Dietary concepts in the dyad: Results from a qualitative study of middle-aged and older couples

Background: The positive effects of a healthy diet on older adults' health status are well established. Yet, inadequate health outcomes prevail. Insufficient healthy dietary styles may be related to the complexity of lay concepts regarding what constitutes a healthy diet. It is hence of importance to disentangle and understand such concepts in depth. The aim of this qualitative study was to explore diet-related intra-couple dynamics and to reconstruct dietary concepts and associated influencing factors among older couples Methods: The qualitative sample consisted of 15 German couples with at least one partner aged between 50 and 70 years. Study participants were recruited using theoretical sampling. Dyadic guideline-based interviews were conducted from 2016 to 2017. The transcripts were analyzed by means of the Grounded Theory Method Results: Diverse Dyadic dietary concepts emerged from the data material and were shown to be dynamically influenced - among others - within the context of the couple relationship. Three major components showed to be integral to Dyadic dietary concepts: Ideas of healthy diet, Taste and Body images. Moreover, in all of the couples interviewed, one of the partners developed the role of a "Health Expert", who was consensually considered to have more solid health expertise. Different expressions of the HE with corresponding couple dynamics were identifiedDiscussion: This study demonstrates the relevance of diet-related intra-couple dynamics in shaping Dyadic dietary concepts. Particularly, the role of the "Health Expert" within couples showed to decisively influence such concepts. Future research is needed to gain a greater in-depth knowledge on the related influencing factors and couple dynamics. Public health (nutrition) strategies targeting older couples should address such intra-couple dynamics such as the role the partners play for shaping Dyadic dietary concepts.