Social relationships and healthful dietary behaviour: Evidence from over-50s in the EPIC cohort, UK

Abstract

Social relationships are an important aspect of a person's social environment that can protect against a wide range of chronic conditions and facilitate recovery from disease. Social relationships have also been linked to dietary behaviour which may be an important pathway through which social circumstances exert their influence on health. Yet, questions remain about which structural aspects of social relationships most affect healthful dietary behaviours and whether different structural components interact to produce a combined effect. Using data from adults (≥50 years) in the European Prospective Investigation of Cancer-Norfolk study (1996–2002), we examined marital status, living arrangement and social isolation in relation to scores for variety of fruit and vegetable intake as a marker of diet quality associated with adverse health outcomes. Data were analysed with multivariable linear regression models for gender-specific and interaction associations. We found that being single or widowed was associated with a lower variety score, particularly vegetable variety, and associations were enhanced when combined with male gender, living alone or infrequent friend contact. Lower variety scores for lone-living were also observed, especially for men. Infrequent friend contact interacted with living arrangement to amplify negative associations of lone-living with variety, with statistically significant differences in contact frequency for vegetable variety. Lower levels of friend contact were associated with reduced variety of fruits and vegetables in a graded trend for both genders; the trend was more pronounced among men. Family contact appeared to have limited association with vegetable variety in men; among women, weekly contact was significantly and positively associated with vegetable variety compared to daily family contact. Results highlight the importance of considering living arrangement and/or frequency of social contact when assessing whether widowed, single or lone-living older adults are at risk of lower fruit and vegetable variety.

The relationship between dietary intake and the six dimensions of wellness in older adults

“…Observational study results demonstrated lower vegetable scores for both widowed men and women, compared to partnered people. Widowed men's vegetable scores were almost half those of widowed women's, and men's' dietary patterns overall were more negatively affected than those of women in regard to living alone, being un-partnered and having limited contact with friends (Conklin et al, 2013). Place of residence may also be associated with marital status and dining companions.…”

“…Authors suggest that limited social contact may be an independent risk factor for poorer dietary pattern quality (Sahyoun & Zhang, 2005). In contrast, weekly family contact (instead of daily) was more positively associated with vegetable variety in women from the European Prospective Investigation of Cancer (EPIC) study (Conklin et al, 2013). Perhaps this is a result of older women feeling that they are monitored by family members when they are checked on daily, versus feeling a more social nature in onceper-week interactions.…”

“…In the NHANES III observational study of subjects aged 65+ years examining eating and social life, living arrangements did not seem to be associated with dietary intake (Sahyoun & Zhang, 2005). However, in an observational study of over 9,500 adults, lone-living men and women had lower fruit and vegetable intake, with men's scores lower than women's, compared to cohabitating people (Conklin et al, 2013). In 2010, fewer than half of those aged 65-74 years old were married, and that proportion declined among the older population (Federal Interagency Forum on AgingRelated Statistics 2012, 2014.…”

“…A greater degree of contact with friends in un-partnered/unmarried people was associated with higher fruit and vegetable scores compared to un-partnered/unmarried people with infrequent contact with friends (Conklin et al, 2013). Similarly, those reporting having friends had higher energy intake than those who did not have friends (Payette et al, 1995).…”

What do we know about the nutritional status of the very old? Insights from three cohorts of advanced age from the UK and New Zealand

“…Also, very little is known about relationship between diet/DP and health and bio-psycho-social factors in this age group. Specifically, diet quality has been linked to socioeconomic status defined either by education, social class (occupation) and income in general and older adults populations (aged 60 and over) (56)(57)(58) , but to which extent and which dimension socioeconomic status plays a role in diet characteristics in very late life is not known. Utilising dietary data collected by 24-h multiple-pass dietary recalls from participants in the Newcastle 85+ study (16,17,34) and two-step clustering, we identified three distinct DP, which differed with respect to the key sociodemographic, lifestyle, health and functioning measures (59) .…”