Associations of social status and health-related beliefs with dietary fat and fiber densities

Abstract

Background. Lower social status groups have higher mortality rates from some diet-related diseases and higher dietary fat and lower dietary fiber intakes. Such dietary patterns have been found to be related to social status, environmental influences, and health-related beliefs and expectations. Methods. Associations of social status and diet-related and health-related beliefs and expectations with dietary fat and fiber densities were examined in a population sample of 874 respondents to a postal questionnaire. A food frequency listing of 172 foods was used to assess usual dietary intake. Results. More positive beliefs and expectations were associated with lower dietary fat and higher dietary fiber densities in univariate models; beliefs and expectations differed little between social status groups. In multivariate models, stronger perceptions of external influences on food choices, fewer perceived barriers to eating a healthy diet, and social status were independently associated with low dietary fat density. Diet-related and health-related beliefs and perceptions of external influences on food choices, but not social status, were independently associated with high dietary fiber density. The belief that diet is a major cause of stroke, diabetes, and hypertension was weakly associated with the dietary fiber density of lower social status groups. Conclusions. Social status and perceptions of external influences on dietary choice, as well as personal beliefs, have independent associations with food intake. Although exclusive targeting of lower social status groups is not indicated, interventions to increase dietary fiber intake should address expectations, attitudes, and beliefs about dietary fiber and health and perceptions of external influences on food choices, especially among lower status groups; interventions to lower dietary fat intake should address a broad range of external and social factors, as well as personal beliefs.