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COLLEGE-AGE WOMEN'S PERCEPTIONS OF DAIRY FOODS

Volume 5, No. 1, Spring 2000

Carolyn A. Weiglein, Denise Brochetti, and Susan E. Duncan

Abstract

Focus groups were conducted with 28 young Caucasian women (ages 19-22 years) to gain insight into their thoughts and feelings toward dairy foods. Women were enrolled in state-funded universities in Virginia. Themes characterizing the group discussions were identified. Women knew that dairy foods were good sources of calcium and discussed calcium in relation to osteoporosis, which they thought was a disease affecting older women. Many used calcium supplements to help meet their calcium requirements. Most thought dairy foods were high in fat. Women said their mothers encouraged them to eat dairy foods throughout their lives. They discussed dairy foods they liked and disliked and indicated that sensory attributes, especially taste, were involved.

Introduction

Osteoporosis is a chronic disease characterized by a decrease in bone mineral density and an increase in the risk of fractures. The American Dietetic Association reported that osteoporosis is one of the five leading nutrition-related causes of morbidity and mortality in North American women (Affenito & Kerstetter, 1999). Of the 25 million Americans who have it, 80 percent are women with Caucasian and Asian women being at high risk. Although older adults suffer from its symptoms, its development is lifelong. To prevent osteoporosis, peak bone mass must be achieved in the first two decades of life, and bone loss must be reduced throughout adulthood. A calcium-rich diet and regular weight-bearing exercise are needed to build and maintain bone mass (National Institutes of Health, 1994). National surveys indicate that young women have suboptimal intakes of calcium and consume less than the recommended number of servings of dairy foods daily (Aliamo et al., 1994; Guthrie, 1996).

Nutrition education programs are needed to help women achieve adequate calcium intakes. To be effective, these programs should be based on needs, behaviors, and motivations of the target audience (Shaffer et al., 1996). Focus groups are instrumental in obtaining this type of information (Lefebvre et al., 1995). Because dairy foods are the principal source of calcium in the American diet, it is necessary to understand women's thoughts and feelings toward dairy foods (Fleming & Heimbach, 1994).

Many factors might motivate young women to consume dairy foods. Finn (1997) reported that women's consumption of dairy foods has decreased during the past few decades because they feel that dairy foods are high in fat. Neumark-Sztainer et al. (1997) found that adolescent females who were chronic dieters consumed fewer dairy foods than infrequent dieters or non-dieters. Barr (1994) found that taste, peers, and family members influenced milk consumption among female adolescents.

The study reported in this article is part of an ongoing project to understand dairy food choices of women of various age and ethnic groups in Virginia. The goal is to develop strategies for improving their dairy food consumption through nutrition education and product development. To date, focus groups have been conducted with various age groups of women to identify what they perceive as health benefits of dairy foods, barriers to consuming dairy foods, and factors that influence dairy food choices. Eddy et al. (1999) conducted focus groups with older Caucasian women (ages 65-89) who lived in retirement communities and had at least a high school education. Results indicated that nutrients in dairy foods, taste of dairy foods, packaging, cost, and labeling of dairy products were important to older women. However, their feelings toward those characteristics pertained to health concerns, physical limitations, fixed incomes, and small households. In this article, results of focus groups with young Caucasian women (ages 19-22 years) are reported.

Methods

Two pilot tests followed by four focus groups (6-8 women/group) were conducted. Pilot testing was done with young women to develop questions and procedures. A series of open-ended questions, based on questions developed by Eddy et al. (1999) for use with older women, were tested. Logical sequential flow, clarity of the questions, and ability of the questions to elicit appropriate information were examined. Final procedures and questions (Table 1) were developed to conform with specifications described by Krueger (1994). The study was approved by the Institutional Review Board for Research Involving Human Subjects at a southeastern land grant university. Informed consent was obtained from all subjects prior to their participation in either a pilot test or focus group discussion. None of the subjects were paid for their participation in the groups.

