title: 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.
authors.affiliation: Medical Research Council Epidemiology Unit, Institute of Metabolic Science, Cambridge, UK; UK Clinical Research Collaboration Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK.
authors.forename: Annalijn I
authors.initials: AI
authors.lastname: Conklin
authors.affiliation: Medical Research Council Epidemiology Unit, Institute of Metabolic Science, Cambridge, UK.
authors.forename: Nita G
authors.initials: NG
authors.lastname: Forouhi
authors.affiliation: Department of Public Health and Primary Care, University of Cambridge, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Surtees
authors.affiliation: Department of Public Health and Primary Care, University of Cambridge, UK.
authors.forename: Kay-Tee
authors.initials: KT
authors.lastname: Khaw
authors.affiliation: Medical Research Council Epidemiology Unit, Institute of Metabolic Science, Cambridge, UK; UK Clinical Research Collaboration Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Wareham
authors.affiliation: UK Clinical Research Collaboration Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK; Department of Public Health and Primary Care, University of Cambridge, UK. Electronic address: pm491@medschl.cam.ac.uk.
authors.forename: Pablo
authors.initials: P
authors.lastname: Monsivais
mesh_terms: D000368:Aged; D004032:Diet / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D005638:Fruit; D006801:Humans; D007398:Interpersonal Relations; D016014:Linear Models; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012737:Sex Factors; D012934:Social Isolation / Q000523:psychology; D006113:United Kingdom; D014675:Vegetables
keywords: Chronic disease; Diet variety; Gender; Health behaviour; Interactions; Social relationships; Social ties; UK
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