Dietary transition among Sub-Saharan Africa women post-immigration and during pregnancy

Background Black immigrant women experience high risks for maternal complications, and some of these complications are related to dietary outcomes. This study aimed to explore Sub-Saharan African (SSA) pregnant women's dietary patterns and dietary transition post-immigration and during pregnancy. Methods We used a narrative design with a Photovoice approach and collected data through semi-structured interviews, digital food diaries, and Photovoice interviews. We recruited eleven participants (n = 11) through community gatekeepers and analyzed data using a constructivist grounded theory approach with constant comparative methods. Results The changes in food processes and participants' reactions to these changes generated a dietary transition model with three stages: perplexity, deliberation, and acceptance. (1) Perplexity was caused by different food characteristics such as taste, texture, and options. (2) Participants described deliberation as a process of deciding the kind of foods/cooking styles that would be an integral part of their regular diet. All participants opted for what they referred to as the 'African diet.' (3) Acceptance was characterized by participants' resolve to figure out how to make their chosen types of food and eating habits 'work' for themselves and their families. Conclusion This study emphasizes the importance of having a sense of self-efficacy, a positive attitude, and community support in enabling migrant women to navigate dietary transition until they are satisfied with newly constructed eating habits. This determination, along with community support and persistent connection to their home culture, might help immigrants resist dietary acculturation and maintain healthy cultural eating habits, which is particularly important during pregnancy, given the impact of diet on maternal and neonatal outcomes. These findings underscore the need for collaborating with migrants from SSA to develop culturally tailored dietary interventions focused on each stage of dietary transition. Future studies should include focus group discussions to leverage women's shared experiences and create knowledge/information exchange opportunities.