Abstract
BACKGROUND: Understanding how individuals currently perceive healthy eating is essential for developing food policies and dietary recommendations that improve the health and well-being of populations. The purpose of this qualitative evidence synthesis was to systematically outline the views and understandings of healthy eating, focusing on how foods are classified as healthy and unhealthy and what meanings are attached to food and eating by the general adult population in high-income countries. METHODS: A systematic search of four electronic databases was conducted and yielded 24 relevant primary qualitative studies of generally healthy, community-dwelling adults. RESULTS: Thematic synthesis of the included studies identified three analytic themes: constructions of healthy and unhealthy eating, considerations on dietary recommendations, and meanings attached to food and eating. Study participants generally understood what constitutes a healthy and unhealthy diet which was in line with dietary recommendations, but those of lower socioeconomic status exhibited gaps in nutrition knowledge. Participants expressed diverse opinions on dietary recommendations, including skepticism and a lack of trust. Food and eating were associated with various meanings, including pleasure, stress relief, and feelings of guilt. Moral, health, and sociocultural considerations also played a role in dietary behaviors. CONCLUSIONS: The findings suggest that improving population diet requires considering how dietary recommendations are phrased and communicated to ensure that healthy eating is associated with pleasure and immediate well-being. This review provides valuable insights for developing consumer-oriented, practicable, and acceptable food policies and dietary recommendations that effectively improve population health and well-being.