Caucasian women, ages 19-22 years, were recruited from four state-funded universities in Virginia, one from the northern, eastern, central, and southern regions. Women were invited to participate in the groups via personal contacts at the universities. One focus group was held at each university, and each group met only once. The women were students, but none of the women were nutrition, dietetics, or food science majors. The primary author served as moderator of each group; an assistant was present to take notes and audio-tape the discussions. Discussions began with an overview of the topic and ground rules. Next, women ranked and discussed four factors (convenience, healthy, economical, and tastes good) important to their food choices (Table 1) to start them thinking about their choices. Next, women generated lists of dairy foods to help focus them on a variety of dairy foods throughout the discussions. The series of open-ended questions developed during pilot testing then were asked (Table 1). Discussions lasted approximately 1 hour; women completed a socio-demographic questionnaire at the end. The research team held a debriefing session after each group to discuss overall impressions and identify emerging themes (Krueger, 1994).

Data generated from the focus group discussions were analyzed according to procedures described by Knodel (1993). Written transcripts were prepared for each discussion from the audio recordings. A word processing program was used to transcribe participants' responses directly from the recordings. An assistant analyst reviewed all written transcripts to verify that recordings had been transcribed accurately. Data in the transcripts then were analyzed to identify themes characterizing the discussions. As recommended by Knodel (1993), preliminary codes were generated for use in the initial stages of analyzing the data and were based on objectives of the study and key ideas identified from focus group notes and summaries. These codes were used for grouping similar responses from the transcripts. As the primary researcher progressed through the analysis, preliminary codes were refined (Krueger, 1994). After completing the analyses, the research team met to discuss results until consensus was reached and final codes were developed. Final codes represented themes of the focus group discussions.

Results and Discussion

Socio-demographic characteristics of women in the groups are presented in Table 2; themes characterizing the discussions are presented in Table 3. Focus group results are reported according to the interpretive summary method, described by Krueger (1994), in which themes are explained in terms of the women's thoughts and feelings. Some responses from the women are given in quotes to help explain the themes. Because focus group data are qualitative, adjectival phrases, such as "most women" or "few women," are used in reporting results (Krueger, 1994). Results of all groups are reported collectively because researchers were interested in thoughts and feelings common to this sample of women.

Nutrition/Health Perceptions of Dairy Foods

Nutrition/Health Benefits

Women thought calcium was the major health benefit of dairy foods, but they discussed it only in relation to milk. They knew that calcium was important for bone strength as evident in responses such as, "Doesn't it increase bone density? Is that it? So that just makes your bones stronger and healthier." However, this might not influence their dairy food consumption as evident in the following: "I always heard calcium was good for your bones, but other than that, I really don't think about it." Many said they would be more concerned with their dairy food consumption at their grandmother's age for reasons such as, "I just have this feeling that you may just be a little more conscious of it, like oh my hip needs it." and "To maintain your bones, you need to get a lot more calcium then." None of the women mentioned dairy foods as sources of protein, vitamins, and minerals other than calcium, but only a few had taken a college-level nutrition course (Table 2).

When the women were asked to discuss the advantages of dairy foods (Table 1), many mentioned calcium for osteoporosis prevention. When they were asked to discuss osteoporosis, many indicated it was a disease afflicting older women as the following illustrate: "I picture a little old lady who's just bent over." and "...old people that can't walk." Some did not seem concerned with developing osteoporosis for reasons such as, "I don't think I'm at risk at all, maybe I am, but I just don't even think about it" and "I don't really think about that either, because I just like milk so much that I don't really think I'm affected." The women's discussions of calcium and osteoporosis indicate that they do not seem to understand that osteoporosis begins early in life.

Eddy et al. (1999) found that older Caucasian women in Virginia knew that dairy foods were good sources of calcium, but none identified other nutrients as health benefits. The women knew that calcium was important in osteoporosis prevention; some had osteoporosis, and others were concerned about developing it.

Vitamin and Mineral Supplementation

Many women discussed taking vitamin/mineral supplements, although they said they did this irregularly. Other researchers also have reported that young women use supplements sporadically (Eldridge & Sheehan, 1994). Many felt the use of supplements was a good health practice for reasons such as, "I take vitamin C because I don't eat as much fruit at school as I do during the summer at home." and "I knew I wasn't eating as good as I should've been. I figured I wasn't getting the proper vitamins and stuff." Some said they took calcium supplements because they did not eat enough dairy foods, and others said their mothers encouraged them to take supplements as evident in the following: "My mom sends calcium supplements to me, and I willingly take them, so it works out. I get the calcium, and it's her peace of mind."

