Vinther Johan L, Conklin Annalijn I, Wareham Nicholas J, Monsivais Pablo
London School of Hygiene & Tropical Medicine, University of London, UK; Danish Cancer Society, Documentation & Quality, Copenhagen, Denmark; Centre for Diet and Activity Research (CEDAR), Medical Research Council Epidemiology Unit, University of Cambridge, UK.
Centre for Diet and Activity Research (CEDAR), Medical Research Council Epidemiology Unit, University of Cambridge, UK; WORLD Policy Analysis Center, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
Soc Sci Med. 2016 May;157:120-6. doi: 10.1016/j.socscimed.2016.04.004. Epub 2016 Apr 6.
Diet 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.
Longitudinal 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.
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 (-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.
Unhealthy 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.
饮食对健康至关重要,而社会关系是饮食的重要决定因素。我们报告了英国人群婚姻状况转变与健康饮食行为之间的关联。
对基于人群的队列研究EPIC - 诺福克中39 - 78岁的中年及老年人(n = 11577)进行纵向研究,这些参与者在1993 - 1997年和1998 - 2002年完成了食物频率问卷调查。多变量线性回归分析评估了五类婚姻转变与水果或蔬菜摄入量(克/天)及种类(每月种类数)变化之间的性别特异性关联。
在3.6年的随访中,与已婚男性相比,丧偶男性在所有四项健康饮食指标上均出现显著下降(平均差异,95%置信区间),包括水果摄入量(-47.7,-80.6至-14.9克/天)、水果种类(-0.6,-1.1至-0.2种/月)、蔬菜摄入量(-27.7,-50.5至-4.9克/天)和蔬菜种类(-1.6,-2.2至-0.9种/月)。分居、离婚或单身的男性在三项指标上也出现显著下降。在女性中,只有分居/离婚或单身的女性在一项指标(蔬菜种类)上出现下降。
离婚、分居和丧偶后饮食的不健康变化在男性中可能比女性更常见。此外,水果和蔬菜摄入量的下降在种类方面比摄入量方面更为明显。促进老年人健康饮食的项目需要认识到这些饮食的社会决定因素,并考虑优先关注独居人群,特别是那些最近结束关系或丧偶的男性。