Abstract
BackgroundMultiple economic factors and social relationships determine dietary behaviours, but the inter-relations between determinants is unknown. Whether women and men differ in the vulnerability to, and impact of, combined disadvantages is also unclear. We examined associations between diverse combinations of economic resources and social relationships, and healthy eating in British older women and men.MethodsOur sample comprised 9,580 over-50s (47 % of over-50 respondents) in the EPIC-Norfolk cohort study. We examined six economic factors (education, social class, home-ownership, money for needs, frequency of insufficient money for food/clothing, paying bills) and three social relationships (marital status, living arrangement and friend contact), independently and in combination, in relation to fruit variety and vegetable variety. We analysed gender-specific associations using multivariable linear regression with interaction terms.ResultsLower social class, lower education, and difficulty paying bills were associated with lower fruit and vegetable variety in both genders, independent of social relationships. All social relationships were independently associated with fruit variety in men and with vegetable variety in both genders. Substantially lower variety was found for all combinations of low economic resources and lack of social relationship than for either measure alone, with men faring worse in the majority of combined disadvantages. For example, the difference in vegetable variety for men reporting low social class and non-married was much greater (β -4.1, [-4.8, -3.4]), than the independent association of low social class (β -1.5, [-1.8,–1.2]), or non-married (β -1.8, [-2.3,–1.3]). Variety was also lower among men with high economic resources but non-married or lone-living.ConclusionA double burden of low economic resources and lack of social relationships suggested they are unique joint determinants, particularly in older men, and that public health efforts to improve healthy eating would offer most benefit to older adults with intersecting economic and social disadvantages.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1895-y) contains supplementary material, which is available to authorized users.
Highlights
Multiple economic factors and social relationships determine dietary behaviours, but the inter-relations between determinants is unknown
Older age correlates with poorer economic resources and fewer social relationships, and both are linked to lower fruits and vegetables (FV) consumption [5, 6]
Most (83 %) rated their general health as good/excellent, Independent associations of economic resources or social relationships with FV variety We found low social class and low education were each associated with lower variety of intake of fruits or vegetables in both women and men, independent of their social relationships (Table 3, Model 2)
Summary
Multiple economic factors and social relationships determine dietary behaviours, but the inter-relations between determinants is unknown. We examined associations between diverse combinations of economic resources and social relationships, and healthy eating in British older women and men. Consumption of fruits and vegetables (FV) is critical to healthy eating as inadequate intakes contribute to many chronic diseases and nearly 5 % of excess deaths globally [1]. Both quantity and variety of FV intake are independently associated with reduced risk of diabetes and some cancers [2, 3]. Older age correlates with poorer economic resources and fewer social relationships, and both are linked to lower FV consumption [5, 6]. FV variety was lower among older adults with lower education, lower social class, and greater financial hardships [8]
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