Eddy et al. (1999) reported that older Caucasian women were very knowledgeable of calcium supplements. They were able to discuss dosages, types, and brands of supplements. Many said they used supplements because they either could not get enough calcium from dairy foods or preferred to get calcium from supplements.

Disadvantages of Dairy Foods

Women said fat was the major disadvantage of dairy foods, and this is consistent with what other researchers have reported (Finn, 1997; Neumark-Sztainer et al., 1997). Women discussed their concern with fat in general. Many indicated that they followed a low-fat diet (Table 2), which was self-imposed. Women seldom discussed the cholesterol, sodium, and lactose in dairy foods. The emphasis placed on fat suggests that this disadvantage might outweigh the perceived benefits of dairy foods.

Many said they did not eat some dairy foods because of fat as the following illustrate: "I love cheese. I just don't eat it because it's got so much fat" and "I never eat real ice cream because it's got so much fat." Women frequently discussed fat-free dairy foods such as, "I only eat fat-free cheese." and "I usually, like, buy a big gallon of skim milk." Interestingly, some considered high fat dairy foods as treats they ate in restaurants, for example, "...cheesecake only when I go to fine dining," and "If I go to a restaurant that has tiramisu, I get it all the time."

Women were asked to discuss dairy foods they thought they would eat when they reached their mothers' and grandmothers' ages (Table 1). Many said they would be more concerned with fat in dairy foods at their mothers' age because, "I'll probably cut back on ice cream, um, because I'll probably be less active" and "...probably the same things, but probably in moderation, because after having kids you gain weight." However, many said they would be less concerned with fat at their grandmother's age because, "I think I'd be eating a lot more fatty stuff by then because I will have kept my girlish figure up until then, and then I'll be about ready to let go." and "I think I'll eat whatever I want, because it won't really matter by then, like whatever seems good." The women's discussion of fat indicates they associate fat intake with weight gain. It also suggests that they might not be concerned with the chronic diseases that occur with age and impose dietary restrictions.

Eddy et al. (1999) reported that older Caucasian women thought fat was the major disadvantage of dairy foods. They discussed the need to lower fat in their diet; many followed a diet prescribed by their physicians. Diets usually included reductions in fat, cholesterol, sodium, and/or calories. They knew how to reduce their fat intake by altering recipe ingredients and by using reduced-fat products.

Young women also were concerned with the safety of dairy foods. Several said they did not order milk in restaurants because they were unsure of how it was handled: "It's scary to think how long it's been sitting out." Some had negative feelings regarding the use of additives in dairy foods as the following illustrate: "I don't think you should mess with food. I mean, like, putting chemicals and stuff to make dairy foods less fatty or breeding cows." and "...all those preservatives. I'm sure it is doing worse stuff to me. There's real benefits to the calcium; they're probably taking away from it."

Influences on Dairy Food Choices

Family Members

Women discussed their mothers' influences on their dairy food consumption. They said their mothers encouraged them to eat dairy foods, particularly milk and yogurt, throughout their lives. Some discussed their mothers' habits; for example, a few mentioned that their mothers ate cottage cheese frequently, so they felt they would do the same at that age. Some mentioned their mother's concern with osteoporosis as the following illustrates: "Now my mom's going through menopause, and she's constantly complaining about how her bones are going to break." Women discussed dairy foods in relation to other family members less frequently, and this usually focused on their fathers' need to switch from whole to skim milk to reduce fat intake.

Eddy et al. (1999) found that physicians influenced dairy food choices of older women. Women said their physicians recommended that they avoid certain dairy foods due to the fat, cholesterol, and/or sodium in those foods. They said their physicians recommended calcium supplements to help them meet their calcium needs.

Media Campaigns

Women were asked to recall and discuss dairy food advertisements (Table 1). They readily recalled advertisements in the Got Milk?; Milk, It Does A Body Good; Cheese to the Rescue; and Milk Mustache campaigns, but feelings about these were mixed. Some thought the advertisements were funny, which captured their attention. Others disliked the advertisements, especially the Milk Mustache. They indicated it had a negative effect on their feelings toward milk, for example, "It's so ugly...... It makes you just not want to drink milk." and "It doesn't make me want to drink milk, like, it's not a realistic thing, the mustache."

