Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-21T15:13:41.295Z Has data issue: false hasContentIssue false

Healthy dietary habits in relation to social determinants and lifestyle factors

Published online by Cambridge University Press:  09 March 2007

Lars Johansson*
Affiliation:
National Nutrition Council, Box 8139 Dep, N-0033 Oslo, Norway
Dag S. Thelle
Affiliation:
Centre for Epidemiologic Research, University of Oslo, Norway
Kari Solvoll
Affiliation:
Institute for Nutrition Research, University of Oslo, Norway
Gunn-Elin Aa. Bjørneboe
Affiliation:
National Nutrition Council, Box 8139 Dep, N-0033 Oslo, Norway
Christian A. Drevon
Affiliation:
Institute for Nutrition Research, University of Oslo, Norway
*
*Corresponding author: Lars Johansson, fax +47 2224 9091, email lars.johansson@se.dep.telemax.no
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The aim of the present study was to evaluate the importance of social status and lifestyle for dietary habits, since these factors may influence life expectancy. We studied the association of four indicators for healthy dietary habits (fruits and vegetables, fibre, fat and Hegsted score) with sex, age, socio-economic status, education, physical leisure exercise, smoking and personal attention paid to keeping a healthy diet. Data were gathered with a self-administered quantitative food-frequency questionnaire distributed to a representative sample of Norwegian men and women aged 16–79 years in a national dietary survey, of whom 3144 subjects (63%) responded. Age and female sex were positively associated with indicators for healthy dietary habits. By separate evaluation length of education, regular physical leisure exercise and degree of attention paid to keeping a healthy diet were positively associated with all four indicators for healthy dietary habits in both sexes. Socio-economic status, location of residence and smoking habits were associated with from one to three indicators for healthy dietary habits. In a multiple regression model, age, education and location of residence together explained from 1 to 9% of the variation (R2) in the four dietary indicators. Length of education was significantly associated with three of four dietary indicators both among men and women. By including the variable ‘attention paid to keeping a healthy diet’ in the model, R2 increased to between 4 and 15% for the four dietary indicators. Length of education remained correlated to three dietary indicators among women, and one indicator among men, after adjusting for attention to healthy diet, age and location of residence. Residence in cities remained correlated to two indicators among men, but none among women, after adjusting for age, education and attention to healthy diet. In conclusion, education was associated with indicators of a healthy diet. Attention to healthy diet showed the strongest and most consistent association with all four indicators for healthy dietary habits in both sexes. This suggests that personal preferences may be just as important for having a healthy diet as social status determinants.

