Attitudes toward healthy eating: a mediator of the educational level–diet relationship

Abstract

BACKGROUNG/OBJECTIVES: A higher educational level is associated with a healthier diet. The goal of this study was to establish whether this association is mediated by attitudes toward healthy eating. SUBJECTS/METHODS: The cross-sectional MONA LISA-NUT study was performed in 2005-2007 on adults aged 35-64 years from northern and north-eastern France. Diet quality was assessed on the basis of a 3-day food record and a validated score based on French national dietary guidelines. Specific questions investigated attitudes toward healthy eating. Multivariate analyses were used to quantify the proportion of the educational level-diet relationship that was mediated by attitudes toward healthy eating. RESULTS: Among the 1631 subjects, favourable attitudes toward healthy eating were associated with both higher educational level and diet quality. In the mediation analysis, 'organic food consumption' explained 14% (95% confidence interval (8;24)) of the educational level-diet relationship and 'attention paid to health when buying food' explained 9% (3;16). In contrast, 'attention to food choice', 'searching for information about food' and 'perceived role of eating' were not mediators of the association between educational level and diet. In a multivariate model, the attitude items together accounted for 25% (10;45) of the relationship. The mediation was more pronounced in women than in men (37% (15;54) vs 16% (1;27), respectively) and was significant for consumption of fruits and vegetables (23% (13;37)), whole-grain food (32% (15;58)) and seafood (22% (9;55)). CONCLUSIONS: Our results suggest that poor attitudes toward healthy eating in groups with low socioeconomic status constitute an additional factor (along with cost constraints) in the choice of unhealthy foods.

Differences in nutritional status of preschool children in the context of the maternal social characteristics

“…Our result on the lack of relation of education with the nutritional status seems surprising since the level of education is commonly considered as a strong predictor of health behavior. Such result was confirmed by a French research including adults aged 35-64 -it showed that higher education related to the positive attitude towards healthy food and the choice of healthier products [16]. It was also revealed that children of the better-educated mothers consumed more portions of fruit and vegetables during the day and ate breakfasts more often that the children of lower-educated mothers did [39].…”

“…Social factors refer to the mother's socio-economic and socio-demographic features. Education, income or professional status indicate the socio-economic status (SES) of a particular person [15][16][17]. It is widely acknowledged that the higher the SES, the healthier the lifestyle, including diet [15,[18][19][20].…”

Importance of taste, nutrition, cost and convenience in relation to diet quality: Evidence of nutrition resilience among US adults using National Health and Nutrition Examination Survey (NHANES) 2007–2010

“…Those Finnish adults who rated healthfulness over price and convenience consumed more fruit and vegetables and less energy-dense foods (Konttinen et al, 2012). Similar associations between nutrition-related attitudes, food purchasing behaviors (Turrell and Kavanagh, 2006; Gittelsohn et al, 2006), and other diet quality measures were observed in small-scale studies in France (Le et al, 2013), the UK (Traill et al, 2011), Australia (Turrell and Kavanagh, 2006), Finland (Konttinen et al, 2012), and the US (Gittelsohn et al, 2006; Pelletier et al, 2013; Aggarwal et al, 2014). …”

“…Food-related attitudes have been known to affect diet quality (Beydoun and Wang, 2008a, 2008b; Le et al, 2013; Acheampong and Haldeman, 2013; Traill et al, 2011; Turrell and Kavanagh, 2006; Gittelsohn et al, 2006). For example: In the US Continuing Survey of Food Intake by Individuals (CSFII 1994–96), perceived value of cost over nutrition was associated with lower quality diets and higher consumption of fats, added sugars and sodium, and vice a versa (Beydoun and Wang, 2008a).…”

“…It is already well-established that diet quality follows a social gradient, improving with both education and incomes (Beydoun and Wang, 2008b; Le et al, 2013; Turrell and Kavanagh, 2006; Wardle et al, 2000; Wang and Chen, 2011; Miura and Turrell, 2014). However, one question that is worth exploring is whether positive food-related attitudes exist among lower socioeconomic groups and racial/ethnic minorities, and how does it improve diet quality despite their economic and physical accessibility constraints (Beydoun and Wang, 2008b; Acheampong and Haldeman, 2013; Aggarwal et al, 2014; Williams et al, 2010; Moser et al, 2005).…”