Abstract
Social relationships are an important aspect of a person's social environment that can protect against a wide range of chronic conditions and facilitate recovery from disease. Social relationships have also been linked to dietary behaviour which may be an important pathway through which social circumstances exert their influence on health. Yet, questions remain about which structural aspects of social relationships most affect healthful dietary behaviours and whether different structural components interact to produce a combined effect. Using data from adults (≥50 years) in the European Prospective Investigation of Cancer-Norfolk study (1996–2002), we examined marital status, living arrangement and social isolation in relation to scores for variety of fruit and vegetable intake as a marker of diet quality associated with adverse health outcomes. Data were analysed with multivariable linear regression models for gender-specific and interaction associations. We found that being single or widowed was associated with a lower variety score, particularly vegetable variety, and associations were enhanced when combined with male gender, living alone or infrequent friend contact. Lower variety scores for lone-living were also observed, especially for men. Infrequent friend contact interacted with living arrangement to amplify negative associations of lone-living with variety, with statistically significant differences in contact frequency for vegetable variety. Lower levels of friend contact were associated with reduced variety of fruits and vegetables in a graded trend for both genders; the trend was more pronounced among men. Family contact appeared to have limited association with vegetable variety in men; among women, weekly contact was significantly and positively associated with vegetable variety compared to daily family contact. Results highlight the importance of considering living arrangement and/or frequency of social contact when assessing whether widowed, single or lone-living older adults are at risk of lower fruit and vegetable variety.
Highlights
Social relationships are known to affect health and survival to an extent comparable with smoking (Holt-Lunstad, Smith, & Layton, 2010)
Variety scores were normally distributed and crude means for fruit variety and vegetable variety were higher in women than men (7.7 and 16.5 versus 6.7 and 15.9, respectively)
This study confirms the gender-specific associations of social relationships with variety of intake of fruits and vegetables in a UK population, and contributes new evidence on the combined influence of structural components of relationships
Summary
Social relationships are known to affect health and survival to an extent comparable with smoking (Holt-Lunstad, Smith, & Layton, 2010). Women and men differ in the number and size of different types of social relationships (Fuhrer, Stansfeld, Chemali, & Shipley, 1999), and in the health impacts (Hessler, Jia, Madsen, & Pazaki, 1995; Kimmel et al, 2000; Shye, Mullooly, Freeborn, & Pope, 1995). Several health-related behaviours are likely to mediate this link for some but not all aspects of a person’s social context (Chuang & Chuang, 2008). A person’s social circumstances can influence the type and variety of foods consumed in multiple ways and thereby impact health.
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