Abstract
BackgroundDescriptive norms (what other people do) relate to individual-level dietary behaviour and health outcome including overweight and obesity. Descriptive norms vary across residential areas but the impact of spatial variation in norms on individual-level diet and health is poorly understood. This study assessed spatial associations between local descriptive norms for overweight/obesity and insufficient fruit intake (spatially-specific local prevalence), and individual-level dietary intakes (fruit, vegetable and sugary drinks) and 10-year change in body mass index (BMI) and glycosylated haemoglobin (HbA1c).MethodsHbA1c and BMI were clinically measured three times over 10 years for a population-based adult cohort (n = 4056) in Adelaide, South Australia. Local descriptive norms for both overweight/obesity and insufficient fruit intake specific to each cohort participant were calculated as the prevalence of these factors, constructed from geocoded population surveillance data aggregated for 1600 m road-network buffers centred on cohort participants’ residential addresses. Latent growth models estimated the effect of local descriptive norms on dietary behaviours and change in HbA1c and BMI, accounting for spatial clustering and covariates (individual-level age, sex, smoking status, employment and education, and area-level median household income).ResultsLocal descriptive overweight/obesity norms were associated with individual-level fruit intake (inversely) and sugary drink consumption (positively), and worsening HbA1c and BMI. Spatially-specific local norms for insufficient fruit intake were associated with individual-level fruit intake (inversely) and sugary drink consumption (positively) and worsening HbA1c but not change in BMI. Individual-level fruit and vegetable intakes were not associated with change in HbA1c or BMI. Sugary drink consumption was also not associated with change in HbA1c but rather with increasing BMI.ConclusionAdverse local descriptive norms for overweight/obesity and insufficient fruit intake are associated with unhealthful dietary intakes and worsening HbA1c and BMI. As such, spatial variation in lifestyle-related norms is an important consideration relevant to the design of population health interventions. Adverse local norms influence health behaviours and outcomes and stand to inhibit the effectiveness of traditional intervention efforts not spatially tailored to local population characteristics. Spatially targeted social de-normalisation strategies for regions with high levels of unhealthful norms may hold promise in concert with individual, environmental and policy intervention approaches.
Highlights
Descriptive norms relate to individual-level dietary behaviour and health outcome including overweight and obesity
Adverse local descriptive norms for overweight/obesity and insufficient fruit intake are associated with unhealthful dietary intakes and worsening Glycosylated haemoglobin (HbA1c) and body mass index (BMI)
This study aimed to evaluate the direct effects of local descriptive norms for overweight/obesity and insufficient fruit intake on individual-level dietary intakes of fruits, vegetables and sugary drinks and 10-year change in HbA1c and BMI
Summary
Descriptive norms (what other people do) relate to individual-level dietary behaviour and health outcome including overweight and obesity. Individual-level dietary choices are implicated in the development of overweight/obesity and cardiometabolic risk and disease, as well as other chronic diseases [4,5,6,7,8]. Diets rich in fruits and vegetables, and low in sugar sweetened beverages are associated with better health outcomes [6, 9,10,11,12]. Such food consumption behaviours are influenced by a multitude of inter-related individual and environmental factors. Women, older adults, and individuals with higher incomes eat more fruits and vegetables [15,16,17]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
More From: International Journal of Behavioral Nutrition and Physical Activity
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.