Drivers of Food Choice among Lactating Women: The Case of Debrebirhan Town, North Shoa Zone, Amhara Region, Ethiopia

Drivers of Food Choice among Lactating Women: The Case of Debrebirhan Town, North Shoa Zone, Amhara Region, Ethiopia

Gesessew Kibr1*, Afework Mulugeta 2, Tafese Bosha3

1Department of Food Science and Nutrition, Wollega University, Shambu, Ethiopia; 2Department of Public Health, Mekelle University, Mekelle, Ethiopia;3School of Nutrition, Food Science and Technology, Hawassa University, Hawassa, Ethiopia

International Journal of Food and Nutrition Research

While access to foods and more information on healthy eating are important, decisions to adopt health-enhancing behavior of lactating women (nutritional vulnerable group) are often constrained by socio-economic barriers, personal and food related drivers that influence food choice. Therefore, this study aimed to assess drivers of food choice, & socio-economic variables associated with drivers of food choice among lactating women in Debrebirhan Town. A survey study was conducted on 423 randomly selected lactating women. Data was collected by face to face interview and analyzed via SPSS version 20. Logistic regression analysis was used to find association b/n socio-economic variables and drivers of food choice. P-value < 0.05 was taken as statistically significant. Influences of religion, price, preparation convenience, health value and taste during food choice were responded by above half of women (92%, 84%, 83%, 66% & 56%). From multivariate analysis of binary logistic regression, influence of mood in food choice was associated to age (15-25 and 26-35 years) and estimated monthly income (≤3500 vs.>3500 ETB) with AOR (95%CI) of 3.24(1.3-8.08), 3.95(1.85-8.4) and 1.83(1.03-3.24). Age (15-25 & 26-35 years) was associated to choosing of foods for weight management with AOR (95%CI) of 2.64(1.12-6.22) and 3.52(1.66-7.43). 15-25 years’ age and self-employee were linked to religion influence in food choice with AOR (95%CI) of 0.09(0.01-0.48) and 4.13(1.4-12.24). Age (15-25 & 26-35 years), education (no, primary & secondary) and being housewife were associated to choosing of foods for their health value with AOR (95%CI) of 0.26(0.12-0.6), 0.37(0.18-0.76), 0.14(0.04-0.42), 0.25(0.13-0.54), 0.33(0.17-0.66) and 2.5(1.23-5). Avoidance of foods for nutrient content was related to age (15-25 &26-35 years) with AOR (95%CI) of 6.75(2.77-16.5) and 5.77(2.7-12.32). Primary education and being housewife were associated to ingredient contents of foods during selection with AOR (95%CI) of 0.29(0.14-0.6) and 2.24(1.15-4.35). Only family size (2-4 vs.>4 persons) was associated with price concern in food choice with AOR (95%CI) of 0.39(0.21-0.71). Primary & secondary education were associated to choosing of foods based on ethical value with AOR (95%CI) of 0.38(0.19-0.75) and 0.44(0.24-0.83). Being divorced, husband headed, 7-12 &13-18 months’ lactation period, 15-25 and 26-35 years’ age were related to preparation convenience of foods with AOR (95%CI) of 5.94(1.13-31.33), 0.42(0.18-0.96), 3.26(1.34-7.93), 4.4(1.81-10.72), 0.16(0.05-0.47) and 0.25(0.11-0.59). From multivariate analysis of multinomial logistic regression using taste as a reference; 13-18 months’ lactation period, husband, mother and father of lactating women headed were associated to choosing of foods for their smell with AOR (95%CI) of 2.92(1.45-5.87), 0.43(0.19-0.96), 0.07(0.01-0.64) and 0.12(0.02-0.76). Also, husband headed and 7-12 months’ lactation period were associated to choosing of foods for their appearance with AOR (95%CI) of 0.32(0.11-0.91) and 3.5(1.46-8.38). Religion, price & preparation convenience were the key, and mood, nutrient content & ethical concern were the least drivers of food choice among women. Most women were motivated by six basic drivers of food choice. Various socio-economic variables were associated to drivers of food choice. Self-management approaches by nutrition education & promotion to change eating behaviors of women, increasing supply & price regulation towards healthy foods are recommended.

Keywords: Motives, food choice, Lactating women

Free Full-text PDF

How to cite this article:
Gesessew Kibr, Afework Mulugeta, Tafese Bosha. Drivers of Food Choice among Lactating Women: The Case of Debrebirhan Town, North Shoa Zone, Amhara Region, Ethiopia. International Journal of Food and Nutrition Research, 2019; 3:27.


