Carolina Population Center, University of North Carolina, Chapel Hill, NC.
Harvard Center for Population and Development Studies, Harvard T. H. Chan School of Public Health, Cambridge, MA; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
J Acad Nutr Diet. 2022 May;122(5):918-931.e7. doi: 10.1016/j.jand.2021.12.005. Epub 2021 Dec 8.
There are persistent disparities in weight- and diet-related diseases by sexual orientation. Lesbian and bisexual females have a higher risk of obesity and cardiovascular disease compared with heterosexual females. Gay and bisexual males have a higher risk of diabetes and cardiovascular disease compared with heterosexual males. However, it remains unknown how sexual orientation groups differ in their dietary quality.
This study aimed to determine whether dietary quality differs by sexual orientation and sex among US adults.
This was a cross-sectional study of 24-hour dietary recall data from a nationally representative sample of adults aged 20 through 65 years participating in the 2011-2016 National Health and Nutrition Examination Survey.
PARTICIPANTS/SETTING: Study participants were adults (n = 8,851) with complete information on dietary intake, sexual orientation, and sex.
The main outcome measures were daily energy intake from 20 specific food and beverage groups and Healthy Eating Index-2015 (HEI-2015) scores for sexual orientation groups (heterosexual vs gay/lesbian/bisexual).
Ordinary least squares regressions were used to calculate adjusted means for each food and beverage group and HEI-2015, stratified by sex and controlling for covariates (eg, age and race/ethnicity) and survey cycles (2011-2012, 2013-2014, and 2015-2016).
Among males, red and processed meat/poultry/seafood (P = .01) and sandwiches (P = .02) were smaller contributors to energy intake for gay/bisexual males compared with heterosexual males. Among females, cereals (P =.04) and mixed dishes (P = .02) were smaller contributors to energy intake for lesbian/bisexual females compared with heterosexual females. Gay/bisexual males had significantly higher total HEI-2015 scores than heterosexual males (mean ± standard deviation 53.40 ± 1.36 vs 49.29 ± 0.32, difference = 4.14; P = .004). Lesbian/bisexual females did not differ in total or component HEI-2015 scores from heterosexual females.
Although gay/lesbian/bisexual groups were similar for a variety of dietary outcomes compared with heterosexual groups, gay and bisexual men displayed healthier dietary quality for processed meat (by consuming smaller amounts) and overall dietary quality (according to HEI-2015) compared with heterosexual males.
性取向与体重和饮食相关疾病之间存在持续的差异。与异性恋女性相比，女同性恋和双性恋女性肥胖和心血管疾病的风险更高。与异性恋男性相比，男同性恋和双性恋男性患糖尿病和心血管疾病的风险更高。然而，目前尚不清楚性取向群体在饮食质量方面有何不同。
本研究旨在确定美国成年人的性取向和性别是否会影响饮食质量。
这是一项横断面研究，对 2011-2016 年全国健康与营养调查中 20 至 65 岁的成年人进行了 24 小时饮食回顾数据的分析。
参与者/设置：研究参与者为具有完整饮食摄入、性取向和性别的成年人（n=8851）。
主要观察指标为 20 种特定食物和饮料组的每日能量摄入以及性取向组（异性恋与同性恋/双性恋）的健康饮食指数-2015（HEI-2015）评分。
采用普通最小二乘回归计算每种食物和饮料组以及 HEI-2015 的调整均值，按性别分层，并控制协变量（如年龄和种族/民族）和调查周期（2011-2012、2013-2014 和 2015-2016）。
在男性中，与异性恋男性相比，同性恋/双性恋男性的红肉类和加工肉类/禽类/海鲜（P=.01）和三明治（P=.02）对能量摄入的贡献较小。在女性中，与异性恋女性相比，同性恋/双性恋女性的谷物（P=.04）和混合菜肴（P=.02）对能量摄入的贡献较小。与异性恋男性相比，男同性恋/双性恋男性的总 HEI-2015 评分显著更高（平均值±标准偏差 53.40±1.36 与 49.29±0.32，差异=4.14，P=.004）。女同性恋/双性恋女性的总 HEI-2015 评分或各组成部分评分与异性恋女性无差异。
尽管与异性恋群体相比，同性恋/双性恋群体在各种饮食结果上相似，但与异性恋男性相比，男同性恋和双性恋男性的加工肉类（食用量较小）和整体饮食质量（根据 HEI-2015）更健康。
