Gender disparities in dietary status and its risk factors in underserved populations.

OBJECTIVES

To examine dietary status and its risk factors among adults aged 40-74 years at high risk of colorectal cancer (CRC) in an economically and medically underserved population.

STUDY DESIGN

Cross-sectional survey in 2007.

METHODS

A survey was conducted among a random sample (n = 1844) nested in a screening cohort of a rural population in Jiashan County, China. Information about diet, family history of CRC and other factors was collected by questionnaire. The primary outcome was dietary status, assessed by consumption (servings/week) of plant-based food and unhealthy food. Linear or multinomial logistic regressions were used to determine risk factors for dietary status.

RESULTS

On average, individuals with a family history of CRC ate 2.25 fewer servings of plant-based food each week compared with individuals without a family history of CRC. Individuals who smoked and drank alcohol ate less plant-based food. After stratification by gender, there were multiple determinants for consumption of plant-based food for men, including family history of CRC, smoking, alcohol consumption and income. For women, the only association was found for income. Consumption of unhealthy food was positively associated with high income and high body mass index. Determinants for an unhealthy diet were the same in both genders.

CONCLUSIONS

There are gender disparities in the consumption of plant-based food and the risk factors for CRC in medically and economically underserved populations. Men's insufficient consumption of plant-based food and unhealthy lifestyle behaviours, such as smoking and drinking, may explain, in part, why men have a higher risk of CRC than women.