1. World Health Organization. 2007. Africa Regional Health Office: The Health of the People. The Africa regional health report.
2. Federal Ministry of Health. 2008. Program Implementation Manual of National Nutrition Program, Addis Ababa, Ethiopia.
3. Nega, T. 2010. Dietary adequacy and nutritional practice of lactating mothers in Wonsho Woreda Sidama Zone Southern Ethiopia. MSc. Thesis: College of Agriculture, Hawassa University, Hawassa. 83 PP (unpublished).
4. Ethiopia Demographic and Health Survey. 2011. Central Statistics Agency, Addis Abeba, Ethiopia.
5. Kiday, H., Afework, M. and Meron, G. 2013. Feeding practices, nutritional status and associated factors of lactating women in Samre Woreda, South Eastern Zone of Tigray, Ethiopia. Nutrition journal 12:28.
6. Ethiopia Mini Demographic and Health Survey. 2014. Central Statistics Agency, Addis Abeba, Ethiopia.
7. Temesgen, D., Habtamu, F. and Demeda, D. 2015. Nutritional status and associated factors among Lactating Mothers in Nekemte Referral hospital and health centre, Ethiopia. Food science and quality management 35 (64).
8. Hadiya,H., Samson, G., Susan, J.W. and Addisalem, M. 2016. Prevalence and factors associated with under nutrition among lactating women in Arbaminch Zuriya Woreda, SNNPR. MSc. Thesis. College of Agriculture, Hawassa University, Hawassa. 75 PP (Unpublished).
9. Fantahun, M. and Degu, G. 2004. Burden of disease in Amahra region, Ethiopia. Ethiopian Medicine Journal 42(3):165–172.
10. Central Statistical Agency. 2007. Federal Democratic Republic of Ethiopia: Household Income, Consumption, and Expenditure Survey of 2004/5. Addis: Statistical Bulletin 394 Volume I.
11. Thompson, B.K., Peck, M. and Brandert, K. 2008. Preconception Health in to public health practice. A Tale of three cities. Journal of women health 17(5):723-727.
12. Bartley, K.A., Underwood, B.A. and Deckelbaum, R.J. 2005. A life cycle micronutrient perspective for women’s health. American Journal of Clinical Nutrition 81(1):188S- 193S.
13. Moos, M.K., Dunlop, A.L., Jack, B.W., Nelson, L., Coonrod, D.V., Long, R., et al. 2008. Healthier women healthier reproductive outcome. Recommendation for routine care of all women of reproductive age. American Journal of Obstetric Gynecology 199: S280 -S289. Doi:10.1016/ajog.2008.08.060.
14. Dunneram, Y. and Jeewon, R. 2015. Healthy diet and Nutrition Education Program among Women of Reproductive Age. A Necessity of Multilevel Strategies or Community Responsibility. Health Promote Perspective 5(2): 116-127
15. Soyer, M.T., Ergink2, I. and Gursoy, S.T. 2008. Effects of social determinants on food choice and skipping meals among Turkish adolescents. Asia Pacific Journal of Clinical Nutrition 17(2): 208-215.
16. Asma, A., Nawalyah, A.G., Rokiah, M.Y. and Mohd Nasir, M.T. 2010. Comparison of Food Choice Motives between Malay Husbands and Wives in an Urban Community. Malay Journal of Nutrition 16(1): 69-81.
17. Miloševic, J., Ezelj, I.Z., Gorton, M. and Barjolle, M. 2012. Understanding the motives for food choice in Western Balkan Countries. Appetite 58፡ 205–214.
18. Suzanah, A.R., Muhammad, M., Ali, K.K. and Najibatul, R.M. 2013. Determinants of food choice among adults in an urban community: A highlight on risk perception. Emerald Group Publishing Limited 0034-6659. Nutrition and Food Science Vol. 43 (5):413-421. Doi 10.1108/NFS-07-2012-0072. www.em 4-6659.htm.
19. Sushma, R., Vanamala, N., Nagabhushana, D., Maurya, M., Sunitha, S. and Reddy, C. 2014. Food choice motives among the students of a dental institution in Mysore city, India. Annals of Medical Health Science Research 4(5):802-805.
20. Hayford, F., Steiner-Asiedu, M. and Sakyi-Dawson, S. 2015. Food Choice Behaviors among Ghanaians: Implications for Health Promotion. World Journal of Nutrition and Health 3(1): 22-28. Doi: 10.12691/jnh-3-1-4.
21. Naughton, P., Sinéad, N.M. and Mary, B.M. 2015. The creation of a healthy eating motivation score and its association with food choice and physical activity in a cross sectional sample of Irish adults. International Journal of Behavioral Nutrition and
