Madrid immigrants' perceptions of urban food environments and their dietary behaviours.

Large cities are home to several groups of immigrants who undergo important changes in their environmental conditions and lifestyles that significantly modify their risk of chronic diseases. Quantitative evidence indicates that both their health and diet worsen over time; much less is known about the qualitative mechanisms that cause these changes. The aim of this article is to understand how immigrants in the city of Madrid perceive the relation between the urban food environment and dietary behaviour. Based on a Social Ecological Framework, we conducted a secondary qualitative analysis derived from data from 41 immigrant residents, collected in eight focus groups (FGs), conducted in two neighbourhoods in the city of Madrid. We identified the following main categories: 1) Transnational identity and dietary behaviour in the neighbourhood; 2) Transitions in dietary behaviour; and 3) Societal/structural factors determining dietary behaviour in the neighbourhood. The participants in the FGs mentioned that they try to maintain traditional dietary customs and perceive that the taste of their typical dishes is better than those of Spanish dishes. Contradictorily, some participants considered their traditional dietary patterns to be less healthy than Mediterranean ones (consuming olive oil, vegetables, fish). Some participants acknowledged having adapted to the latter voluntarily or through dietary negotiations with their children. Immigrant families with two working parents have difficulties cooking homemade food and resort to less healthy options, such as eating fast food or ready-made meals. Due to their low purchasing power, they buy both ethnic products and other products, as well as considering the prices and offers in supermarkets. Our study highlights several structural mechanisms connecting the physical and social urban food environment with dietary behaviours among immigrant residents of a large city.