Traditional ethnic groups in Kenya are unlikely to eat a healthy and diversified diet due to many individual and environmental factors, which may result in poor health status. Therefore, the determinants of eating behavior need to be identified prior to any public health action. For this study, focus group discussions (15 in total) in a double-layer design were conducted, comprising adult men and women from 5 villages of Vihiga County. Questions explored knowledge; barriers and cues to action toward eating a healthy diet containing a variety of foods; including indigenous food species. We found that healthy eating concepts are known; however, several taboos that restrict food consumption reduce local diet quality in terms of diversity. Nutrition education is a cue to action. We identified several individual and environmental determinants of eating behavior in the studied communities. Public health action should focus on supporting healthy eating behaviors and refining some taboos' beliefs.

Alliance of Bioversity International and CIAT Via dei Tre Denari 472 a 00054 Rome Italy

Faculty of Tropical AgriSciences Czech University of Life Sciences 165 00 Prague Czech Republic

Research Center Faculty of Medicine Universidad de Especialidades Espíritu Santo Samborondom 092301 Ecuador

Rural Research Center Faculty of Social Sciences Escuela Superior Politècnica del Litoral Guayaquil 090112 Ecuador

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Thomson C.A., Foster G. Dietary behaviors: Promoting healthy eating. In: Riekert K.A., Ockene J.K., Pbert L., editors. The Handbook of Health Behavior Change. 4th ed. Springer Publishing Company; New York, NY, USA: 2014.

Ruel M.T. Operationalizing dietary diversity: A review of measurement issues and research priorities. J. Nutr. 2003;133:3911S–3926S. doi: 10.1093/jn/133.11.3911S. PubMed DOI

Hatloy A., Torheim L.E., Oshaug A. Food variety a good indicator of nutritional adequacy of the diet? A case study from an urban area in Mali, West Africa. Eur. J. Clin. Nutr. 1998;52:891–898. doi: 10.1038/sj.ejcn.1600662. PubMed DOI

Steyn N.P., Nel J.H., Nantel G., Kennedy G., Labadarios D. Food variety and dietary diversity scores in children: Are they good indicators of dietary adequacy? Public Health Nutr. 2006;9:644–650. doi: 10.1079/PHN2005912. PubMed DOI

Lachat C., Raneri J.E., Walker K., Kolsteren P., Van Damme P., Verzelen K., Penafiel D., Vanhove W., Kennedy G., Hunter D., et al. Dietary species richness as a measure of food biodiversity and nutritional quality of diets. Proc. Natl. Acad. Sci. USA. 2018;115:127–132. doi: 10.1073/pnas.1709194115. PubMed DOI PMC

Arimond M., Ruel M.T. Dietary diversity is associated with child nutritional status: Evidence from 11 demographic and health surveys. J. Nutr. 2004;134:2579–2585. doi: 10.1093/jn/134.10.2579. PubMed DOI

Delisle H. Poverty: The double burden of malnutrition in mothers and the intergenerational impact. Ann. N. Y. Acad. Sci. 2008;184:172–184. doi: 10.1196/annals.1425.026. PubMed DOI

Moursi M.M., Arimond M., Dewey K.G., Tre S., Ruel M.T., Delpeuch F. Dietary diversity is a good predictor of the micronutrient density of the diet of 6- to 23-month-old children in Madagascar. J. Nutr. 2008;138:2448–2453. doi: 10.3945/jn.108.093971. PubMed DOI

Onyango A., Koski K.G., Tucker K.L. Food diversity versus breastfeeding choice in determining anthropometric status in rural Kenyan toddlers. Int. J. Epidemiol. 1998;27:484–489. doi: 10.1093/ije/27.3.484. PubMed DOI

Food and Agriculture Organization of the United Nations (FAO) Family Health International (FHI 360) Minimum Dietary Diversity for Women: A Guide for Measurement. 2016. [(accessed on 12 April 2022)]. Available online: http://www.fao.org/3/a-i5486e.pdf.

Termote C., Bwama Meyi M., Dhed’a Djailo B., Huybregts L., Lachat C., Kolsteren P., Van Damme P. A biodiverse rich environment does not contribute to a better diet: A case study from DR Congo. PLoS ONE. 2012;7:e30533. PubMed PMC

Sibhatu K.T., Krishna V.V., Qaim M. Production diversity and dietary diversity in smallholder farm households. Proc. Natl. Acad. Sci. USA. 2015;112:10657–10662. doi: 10.1073/pnas.1510982112. PubMed DOI PMC

Meyer-Rochow V.B. Food taboos: Their origins and purposes. J. Ethnobiol. Ethnomed. 2009;5:18. doi: 10.1186/1746-4269-5-18. PubMed DOI PMC

Wambiya E.O.A., Kisia L., Osindo J., Kisiangani I., Kipruto S., Ilboudo P.G., Donfouet H.P.P., Mohamed S.F. Patterns and determinants of eating healthy in Kenya. Res. Sq. 2021 submitted .

Steyn N.P., Nel J.H., Parker W.-A., Ayah R., Mbithe D. Dietary, social, and environmental determinants of obesity in Kenyan women. Scand. J. Public Health. 2011;39:88–97. doi: 10.1177/1403494810384426. PubMed DOI

Biodiversity International Improving Nutrition through Increased Utilisation of Local Agricultural Biodiversity in Kenya—The INULA Initiative. 2012. [(accessed on 12 April 2022)]. Available online: https://www.bioversityinternational.org/fileadmin/user_upload/online_library/publications/pdfs/Improving_nutrition_through_increased_utilisation_of_local_agricultural_biodiversity_in_Kenya_the_INULA_initiative_1815.pdf.

McTaggart R. Participatory action research: Issues in theory and practice. Educ. Action Res. 1994;2:313–337. doi: 10.1080/0965079940020302. DOI

Boedecker J., Odhiambo Odour F., Lachat C., Van Damme P., Kennedy G., Termote C. Participatory farm diversification and nutrition education increase dietary diversity in Western Kenya. Matern. Child Nutr. 2019;15:e12803. doi: 10.1111/mcn.12803. PubMed DOI PMC

Swift J.A., Tischler V. Qualitative research in nutrition and dietetics: Getting started. J. Hum. Nutr. Diet. 2010;23:559–565. doi: 10.1111/j.1365-277X.2010.01116.x. PubMed DOI

Contento I.R. Nutrition Education: Linking Research, Theory, and Practice. 3rd ed. Jones and Bartlett Learning; New York, NY, USA: 2015. PubMed

Achterberg C., Clark K.L. A retrospective examination of theory use in nutrition education. J. Nutr. Educ. 1992;24:227–233. doi: 10.1016/S0022-3182(12)81236-2. DOI

Penafiel D., Termote C., Lachat C., Espinel R., Kolsteren P., Van Damme P. Barriers to eating traditional foods vary by age group in Ecuador with biodiversity loss as a key issue. J. Nutr. Educ. Behav. 2016;48:258–268. doi: 10.1016/j.jneb.2015.12.003. PubMed DOI

Krau S.D. Creating educational objectives for patient education using the new Bloom’s Taxonomy. Nurs. Clin. 2011;46:299–312. doi: 10.1016/j.cnur.2011.05.002. PubMed DOI

Hsieh H.-F., Shannon S.E. Three approaches to qualitative content analysis. Qual. Health Res. 2005;15:1277–1288. doi: 10.1177/1049732305276687. PubMed DOI

Cho J.Y., Lee E.H. Reducing confusion about grounded theory and qualitative content analysis: Similarities and differences. Qual. Rep. 2014;19:64. doi: 10.46743/2160-3715/2014.1028. DOI

Korstjens I., Moser A. Series: Practical guidance to qualitative research. Part 4: Trustworthiness and publishing. Eur. J. Gen. Pract. 2018;24:120–124. doi: 10.1080/13814788.2017.1375092. PubMed DOI PMC

Pilnick A., Swift J. Qualitative research in nutrition and dietetics: Assessing quality. J. Hum. Nutr. Diet. 2011;24:209–214. doi: 10.1111/j.1365-277X.2010.01120.x. PubMed DOI

Global Nutrition Report (GNR) Global Nutrition Report Country Profiles: Kenya. 2021. [(accessed on 12 April 2022)]. Available online: https://globalnutritionreport.org/resources/nutrition-profiles/africa/eastern-africa/kenya/

Ekesa B., Walingo M., Abukutsa-Onyango M. Influence of agricultural biodiversity on dietary diversity of preschool children in Matungu division, western Kenya. Afr. J. Food Agric. Nutr. Dev. 2009;8:26–32. doi: 10.4314/ajfand.v8i4.19200. DOI

Verstraeten R., Van Royen K., Ochoa-Avilés A., Penafiel D., Holdsworth M., Donoso S., Maes L., Kolsteren P. A conceptual framework for healthy eating behavior in Ecuadorian adolescents: A qualitative study. PLoS ONE. 2014;9:e87183. doi: 10.1371/journal.pone.0087183. PubMed DOI PMC

Verstraeten R., Leroy J.L., Pieniak Z., Ochoa-Avilès A., Holdsworth M., Verbeke W., Maes L., Kolsteren P. Individual and environmental factors influencing adolescents’ dietary behavior in low- and middle-income settings. PLoS ONE. 2016;11:e0157744. doi: 10.1371/journal.pone.0157744. PubMed DOI PMC

Smart J.C., Tschirley D., Smart F. Diet quality and urbanization in Mozambique. Food Nutr. Bull. 2020;41:298–317. doi: 10.1177/0379572120930123. PubMed DOI

Kamphuis C.B.M., Giskes K., De Bruijn G., Wendel-Vos W., Brug J., Van Lenthe F.J. Environmental determinants of fruit and vegetable consumption among adults: A systematic review. Br. J. Nutr. 2006;96:620–635. doi: 10.1079/BJN20061896. PubMed DOI

Rehima M., Belay K., Dawit A., Rashid S. Factors affecting farmer’ crops diversification: Evidence from SNNPR, Ethiopia. Int. J. Agric. Sci. 2013;3:568–585.

Sichoongwe K., Mapemba L., Tembo G., Ng’ong’ola D. The Determinants and extent of crop diversification among smallholder farmers: A case study of southern province Zambia. J. Agric. Sci. 2014;6:150. doi: 10.5539/jas.v6n11p150. DOI

Pretty J., Toulmin C., Williams S. Sustainable intensification in African agriculture. Int. J. Agric. Sustain. 2011;9:5–24. doi: 10.3763/ijas.2010.0583. DOI

Spronk I., Kullen C., Burdon C., O’Connor H. Relationship between nutrition knowledge and dietary intake. Br. J. Nutr. 2014;111:1713–1726. doi: 10.1017/S0007114514000087. PubMed DOI

Guillaumie L., Godin G. Psychosocial determinants of fruit and vegetable intake in adult population: A systematic review. Int. J. Behav. Nutr. Phys. Act. 2010;7:12. doi: 10.1186/1479-5868-7-12. PubMed DOI PMC

Latham M.C. Human Nutrition in the Developing World. Food and Agriculture Organization of the United Nations (FAO); Rome, Italy: 1997.

World Health Organization (WHO) Food and Agriculture Organization of the United Nations (FAO) Diet, Nutrition and the Prevention of Chronic Diseases. Food and Agriculture Organization of the United Nations (FAO); Rome, Italy: 2002.

Das S. Textbook of Community Nutrition. 2nd ed. Academic Publishers; Kolkata, India: 2016.

Oniang’o R.K., Komokoti A. Food Habits in Kenya: The Effects of Change and Attendant Methodological Problems. Appetite. 1999;32:93–96. doi: 10.1006/appe.1998.0201. PubMed DOI

Ogbeide O. Nutritional hazards of food taboos and preferences in Mid-West Nigeria. Am. J. Clin. Nutr. 1947;27:213–216. doi: 10.1093/ajcn/27.2.213. PubMed DOI

Triratnawati A., Ditya Kristianti R., Putra A.P., Bagas Setyaji P. The effort to decrease maternal and child mortality rates through cultural transformation. Int. J. Public Health Sci. 2016;5:84. doi: 10.11591/ijphs.v5i1.4768. DOI