Between-group differences in nutrition- and health-related psychosocial factors among US adults and their associations with diet, exercise, and weight status.
BACKGROUND
Large disparities exist across ethnic and socioeconomic status groups regarding obesity and other chronic diseases. Eliminating health disparities is a national priority in the United States.


OBJECTIVE
To test between-group differences in nutrition- and health-related psychosocial factors (NHRPF) and their associations with US adults' diet, exercise, and weight status. DESIGN AND PARTICIPANTS/SETTING: Nationally representative data from the Continuing Survey of Food Intakes by Individuals and the Diet and Health Knowledge Survey 1994-96 from 4,356 US adults aged 20 to 65 years were used. Diet was assessed using 24-hour recalls, NHRPF was assessed by 25 questions, and weight status was determined by self-reported weight and height. Index scores were created to measure NHRPF. Diet quality was assessed using the US Department of Agriculture 2005 Healthy Eating Index (HEI).


METHODS
Multivariate linear and logistic regression models were conducted to examine the associations.


RESULTS
Some ethnic differences in NHRPF existed but were small. There were statistically significant (P<0.05) and large ethnic differences in diet (blacks had the worst average HEI and whites the best at 47.6 vs 52.3, respectively). Groups with higher socioeconomic status had better NHRPF (ie, had better nutrition knowledge and beliefs, made better food choices, and had better awareness of nutrition-related health risks) and HEI score. Subjects with high school education had higher NHRPF score (37.2 vs 35.7) and HEI score (54.5 vs 49.5) than those with less than a high school education.


CONCLUSIONS
Ethnic differences among American adults' NHRPF were small, but socioeconomic status differences were greater. More efforts are needed to study the influences of the complex interactions between individual and social environmental factors that affect Americans' diet and weight status and to explain related ethnic disparities.
Johns Hopkins Bloomberg School of Public Health, Department of International Health, 615 N Wolfe St., Baltimore, MD 21205, USA. ywang@jhsph.edu
Youfa
Y
Wang
Xiaoli
X
Chen
D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000191:economics / Q000453:epidemiology / Q000208:ethnology / Q000523:psychology; D004032:Diet / Q000208:ethnology*; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data*; D015444:Exercise; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006292:Health Priorities; D054624:Health Status Disparities; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D009765:Obesity / Q000191:economics / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology*; D012650:Self Disclosure; D012923:Social Class; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult