Abstract
BackgroundDiet is critical to health and social relationships are an important determinant of diet. We report the association between transitions in marital status and healthy eating behaviours in a UK population. MethodsLongitudinal study of middle-age and older adults 39−78y (n = 11 577) in EPIC-Norfolk, a population-based cohort, who completed food frequency questionnaires in 1993–97 and 1998–2002. Multivariable linear regression analyses assessed gender-specific associations between five categories of marital transitions and changes in quantity (g/d), and variety (no/month) of fruits or vegetables. ResultsIn 3.6 years of follow-up and relative to men who stayed married, widowed men showed significant declines (mean difference, 95% CI) in all four indicators of healthy eating including fruit quantity (−47.7, −80.6 to −14.9 g/d), fruit variety (−0.6, −1.1 to −0.2 no/month), vegetable quantity (−27.7, −50.5 to −4.9 g/d), and vegetable variety (−1.6, −2.2 to −0.9 no/month). Men who were separated or divorced or who remained single also showed significant declines in three of the indicators. Among women, only those who became separated/divorced or stayed single showed declines in one indicator, vegetable variety. ConclusionUnhealthy changes to diet accompanying divorce, separation and becoming widowed may be more common among men than women. Moreover, deterioration in fruit and vegetable intakes was more apparent for variety rather than quantity consumed. Programmes to promote healthy eating among older adults need to recognise these social determinants of diet and consider prioritising people who live alone and in particular men who have recently left relationships or who have been widowed.
Highlights
Non-communicable diseases present a significant societal challenge to both high-income and low-income countries, with a growing health and economic burden of cardiovascular diseases, type 2 diabetes, and other chronic conditions (World Health Organization, 2013)
In a population-based cohort of older adults in UK, we examined changes in fruit and vegetable intake associated with changes in marital status over approximately four years
The gender perspective is a particular strength and novel contribution of the study as it extends the strength and validity of prior research in occupational cohorts (Eng et al, 2005; Lee et al, 2005), and addresses an identified knowledge gap (Braveman et al, 2011). This epidemiological study is the first to examine the relationship between marital transitions and change in healthy dietary behaviours using longitudinal data on men and women in the same population-based cohort
Summary
Non-communicable diseases present a significant societal challenge to both high-income and low-income countries, with a growing health and economic burden of cardiovascular diseases, type 2 diabetes, and other chronic conditions (World Health Organization, 2013). Diet is critical to health and social relationships are an important determinant of diet. Multivariable linear regression analyses assessed gender-specific associations between five categories of marital transitions and changes in quantity (g/d), and variety (no/month) of fruits or vegetables. Results: In 3.6 years of follow-up and relative to men who stayed married, widowed men showed significant declines (mean difference, 95% CI) in all four indicators of healthy eating including fruit quantity (À47.7, À80.6 to À14.9 g/d), fruit variety (À0.6, À1.1 to À0.2 no/month), vegetable quantity (À27.7, À50.5 to À4.9 g/d), and vegetable variety (À1.6, À2.2 to À0.9 no/month). Programmes to promote healthy eating among older adults need to recognise these social determinants of diet and consider prioritising people who live alone and in particular men who have recently left relationships or who have been widowed
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