Northwestern University Feinberg School of Medicine, Department of Preventive Medicine, Chicago, IL, USA.
University of Illinois at Chicago College of Applied Health Sciences, Department of Kinesiology and Nutrition, Chicago, IL, USA.
Appetite. 2019 Aug 1;139:19-25. doi: 10.1016/j.appet.2019.04.003. Epub 2019 Apr 9.
Large and persistent obesity disparities exist in the US by socioeconomic status (SES) and race/ethnicity, and weight loss interventions have traditionally been less effective in these populations. Thus, a better understanding is needed of the behavioral, economic, and geographic factors that influence obesity risk factors such as eating behaviors. We used a discrete choice experiment to evaluate the impact of different meal attributes on meal choice and to test whether the relative importance of these attributes varied by SES and race/ethnicity. Study participants (n = 228) were given a series of 10 choice tasks and asked to choose among 4 meals, each rated based on the following attributes: taste; healthfulness; preparation time; travel time to food outlet for meal/ingredients; and price. SES was measured using education and self-reported difficulty paying for basics. Race/ethnicity was categorized as Hispanic/Latina, non-Hispanic black, non-Hispanic white, and non-Hispanic other. Data were analyzed using mixed logit regression models with interaction terms to determine whether meal attributes influenced meal choices differentially by SES and race/ethnicity. Healthfulness and taste were the most important attributes for all participants. Price was a more important attribute among those in the lowest SES group compared with those in the higher SES groups. Travel was the least important attribute for low SES participants, and it was not significantly related to meal choice in these groups. Discrete choice experiments as illustrated here may help pinpoint the most salient targets for interventions to improve eating behaviors and reduce obesity disparities. Specifically, our findings suggest interventions should incorporate strategies to target the pricing of healthy and unhealthy food options.
在美国,社会经济地位(SES)和种族/民族因素导致肥胖存在较大且持续的差异,而减肥干预措施在这些人群中的效果通常较差。因此,需要更好地了解影响肥胖风险因素(如饮食行为)的行为、经济和地理因素。我们使用离散选择实验来评估不同膳食属性对膳食选择的影响,并测试这些属性的相对重要性是否因 SES 和种族/民族而异。研究参与者(n=228)接受了一系列 10 项选择任务,并被要求在 4 种膳食中进行选择,每种膳食都基于以下属性进行评分:口味;健康度;准备时间;前往食品店购买餐食/食材的时间;以及价格。SES 是通过教育和自我报告的基本生活费用支付难度来衡量的。种族/民族分为西班牙裔/拉丁裔、非西班牙裔黑人、非西班牙裔白人以及非西班牙裔其他。使用混合对数回归模型和交互项分析数据,以确定膳食属性是否会因 SES 和种族/民族的不同而对膳食选择产生不同的影响。健康度和口味对所有参与者来说都是最重要的属性。与 SES 较高的群体相比,价格对于 SES 较低的群体来说是一个更为重要的属性。对 SES 较低的参与者来说,旅行是最不重要的属性,而且在这些群体中,旅行与膳食选择没有显著关系。如本文所示的离散选择实验可以帮助确定改善饮食行为和减少肥胖差异的干预措施的最显著目标。具体而言,我们的研究结果表明,干预措施应纳入针对健康和不健康食品定价的策略。