Dairy Product Characteristics

Women discussed dairy foods they liked and disliked and frequently indicated that sensory attributes were involved. Taste was particularly important to their dairy food and other food choices because, "I definitely want to have a good balanced meal, but it's not as important as if it tastes good." and "...because why eat it if it doesn't taste good?" Women mentioned texture and aroma primarily when discussing dairy foods they dislike, for example, "Cottage cheese is disgusting. The texture, I don't like even thinking about it." and "I don't like cream soups. I don't like having it all creamy." Many mentioned texture as the reason they did not drink whole milk, as evident in the following: "Whole milk is too thick." and "It, like, will stick to my mouth."

Women discussed dairy foods that made them "happy" or "feel good" as the following illustrate: "...and ice cream, I have to have everyday or else I go into some kind of withdrawal. Well, it's like, such a happy thing, it's not that it's milk or whatever, but yeah it tastes good and it makes me feel really good, and so I have to have it." and "I eat frozen yogurt now, especially because it's hot out. You go outside after lunch and you automatically have to have a cone in your hand. It's cold, and I don't know, it's just good, soothing." A few felt that milk complemented certain foods, for example, "But when you have a brownie, you know, you have to drink 2 percent, at least."

Women discussed cost and convenience of dairy foods less frequently than sensory characteristics, but this was expected because many had university meal plans (Table 2). Those who had plans said they were not concerned with cost because, "Mom and Dad pay for it." Women who felt convenience was important explained this was due to a fast-paced lifestyle as the following illustrates: "I eat yogurt a lot because I'm always on the run, and you can get it easily."

Implications

The study provided rich descriptive information regarding young women's thoughts and feelings toward dairy foods. Results are based on a small sample of Caucasian women in Virginia; therefore, generalizations cannot be made to all groups of young women. However, results provide insight regarding young women's dairy food choices, and nutrition educators might investigate these further in their efforts to develop programs.

Women in this study knew that calcium was important in the prevention of osteoporosis; however, they emphasized supplements rather than dairy foods in prevention. They discussed calcium in relation to milk and fat in relation to other dairy foods. Most did not mention the other essential nutrients found in dairy foods. Nutrition educators might consider designing programs that emphasize dairy foods not only as important sources of calcium but also as an essential part of a balanced diet.

Because the women were very aware of dairy food advertisements, the media could be used to deliver nutrition messages on dairy foods and osteoporosis. Educators might work with the dairy industry to research and develop nutrition messages that appeal to young women. The mother-daughter relationship might be portrayed in those messages as mothers seemed to have had a prominent influence on the young women's dairy food choices. Because the women thought osteoporosis was a disease affecting older women, the grandmother-granddaughter relationship might be portrayed as well. Focusing messages on relationships with mothers and grandmothers also might help young women understand that the development of osteoporosis is lifelong. Finally, some messages could focus on the sensory characteristics of food and on dairy foods as comfort foods (e.g., foods that make them "happy" or "feel good") as these were important to their dairy food preferences.

Table 1. Line of Questioning Used In Focus Group Discussions of Dairy Foods with Young Women

  1. Activity. Participants were asked to indicate which of the following was the most important reason for choosing foods: convenience, healthy, economical, and tastes good.
  2. Activity. Participants were asked to list a variety of dairy foods.
  3. Tell me about some dairy foods that you ate regularly over the past few months.
  4. Tell me about some of the dairy foods you seldom or never eat.
  5. What are some of the benefits of dairy foods?
  6. What are some of the disadvantages of dairy foods?
  7. Tell me about some of the dairy foods you ate as a child (as a teenager).
  8. Think about yourself when you are your mother's (grandmother's) age. What dairy foods do you think you will be eating then?
  9. How do you think dining halls (restaurants) could improve the types of dairy foods available?
  10. What does osteoporosis mean to you?
  11. Tell me about calcium supplements. (What are some reasons you take them?)
  12. Think about some of the dairy food advertisements you have seen. Tell me about them and what the advertisements say to you.

