Categorizations of Trust and Distrust in the Classifications and Social Representations of Food among Pregnant and Breastfeeding Women in Spain—Applying the Cultural Domains’ Pile Sort Technique

Pregnancy and lactation are stages during which food becomes central to maternal and child health, yet women must navigate complex and sometimes contradictory information about food safety. This study explored how pregnant and breastfeeding women in Spain classify foods according to trust and distrust, aiming to understand the social representations underlying their dietary decisions. Women expressed great concern about food quality and its potential effects on their own and their children's health. They classified fresh fruits and vegetables as the most trusted foods, with freshness and proximity as preferred criteria. Fish and meat generated serious ambivalence, as trust depended on the food's origin, mode of production, and type; for example, large fish were viewed with suspicion due to mercury concerns. Legumes and cereals were generally trusted due to the perceived simplicity of their production. Prepared, precooked, and highly artificial products with added chemical substances were consistently distrusted. Participants emphasized the importance of reading labels and seeking information, yet acknowledged that excessive worrying could become paralyzing. The authors note that practical factors such as price and availability were not addressed and that the findings may not generalize beyond this Spanish population. The authors recommend incorporating emic knowledge—women's own criteria for food trust—into food safety programmes and public health actions targeting pregnant and breastfeeding women.