Key Dietary Behavioral and Environmental Factors Mediating Dietary Variety Among Japanese Adults with Spinal Cord Injury

Abstract

Adequate food intake is essential for health and is influenced by dietary behaviors and environments. Therefore, we examined the key behavioral and environmental factors mediating dietary variety as indicator of diet quality in a group of community-dwelling Japanese adults with spinal cord injury (SCI). This study used a cross-sectional design. We mailed a questionnaire survey to 2,731 community-dwelling Japanese adults with SCI, and responses from 841 individuals were analyzed. Dietary variety was assessed as the frequency scores of 10 foods which are major components of the Japanese diet. Correlations between the food frequency scores and dietary behavioral and environmental factors were determined by binominal logistic regression analysis. Additionally, the correlations between these scores and answers to the questions of ‘What is required to choose healthy foods?’ and ‘Where do you get information regarding health and nutrition?’ were determined using a chi-square test. High food frequency scores were positively and significantly associated with the dietary behaviors of ‘Concerning yourself with nutrition and meals for your own health’, ‘Eating breakfast’ and ‘Mealtime conversation about diet/nutrition/cooking with family/friends’, and ‘Having family/neighbors support’ in dietary environments. Regardless of the food frequency scores, ‘Knowledge’ was most frequently required to choose healthy foods, while the high food frequency scores were most significantly related to ‘Family/friends’ as sources of information about health and nutrition. Health self-management, mealtime conversation, and health promotion support from others who also provide knowledge about health and nutrition are the key factors mediating dietary variety among people with SCI.