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This is a straightforward cross-sectional study of health services to assess the prevalence of perception of difficulties in ensuring a healthy diet, associated factors and respective motives among a sample of 1,246 adult and elderly primary care users. The prevalence of perception of difficulties was 31.1% (95% CI 28.5-33.6) and associated factors were female gender (PR = 1.69; 95% CI 1.28-2.25), adulthood (PR = 1.33; 95% CI 1.11-1.59), income, with the most marked effect in the highest quintile (PR = 0.63; 95% CI 0.47-0.83), a higher number of self-reported chronic diseases (PR = 1.31; 95% CI 1.03-1.67), food insecurity (PR = 2.28; 95% CI 1.93-2.69), not receiving food guidance (PR = 0.75; 95% CI 0.63 to 0.89) and not reading food labels (PR = 1.42; 95% CI 1.08-1.86). Among those who had difficulties, the reasons mentioned were high cost of foods considered to be healthy (57.6%), insufficient willpower (49.4%), need to give up food considered unhealthy (41.6%), lack of time (35.7%) and insufficient knowledge (31.3%). The results show the importance of the awareness of health professionals about the difficulties of users and the need for adequate actions to promote a healthy diet in order to avoid standard patient care procedures.

Dificuldades para alimentação saudável entre usuários da atenção básica em saúde e fatores associados