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Table 4 Theme 3: barriers to healthy eating

From: A focus group study of healthy eating knowledge, practices, and barriers among adult and adolescent immigrants and refugees in the United States

Subtheme Adults Adolescents
Taste and Cravings Somali: “For us, the type of food we like is the food we know.” Somali: “So it’s like up to you. If you want to eat healthy… but you see chips… you want to buy it so badly. Like an apple, you don’t care.”
Somali: “The goat meat seems good to us. The rice we fill with oil seems good to us. The pasta with lots of sauce seems good to us.”
Sudanese: “[In America], they advertise unhealthy food to look really good.”
Somali: “What seems good to us is a large plate of food. We would fill it with food and pile on more food. Large pieces of meat, rice, oils…” Cambodian: “You want to eat healthy but the others foods are calling for you.”
Cambodian boys: “[At school] they have a box of salad you can pick, but I don’t think a lot of people pick salad; they prefer some fatty food over salad.”
Mexican: “When we got here to the U.S., [my children] wouldn’t like pizza [and] burgers. Now, I can’t get them off the pizza or the burgers!”
Mexican: “There is a lot of hamburger places and you are tempted to not make your own food.”
Mexican: “I get cravings for Mexican food.”
Cambodian: Some [of us] prefer Asian food just because [we] are used to eating it and feel like it stays in the stomach longer. Whereas, if you eat American food, you eat for a little bit and you feel hungry again.” Mexican: “Sometimes people might prefer junk food because they think it tastes better and usually the healthier things don’t always taste good.”
Somali: “I run for the hot cheetos.— Oh my God!”
Sudanese: “I miss a lot of food that I’ve been eating over there. A lot. I realize that those foods back home were more beneficial to our bodies.”
Easy Access to Junk Food Mexican: “When you move to this country, you get used to […] buying and keeping […] cookies, chocolate, chips, peanuts for snacking for desserts and after the meal. […] It is easy, just after the meal to just open a dessert bar or chocolate. Or [when] I am hungry, then I open a bag of chips.” Somali: “There is [a] McDonalds on every corner.”
Somali: “When people don’t have food at home, they just take the family to McDonalds.“
Mexican: “It’s easier to get junk food then healthy food because you just open a bag or put it in the microwave. [With] healthy food, you have to cut the lettuce, cut the tomatoes.”
Somali: “When you come to the U.S., the food is mostly unhealthy because of, you know, the [frozen], and [in] cans, or McDonald’s or something like that, you know, junk food.”
Sudanese: “There is a lot of junk food in our school.”
Somali: “Here it is easier to get unhealthy food than healthy food.”
Role of Family Mexican: “I try to eat healthier but my husband will protest and say: ‘I want rice and beans’.” Somali: “You can’t really tell your parents: ‘Your food, I don’t like it.’ They’ll just say: ‘Eat!’”
Mexican: “We all love our kids but […] part of their bad habits are also our mistakes, our errors. We have taught them wrong.” Somali: “My mom—she buys a lot of pop.”
Sudanese: “My mom always cooks macaroni and cheese and stuff like that… meatballs and pasta […]. Americanized food.”
Sudanese: “The family will be the victim now because the head of the family [decides what is eaten]. In Africa, we cook what the father needs, not the kids.”
Sudanese: “There is a lot of junk food at home because of what my mom buys.”
Cambodian: “For instance if there are four people in the household the difficult thing about eating is, if I wanted sour soup, and someone else just wanted vegetable soup, it is really hard to please everyone.”
Mexican: “So for me, I [am] from a Hispanic family. It is all very social. […] Our problem is, […] we always get together and do a lot of social eating.”
Cultural foods and traditions Somali: “We eat […] more grain than poultry or red meat on a daily basis. We end up eating more than we need. That’s the problem.” Somali: “[Somali food] seems to be healthy but they fry everything.”
Cambodian: “For me I think Cambodian food is healthy but […] it depends […] because sometimes they use pig fat or pig skin and it is really fatty food.”
Somali: “We don’t understand the food here.”
Somali: The food we know was better in our country. It was good and the sun would help you burn it off. The oil and the sugar were burnt off by the sun.”
Mexican: “Sometimes it is hard to make Mexican food healthy unless you want to […] but if you just make it, it is not going to be healthy.”
Somali: We think that, the bigger a person is, the healthier. […] A skinny person is a sick person.”
Mexican: “Well [in] our culture, [food] is not too healthy. Just fat.”
Sudanese: In Sudan, our food [has] a lot of fat in it. If there is no fat, then it is not right. That’s my culture.”
Mexican: [Our] parents want to raise [us] how they were raised or slightly better and they have the idea [that] […] feeding [us] what they had as a child will […] make you in their image.”
Mexican: “[I am] never going to be able to go from: ‘We’ve eaten tortillas our entire life,’ to [just eating] one [tortilla] a day. That’s just impossible for my family.”
Somali: “Usually in the Somali culture […] healthy diet is not really part of their […] routine.”
Time Mexican: “I work and you know [my children] are not going to eat what you tell them to, they are going to eat what is easiest.” Somali: “[Our parents] are just too busy because they work overtime and just come home and sleep. That’s basically what they do.”
Sudanese: “Because I am doing two jobs and at the same time I got to school… you have to wake up early in the morning and prepare breakfast.” Somali: “Me, I always used to get McDonald’s because I worked there. I never
eat at home. I only eat at school. I come home, sleep; I rarely have time to eat at home.”
Mexican: “We don’t have time to make [food]. Sudanese: “My mom doesn’t cook anymore because she is always at her job.”
Sudanese: “My parents both work, so they don’t usually have time to cook on weekdays so they usually elect the easiest thing from McDonalds or something… and bring it back home.”
Sudanese: “For our family, because our mom works a lot, […] we have to make food on our own and it’s easier to make junk than good quality food.”
Sudanese: “My mom is always at work so then we pick the unhealthy choice like pop a pizza in the oven and it’s quicker, just after school.”
Finances Somali: “Fruits and vegetables are very expensive […]. Pasta is cheap and […] when it is cooked, it has a lot of calories. So if [we] had more money, [we] could buy fruits and vegetables.” Cambodian: “Fatty [food] costs less than fruits and vegetables [and] all the healthier stuff.”
Cambodian: “Sometimes we don’t have the money to buy healthy foods.”
Cambodian: “The only thing that [makes it] difficult [to eat healthy] is the money. When it comes to food [availability], it is not difficult.” Sudanese: “Fast food is way cheaper than healthy food, so you go to McDonalds and get a sandwich for a dollar rather than [buying] food and making it yourself at home.”
Cambodian: [Healthy food] is expensive. […] If you want to be healthy and eat healthy but you’re not having enough financial aid or money to purchase them then you just get what you can…buy what you can.”
Sudanese: “My mom doesn’t buy as much [the] healthiest food because sometimes you can’t always afford [that].”
Sudanese: “McDonalds has the dollar menu.— Who is going to compete with that?”
Mexican: “Everything is really expensive in the winter. Everything healthy.”
Mexican: “We don’t have anything to make [healthy food] with. […] Maybe the prices [of healthy food] are too overpriced.”
Cambodian: “In the summer, we can do gardening and grow our own vegetables and we only have to buy meat. But in the winter we have to purchase [everything].”
Somali: “Healthier foods tend to be more expensive at grocery stores.”
  Sudanese: “[The hard things about eating healthy in [this town] are […]: Finance, finances!”