The Open Nutrition Journal

ISSN: 1874-2882 ― Volume 14, 2020

A Questionnaire-based Assessment of Dietary Adherence and Identification of Barriers to Healthy Eating

Karen S. Bishop1, 2, *, Weiming Yi2, Isabella Piper-Jarrett1, Marcus A. Henning3
1 Discipline of Nutrition and Dietetics, School of Medical Sciences, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
2 Auckland Cancer Society Research Centre, School of Medical Sciences, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
3 Centre for Medical and Health Sciences Education, School of Medical Sciences, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.



Adherence to a Mediterranean-style diet is associated with an extensive list of health benefits for people both with and without a disease.


The objective of this study was to develop/modify a questionnaire to investigate the current adherence to a Mediterranean-style dietary eating pattern amongst the New Zealand male population, and to assess the association between perceived barriers to change and behaviours.


The development of this questionnaire was based upon a modified 14-point validated Mediterranean diet adherence screener (PREDiMED) and included an additional section wherein we explored the reasons behind men’s food choices and barriers to healthy eating. Questionnaires were analysed from 295 men. Descriptive analyses were used to determine major barriers to change.


The modification of the PREDiMED questionnaire resulted in a 23 question questionnaire encompassing adherence, demographics and barriers to change. We found that 90.8% of respondents had either low or intermediate adherence to a Mediterranean style diet. Significant associations also existed between adherence and smoking (p=0.003), age (p< 0.01) and opinion of the importance of healthy eating (p< 0.01). We found participants felt the ‘major’ barrier to consume a healthy diet, to be a busy lifestyle, and the most common influencer of food choices was people.


Through identifying how New Zealand men consume food and how they consider their barriers to change, we can better direct policy to aid changes in behaviour and integrate the Mediterranean style diet to complement the New Zealand food culture.

Keywords : Questionnaire, PREDiMED, Mediterranean style diet, Barriers to change, Busy lifestyle, Men, New Zealand.

Article Information

Identifiers and Pagination:

Year: 2019
Volume: 13
First Page: 1
Last Page: 15
Publisher Id: TONUTRJ-13-1
DOI: 10.2174/1874288201913010001

Article History:

Received Date: 02/02/2019
Revision Received Date: 30/03/2019
Acceptance Date: 02/04/2019
Electronic publication date: 31/05/2019
Collection year: 2019

© 2019 Bishop et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand; Tel: +6499234471; Email:

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