Physical Activity. 12:74. DOI:10.1186/s12966-015-0234-0.
22. Bowen, D.J. and Hilliard, T. 2006. What is a Healthy Diet Community? In: Shepherd, R, Raats, M., (Editors). The Psychology of Food Choice 357-74. CABI Press, Oxfordshire, UK.
23. South Africa guidelines on maternal nutrition, 2008.
24. Paula, B.G. 2006. California Food Guide. Fulfilling the Dietary Guidelines for Americans. Maternal Nutrition during Lactation: pp 5-6.
25. Inskip, H.M., Crozier, S.R., Godfrey, K.M., Borland, S.E., Cooper, C. and Robinson, S.M. 2009. Women’s compliance with nutrition and lifestyle recommendations before pregnancy: general population cohort study. Bio-medical journal 338:b481. Doi:10.1136/bmj.b481.
26. Steptoe, A., Pollard, T. and Wardle, J. 1995. Development of a measure of the motives underlying the selection of food. The food choice questionnaire. Appetite 25, 267–284.
27. Hosmer, D.W. and Lemeshow, S. 2000. Applied logistic regression. US, Wiley-Interscience.
28. Sabaté, J. 2004. Religion, Diet and Research. British Journal of Nutrition 92(02): 199–201.
29. Honkanen, P. and Frewer, L. 2009. Russian consumers’ motives for food choice. Appetite 52: 363-371.
30. Izmirli, C. and Phillips, C.J.C. 2011. The relationship between student consumption of animal products and attitudes to animals in Europe and Asia. British Food Journal 113(3):436-450. Doi: 10.1108/00070701111116482.
31. Dyett, P., Sabaté, J., Haddad, E., Rajaram, S. and Shavlik, D. 2013. Vegan lifestyle behaviors. An exploration of congruence with health-related beliefs and assessed health indices. Appetite 67(1): 119–124. Doi:10.1016/j.appet.2013.03.015.
32. Cassady, D., Jetter, K.M. and Culp, J. 2007. Is price a barrier to eating more fruit and vegetables for low-income families? Journal of American Dietetic Association 107: 1909–1915. Doi:10.1016/j.fct.2009.10.031.
33. Kamphuis, C.B., De Bekker-Grob, E.W. and Lenthe, F.J.V. 2015. Factors affecting food choice of older adults from high and low socioeconomic groups: a discrete choice experiment. American Journal of Clinical Nutrition 101:768-774.
34. Ensaff, H., Homer, M., Sahota, P., Braybrook, D., Coan, S. and McLeod, H. 2015. Food choice architecture: An intervention in a secondary school and its impact on students’ plant-based food choice. Nutrients 7: 4426–4437. Doi: 10.3390/nu7064426.
35. Steenhuis, I.H.M., Wilma, E., Waterlander, D. and de Mul, A. 2011. Consumer food choice: the role of price and pricing strategies. Public Health Nutrition 14 (12):2220–2226. Doi:10.1017/S1368980011001637.
36. Woythal, R. 2015. Eating for the Environment: A Demographic Study of Consumer Food Choice and Environmental Knowledge among United States citizens. University of Colorado, Boulder, CU Scholar undergraduate honors theses. Paper 890.
37. Eertmans, A., Victoir, A., Vansant, G. and Bergh, O. 2005. Food-related personality traits, food choice motives and food intake: Mediator and moderator relationships. Food Quality and Preference 16: 714-726.
38. Pohjanheimo, T. 2010. Sensory and non-sensory factors behind the liking and choice of healthy food products western Finland consumer, ISBN 978-951-29-4157-5.
39. Reyes, N.R., Klotz, A.A. and Herring, J.S. 2013. A qualitative study of motivators and barriers to healthy eating in pregnancy for low-income, overweight, African American mothers. Journal of Academic Nutrition and Diet 113(9):1175–1181. Doi:10.1016/j. jand.2013. 05.014.
40. Deliens, T., Clarys, P., Bourdeaudhuij, I. D. and Deforche, B. 2014. Determinants of eating behaviour in university students: a qualitative study using focus group discussions, BMC Public Health 14:53.
41. Kaya, I. H. 2016. Motivation Factors of Consumers’ Food Choice. Food & Nutrition Science 7:149-154.
42. Sun, Y.H.H. 2008. Health concern, food choice motives, and attitudes toward healthy eating: The mediating role of food choice motives. Appetite 51:42–49. Doi:10.1016/j.appet.2007.11.04.
