Navigating ambivalence: perspectives on healthy eating habits and readiness for change among Swedish men with prediabetes

Abstract

Background Type 2 diabetes accounts for over 90% of all diabetes cases and continues to rise globally, with projections reaching 853 million adults by 2050. Prediabetes, a key risk state, offers a critical window for prevention, as lifestyle changes can reduce progression to type 2 diabetes by nearly 50%. Despite clear guidelines emphasizing diet and physical activity, adherence remains challenging due to socioeconomic, cultural, and behavioral barriers. Aim The aim of this study was to explore men’s attitudes toward managing their diet and lifestyle after being diagnosed with prediabetes. Methods A qualitative study used individual and group interviews with 21 Swedish men aged 60–72 with prediabetes, recruited from the Swedish CArdioPulmonary bioImage Study (SCAPIS) cohort via convenience sampling. Data collected from May to August 2025 through Microsoft Teams included open-ended questions. Interviews were audio-recorded and transcribed. Analysis followed Graneheim and Lundman’s qualitative content analysis. Results The men recognized the importance of healthy habits but doubted they could maintain lasting change. This ambivalence was caused by personal limitations and a focus on short-term goals. Some men sought support from family or friends, moving from contemplation to preparation. Learning from successes and setbacks, they gained a more realistic view of their ability to change. The analysis identified one main theme, “Grasping the message about healthy habits but still doubting one’s ability to change”, and two additional themes, each with three subthemes. Conclusion Men with prediabetes know how to eat healthy but struggle to turn knowledge into habits. Emotional distress, ambivalence, and triggers often undermine motivation. Short-term goals like weight loss dominate over long-term strategies. Yet, men seek social support and engaging activities, showing readiness for change. Implications Interventions should target psychological barriers, use social networks, and offer practical strategies for lasting lifestyle changes.