Women’s Perception of and Readiness to Adopt A Healthy and Sustainable Diet: A Cross-Sectional Survey in Enugu City, Nigeria

Background: Perceived benefit of and readiness to adopt healthy and sustainable diets (HSDs) is under-investigated in low-resource countries. We assessed women’s perceived benefit of and readiness to adopt HSDs and their associated factors in Enugu Metropolis, Nigeria. Methods: A household cross-sectional survey of childbearing age women (n = 450) was conducted in January and February 2021 using a questionnaire assessing food choice motives, perceived benefit, and readiness to adopt HSDs. Readiness to adopt HSDs was grouped into pre-contemplation and contemplation (PC/C), preparation and relapse (P/R), and action and maintenance (A/M). Data were analysed using univariate and bivariate statistics and multinominal logistic regression. Statistical significance was set at alpha 0.05 level. Results: About 79% and 60% of women have high perception and adopted HSDs respectively. Perceived benefit of HSD was associated with younger age (β = -0.20, ρ < 0.05), low education (β = -0.19, ρ < 0.05), and poor wealth quintile (β = -0.57, ρ < 0.001). PC/C was predicted by low perceived benefit (OR = 10.07, 95% CI: 4.78-21.22, ρ < 0.001), low education (OR = 2.51, 95% CI: 1.25-5.04, ρ = 0.010), and prioritising taste as a food choice motive (OR = 3.96, 95% CI: 1.61-9.75, ρ = 0.003). PR was predicted by low perceived benefit (OR = 3.92, 95% CI: 1.99-7.73, ρ < 0.001), low education (OR = 1.82, 95% CI: 1.00-3.29, ρ = 0.049). A/M was related to younger age (OR = 0.48, 95% CI: 0.27-0.84, ρ = 0.010, PR), and stating health as a food choice motive (OR = 0.14, 95% CI: 0.06-0.36, ρ < 0.001, PC/C) and (OR = 0.17, 95% CI: 0.08-0.35, ρ < 0.001, P/R). The foregoing findings notwithstanding, significant differences exist in the predictive factors associated with perceived benefits of and readiness to adopt individual healthy and sustainable dietary behaviours. Conclusions: Readiness to adopt HSDs need to improve in Enugu, Nigeria. We identified the factors that should inform dietary guidelines and campaigns to increase women's readiness to adopt HSDs.