Marital transitions and associated changes in fruit and vegetable intake: Findings from the population-based prospective EPIC-Norfolk cohort, UK.

Abstract

BACKGROUND: Diet is critical to health and social relationships are an important determinant of diet. We report the association between transitions in marital status and healthy eating behaviours in a UK population. METHODS: Longitudinal study of middle-age and older adults 39-78y (n = 11 577) in EPIC-Norfolk, a population-based cohort, who completed food frequency questionnaires in 1993-97 and 1998-2002. Multivariable linear regression analyses assessed gender-specific associations between five categories of marital transitions and changes in quantity (g/d), and variety (no/month) of fruits or vegetables. RESULTS: In 3.6 years of follow-up and relative to men who stayed married, widowed men showed significant declines (mean difference, 95% CI) in all four indicators of healthy eating including fruit quantity (-47.7, -80.6 to -14.9 g/d), fruit variety (-0.6, -1.1 to -0.2 no/month), vegetable quantity (-27.7, -50.5 to -4.9 g/d), and vegetable variety (-1.6, -2.2 to -0.9 no/month). Men who were separated or divorced or who remained single also showed significant declines in three of the indicators. Among women, only those who became separated/divorced or stayed single showed declines in one indicator, vegetable variety. CONCLUSION: Unhealthy changes to diet accompanying divorce, separation and becoming widowed may be more common among men than women. Moreover, deterioration in fruit and vegetable intakes was more apparent for variety rather than quantity consumed. Programmes to promote healthy eating among older adults need to recognise these social determinants of diet and consider prioritising people who live alone and in particular men who have recently left relationships or who have been widowed.AIC acknowledges PhD funding from the Gates Cambridge Trust. This work was undertaken by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research of Excellence and was funded by The British Heart Foundation, Economic and Social Research, Medical Research Council, National Institute for Health Research, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration (grant number MR/K023187/1). We further acknowledge core MRC Epidemiology Unit support through Programme grant MC_UU_12015/1.This is the final version of the article. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.socscimed.2016.04.00