68, 0.93], p < .001) knowledge. The perceived cost of food was more strongly associated (r = −.37, 95% CI [−0.66, 0.02], p = .06) with child dietary intake than either healthfulness or social status, with decreasing consumption reported with increasing food cost. Our findings contradicted the notion that the high social status of imported foods may be contributing to increased intake and rising prevalence of childhood obesity in this developing country setting. Despite their nutritional knowledge, Samoan mothers may need additional support in applying their knowledge/beliefs to provide a healthy child diet, including support for access to reasonably priced healthy foods.

Samoa Food and Tobacco Tax Household Survey, 2020

“…Previous studies conducted in Samoa have highlighted cost of food as a major driver of consumption and food choice. 25,[49][50][51] A five-fold increase in the volume of imported foods over the past half century in Samoa has lowered the cost of some imported, high fat, nutrient poor foods enough so that these products have become more affordable for some families than eating locally produced foods. The current rising prevalence of food insecurity in Samoa 11,49 means that any price increases may disproportionately impact the nutritional status of lower-income families which merits special consideration as taxes are formulated.…”

Exploring Food Literacy Domains in an Adult Samoan Population

“…The cost of food or perceptions of cost have been reported to influence food choice in Samoa [ 12 , 13 ], with one study reporting that perceptions of expensive foods were associated with decreased consumption [ 13 ]. The need to focus on cost may be associated with the proportion of income spent on food in Samoa.…”

“…Despite the established nature of health literacy within the context of public health promotion, food literacy explicitly focuses on health literacy abilities in a food context and, as such, advances health literacy in nutrition interventions [ 9 ]. In Samoan populations, elements of food literacy, such as food knowledge and/or education [ 10 , 11 , 12 ], food cost/budgeting [ 12 , 13 ], and food choice behaviours [ 14 , 15 ], have been explored. However, a framework was not previously used to evaluate their level of food literacy.…”