43. Elneim, E.A. 2014. Dietary habits during the postpartum period among a sample of lactating women in Sudan: Journal of Nursing and Health Science e-ISSN: 2320–1959.p- ISSN: 2320–1940; 3(1):01-06
44. Ree, M., Riediger, N. and Moghadasian, M.H. 2008. Factors affecting food selection in Canadian population. European Journal of Clinical Nutrition 62: 1255–1262. Macmillan Publishers Limited.
45. Touhy, T. and Jett, K. 2012. Toward healthy aging: human needs and nursing response. Philadelphia, PA: Mosby.
46. Higginbottom, G.M.A., Vallianatos, H., Forgeron, J., Gibbons, D., Mamede, F. and Barolia, R. 2014. Food choice and practices during pregnancy of immigrant women with high-risk pregnancies in Canada: a pilot study BMC Pregnancy and Childbirth 14:370.
47. Laitinen, J., Ellen, E.K. and Sovio, U. 2002. Stress-Related Eating and Drinking Behavior and Body Mass Index and Predictors of This Behavior. Preventive Medicine 34(1):29-33. Doi: 10.1006/pmed.2001.0948.
48. Jauregui, L. and Ríos, P.B. 2011. What motivates the consumer’s food choice? Nutr Hosp.; 26 (6):1313-1321 ISSN 0212-1611 • CODEN NUHOEQ S.V.R. 318
49. Hartmann, C., Keller, C. and Siegrist, M. 2016. Compensatory beliefs, nutrition knowledge and eating styles of users and non-users of meal replacement products.
50. Ducrot, P., Méjean, C., Allès, B., Fassier, P., Hercberg, S. and Péneau, S. 2015. Motives for dish choice during home meal preparation: results from a large sample of the Nutrition Net-Santé study. International Journal of Behavioral Nutrition and Physical Activity 12:120 .Doi 10.1186/s12966-015-0270-9.
51. Hartmann, C., Dohle, S. and Siegrist, M. 2013. Importance of cooking skills for balanced food choice. Appetite 65:125–31. Doi:10.1016/j.appet.2013.01.016.
52. Devine, C.M., Farrell, T.J., Blake, C.E., Jastran, M., Wethington, E. and Bisogni, C.A. 2009. Work conditions and the food choice coping strategies of employed parents. Journal of Nutrition Education and Behavior 41(5): 365-370.
53. Marie-Claude, P. 2005. Perceptions of Healthy Eating. Canadian Journal of Public Health S15. State of Knowledge and Research Gaps.
54. Hearty, A.P., McCarthy, S.N., Kearney, J.M. and Gibney, M.J. 2007. Relationship between attitudes towards healthy eating and dietary behaviour, lifestyle and demographic factors in a representative sample of Irish adults. Appetite1:1–11.
55. Nestle, M., Wing, R., Birch, L., Disogra, L., Drewnowski, A., Middleton, S., Sigman, G.M., Sobal, J. et al. 2009. Behavioral and Social Influences on Food Choice. Nutrition Reviews 56 (5): 50–64. Doi:10.1111/j.1753-4887.1998.tb01732
56. Cox, D.N. and Anderson, A.S. 2004. Food choice. Public Health Nutrition, Blackwell Science, Oxford.
57. Ricciuto, L., Tarasuk, V. and Yatchew, A. 2006. Socio-demographic influences on food purchasing among Canadian households. European Journal of Clinical Nutrition 60: 778-790. Doi:10.1038/sj.ejcn.1602382.
58. Contento, I.R., Willams, S.S., Michela, J.L. and Franklin, A.B. 2006. Understanding the food choice process of adolescents in the context of family and friends. Journal of adolescent health 38(5):575-582.
59. Janssen, M., Busch, C., Rodiger, M. and Hamm, U. 2016. Motives of consumers following a vegan diet and their attitudes towards animal agriculture.
60. Alencar, B., Toral, N., Recine, E. and Rizzolo, A. 2016. Factors related to food involvement in the adult population. Review of Nutrition, Campinas 29(3):337-345.
61. Agarwalla, R., Sakia, A. and Baruah, R. 2014. Assessment of the nutritional status of the elderly and its correlates. Journal of Family and Community Medicine 22 (1): 39–43.
62. Daniels, S., Glorieux, I., Minnen, J. and Van Tienoven, T.P. 2012. More than preparing a meal? Concerning the meanings of home cooking. Appetite 58:1050–1056.Doi:10.1016/j.appet.2012.02.040.
63. Van der Horst, K., Brunner, T.A. and Siegrist, M. 2011. Ready-meal consumption: associations with weight status and cooking skills. Public Health Nutrition 14(2): 239-245. Doi:10.1017/S1368980010002624.