Table 2. Socio-demographic Characteristics of Young Women Participating in Focus Groups

Characteristic
n
Living arrangements
Alone
1
With Others
27
Housing
Dormitory
9
Apartment
19
University Meal Plan
Yes
16
No
12
Diet Plan
No
14
Yes
14
Low fat
10
Low cholesterol
4
Low sodium
2
Low calorie
6
Vegetarian
4
Vitamin/mineral supplements
Take
14
Do not take
14
College nutrition course
Taken
3
Not taken
25

Note: n=28 Caucasian women ages 19-22 years.

Table 3, Themes Characterizing Focus Groups with Young Women

Results based on four focus groups with a total of 28 Caucasian women, ages 19-22 years.

References

Affenito, S.G., & Kerstetter, J. (1999). Position of The American Dietetic Association and Dietitians of Canada: Women's health and nutrition. Journal of The American Dietetic Association, 99:738-751.

Aliamo, K., McDowell, M.A., Briefel, R.R., Bischof, A.M., Caughman, C.R., Loria, C.M., & Johnson, C.L. (1994). Dietary intake of vitamins, minerals, and fiber of persons ages 2 months and over in the United States: Third National Health and Nutrition Examination Survey, phase I, 1988-91. Advance Data, November 14: 258.

Barr, S.I. (1994). Association of social and demographic variables with calcium intakes of high school students. Journal of The American Dietetic Association, 94:260-266, 269.

Eddy, K.T., Brochetti, D., & Duncan, S.E. (1999). Older women's perceptions of dairy foods. Journal of Nutrition for the Elderly, 18(4):37-53.

Eldridge, A.L. & Sheehan, E.T. (1994). Food supplement use and related food beliefs: Survey of community college students. Journal of Nutrition Education, 26:259-265.

Finn, S. C. (1997). Women in the new world order: where old values command new respect. Journal of The American Dietetic Association, 97:475-480.

Fleming, K.H. & Heimbach, J.T. (1994). Consumption of calcium in the U.S.: Food sources and intake levels. Journal of Nutrition, 124:1426S-1430S.

Guthrie, J.F. (1996). Dietary patterns and personal characteristics of women consuming recommended amounts of calcium. Family Economics and Nutrition Review, 9:33-49.

Knodel, J. (1993). The design and analysis of focus group studies: A practical approach. Ch. 3 in Successful Focus Groups, D.L. Morgan (Ed.), p. 35-50. Newbury Park, CA: Sage Publications, Inc.

Krueger, R.A. (1994). Focus Groups: A Practical Guide for Applied Research, 2nd ed. Thousand Parks, CA: Sage Publications, Inc.

Lefebvre, R.C., Lurie, D, Saunders-Goodman, L., Weinberg, L., & Loughrey, K. (1995). Social marketing and nutrition education: Inappropriate or misunderstood? Journal of Nutrition Education, 27:146-150.

National Institutes of Health. (1994). Optimal Calcium Intake. NIH Consensus Statement, 12:1-31.

Neumark-Sztainer, D., Story, .M, Dixon, L.B., Resnick, M.D., & Blum, R.W. (1997). Correlates of inadequate consumption of dairy products among adolescents. Journal of Nutrition Education, 29:12-20.

Shaffer, L,, Gillespie, A., Wilkins, L., & Borra, S.T. (1996). Position of The American Dietetic Association: Nutrition education for the public. Journal of The American Dietetic Association, 96:1183-1187.

Acknowledgements

Funding for this study was provided by the Agricultural Experiment Station and by the Center for Gerontology, Virginia Polytechnic Institute and State University, Blacksburg.

Authors

Carolyn A. Weiglein, MS, Dietitian, Medical University of South Carolina, Charleston, SC, (843) 769-5848. Previous Affiliation: Graduate Assistant, Department of Human Nutrition, Foods and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24061-0430

Denise Brochetti, PhD, RN, Assistant Professor, Department of Human Nutrition, Foods and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061-0430; (540) 231-9048; Fax: (540) 231-3916; brochett@vt.edu

Susan E. Duncan, PhD, RD, Associate Professor, Department of Food Science and Technology, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061-0418; (540) 231-8675; duncans@vt.edu

Cite this article:

Weiglein, Carolyn, Denise Brochetti, and Susan E. Duncan. "College-age women's perceptions of dairy foods." The Forum for Family and Consumer Issues 5.1 (2000): 27 pars. 31 March 2000.

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