Perceptions of the Three Dietary Patterns of the 2020–2025 United States Dietary Guidelines Among African American Adults After a 12-Week Randomized Intervention Trial to Reduce Type 2 Diabetes Risk: A Qualitative Study

Background: The United States Dietary Guidelines (USDG) form the basis of federal nutrition programs/policies for Americans. There has been little work to ensure that the presentation of the USDG are culturally acceptable and relevant for African Americans (AAs). This study aimed to explore the acceptability and perceptions of a randomized intervention among AA adults adhering to unmodified dietary patterns outlined in the USDG (Healthy US, Mediterranean, Vegetarian). Methods: Qualitative focus groups were conducted with participants from a USDG-based intervention, the Dietary Guidelines: 3 Diets study (DG3D). Six focus group discussions were conducted with AA adults in the Southeastern US in December 2021, after completion of the 12-week DG3D intervention. Verbatim transcripts were coded thematically and analyzed in Nvivo12 using an iterative constant comparative method. Results: Participants (n = 42; median age 52 years, range 26–65, 16 Healthy US, 17 Mediterranean, 9 Vegetarian) shared their perspectives and experiences adopting USDG dietary patterns and reported barriers and facilitators to adopting dietary change. Discussions elicited insights into the cultural relevance of the USDG and dietary intervention. Participants also described their recommended changes to the USDG-based intervention to enhance program implementation and successful dietary change. Conclusions: Study findings suggest that adaptations to the USDG dietary patterns are needed to ensure cultural relevance for AA adults in the US. This study can inform the development of culturally relevant dietary guidelines and intervention programs.