Perceptions and barriers to dietary fiber intake among middle-aged south Indian women: A qualitative study

Dietary fiber plays a critical role in preventing non-communicable diseases (NCDs), yet intake remains low among many Asian women. In India, the average dietary fiber intake is approximately 15-20 g/day, substantially below the recommended range of 25-30 g/day, and fewer than 10-15% of adults meet the recommended daily fiber intake. Rapid urbanization and changing food environments, including increased availability of ultra-processed foods and affordability challenges, may reduce consumption of fiber-rich foods such as whole grains, fruits, and vegetables.In South Asian households, women play a central role in food purchasing and preparation, but time constraints, economic, and household responsibilities may influence dietary behaviors and fiber intake. This qualitative study aimed to explore the perceptions, barriers, and enabling factors influencing dietary fiber consumption among middle-aged South Indian women, specifically comparing those with high versus low fiber intake patterns.An exploratory qualitative design was employed, utilizing in-depth, semi-structured interviews with 13 purposively sampled women (aged 35-55) from a tertiary care hospital in South India. Participants were categorized into high-fiber (n = 7, ≥ 20 g/day) and low-fiber (n = 6, < 20 g/day) groups based on 24-hour dietary recall. Data, collected in Kannada and transcribed verbatim, were analyzed thematically using NVivo 15, adhering to COREQ guidelines.Six major themes emerged: cultural/routine-based preferences, dietary practices/behaviours, economic influences, knowledge-related factors, physical activity/lifestyle constraints, and psychosocial determinants. High-fiber consumers exhibited greater dietary awareness, structured meal planning, adherence to traditional practices, and stronger family support. In contrast, low-fiber consumers faced time constraints, limited nutritional knowledge, reliance on convenience foods, and greater psychological strain, often compromising dietary quality.Dietary fiber intake among South Indian women is shaped by complex interactions of cultural norms, socioeconomic status, lifestyle, and psychosocial factors, transcending mere nutritional knowledge. Interventions must be culturally sensitive, gender-responsive, and address systemic barriers, empowering women to improve family nutrition and combat NCDs effectively.