Type
Research Article
Copyright
Copyright © The Nutrition Society 1999

References

Aarø, LE (1986) Health behaviour and socio-economic status. A survey among the adult population in Norway. PhD Thesis, University of Bergen, Norway.Google Scholar
Axelson, ML (1986) The impact of culture on food-related behavior. Annual Review of Nutrition 6, 345363.Google Scholar
Bjartveit, K, Stensvold, I, Lund-Larsen, PG, Gjervig, T, Krüger, Ø & Urdal, P (1991) Cardiovascular diseases prevention programmes in Norwegian counties (English summary). Tidskrift for Den Norske Lægeforening 111, 20632072.Google Scholar
Blaker, B & Aarsland, M (1989) Household Measures and Weights of Foods (in Norwegian). Otta: Engers Boktrykkeri A/S.Google Scholar
Blaker, B, Solvoll, K & Lund-Larsen, K (1988) Dietary Habits in Vestre Toten 1987. Results From a 24 h Recall in Men and Women 30–59 Years of Age (in Norwegian). Oslo: Section for Dietary Research, University of Oslo.Google Scholar
Blaxter, M (1987) Evidence on inequality in health from a national survey. Lancet 2, 3033.CrossRefGoogle ScholarPubMed
Blaxter, M (1990) Health and Lifestyles. London: Tavistock/Routledge.Google Scholar
Central Bureau of Statistics (1977) Sampling Methods Applied by the Central Bureau of Statistics of Norway. Samfunnsøkono-miske Studier no. 33. Oslo: Central Bureau of Statistics.Google Scholar
Central Bureau of Statistics (1984) Standard Classification of Socio-economic Status. Standards for Norwegian Statistics no. 5. Oslo: Kongsvinger.Google Scholar
Central Bureau of Statistics (1989) Standard Classification of Education, revised 1989. Oslo: Kongsvinger.Google Scholar
Department of Health and Human Services (1988) The Surgeon General's Report on Nutrition and Health. US (PHS) Publication no. 88–50210. Washington, DC: Public Health Service.Google Scholar
Frost, Andersen L, Solvoll, K & Drevon, CA (1996) Very long-chain n-3 fatty acids as biomarkers for intake of fish and n-3 fatty acid concentrates. American Journal of Clinical Nutrition 64, 305311.Google Scholar
Gregory, J, Foster, K, Tyler, H & Wiseman, M (1990) The Dietary and Nutritional Survey of British Adults. London: H. M. Stationery Office.Google Scholar
Hegsted, M, Ausman, LM, Johnson, JA & Dallal, GE (1993) Dietary fat and serum lipids: an evaluation of the experimental data. American Journal of Clinical Nutrition 57, 875883.CrossRefGoogle ScholarPubMed
Hollis, JF, Carmody, TP, Connor, SL, Fey, SG & Matarazzo, JD (1986) The Nutrition Attitude Survey: associations with dietary habits, psychological and physical well-being, and coronary risk factors. Health Psychology 5, 359374.CrossRefGoogle ScholarPubMed
Holme, I, Helgeland, A, Hjermann, I, Leren, P & Lund-Larsen, PG (1980) Four-year mortality by some socio-economic indicators. The Oslo study. Journal of Epidemiology and Community Health 34, 4852.Google Scholar
Hulshof, KF, Löwik, MR, Kok, FJ, Wedel, M, Brants, HA, Hermus, RJ & ten Hoor, F (1991) Diet and other life-style factors in high and low socio-economic groups (Dutch Nutrition Surveillance System). European Journal of Clinical Nutrition 45, 441450.Google ScholarPubMed
Hulshof, KF, Wedel, M, Löwik, MR, Kok, FJ, Kistemaker, C, Hermus, RJ, ten Hoor, F & Ockhuizen, T (1992) Clustering of dietary variables and other lifestyle factors (Dutch Nutritional Surveillance System). Journal of Epidemiology and Community Health 46, 417424.CrossRefGoogle ScholarPubMed
Jacobsen, BJ & Thelle, DS (1988) The Tromsø Heart Study: risk factors for coronary heart disease and length of education. American Journal of Epidemiology 127, 923932.CrossRefGoogle Scholar
Jarvinen, R, Knekt, P, Seppänen, R, Reunanen, A, Heliovaara, M, Maatela, J & Aromaa, A (1994) Antioxidant vitamins in the diet: relationships with other personal characteristics in Finland. Journal of Epidemiology and Community Health 48, 549554.CrossRefGoogle ScholarPubMed
Johansson, L, Drevon, CA & Bjørneboe, GE Aa (1996) The Norwegian diet during the last hundred years in relation to coronary heart disease. European Journal of Clinical Nutrition 50, 277283.Google ScholarPubMed
Johansson, L, Solvoll, K, Bjørneboe, G-E Aa & Drevon, CA (1997 a) Dietary habits among Norwegian men and women. Scandinavian Journal of Nutrition 41, 6370.Google Scholar
Johansson, L, Solvoll, K, Bjørneboe, G-E Aa & Drevon, CA (1998) Under- and overreporting of energy intake related to weight status and lifestyle in a nationwide sample. American Journal of Clinical Nutrition 68, 266274.CrossRefGoogle ScholarPubMed
Johansson, L, Solvoll, K, Opdahl, S, Bjørneboe, G-E Aa & Drevon, CA (1997 b) Response rates with different distribution methods and reward, and reproducibility of a quantitative food-frequency questionnaire. European Journal of Clinical Nutrition 51, 346353.Google Scholar
Jörgensen, LM (1992) Who completes seven-day food records?. European Journal of Clinical Nutrition 46, 735741.Google Scholar
Kaplan, GA & Keil, JE (1993) Socioeconomic factors and cardiovascular disease: a review of the literature. Circulation 88, 19731998.CrossRefGoogle ScholarPubMed
Kleemola, P, Virtanen, M & Pietinen, P (1994) The 1992 Dietary Survey of Finnish Adults. Publications of the National Public Health Institute, B2/1994. Helsinki: National Public Health Institute.Google Scholar
Kristofersen, LB (1986) Mortality Among Occupationally Active. Social Differences During the 1970s (in Norwegian). Oslo: Central Bureau of Statistics.Google Scholar
Krüger, O, Aase, A & Westin, S (1995) Ischaemic heart disease mortality among men in Norway: reversal of urban–rural difference between 1966 and 1989. Journal of Epidemiology and Community Health 49, 271276.Google Scholar
Law, MR, Wald, NJ & Thompson, SG (1994) By how much and how quickly does reduction in serum cholesterol concentration lower risk of ischaemic heart disease?. British Medical Journal 308, 367372.CrossRefGoogle ScholarPubMed
Liberatos, P, Link, BG & Kelsey, JL (1988) The measurement of social class in epidemiology. Epidemiology Review 10, 87121.Google Scholar
Luoto, R, Pekkanen, J, Uutela, A & Tuomilehto, J (1994) Cardiovascular risks and socioeconomic status: differences between men and women in Finland. Journal of Epidemiology and Community Health 48, 348354.Google Scholar
Lynch, JW, Kaplan, GA, Cohen, RD, Tuomilehto, J & Salonen, JT (1996) Do cardiovascular risk factors explain the relation between socioeconomic status, risk of all-cause mortality, cardiovascular mortality, and acute myocardial infarction?. American Journal of Epidemiology 144, 934942.Google Scholar
Lynch, JW, Kaplan, GA & Salonen, JT (1997) Why do poor people behave poorly? Variation in adult health behaviours and psychosocial characteristics by stages of the socioeconomic lifecourse. Social Science and Medicine 44, 809819.CrossRefGoogle ScholarPubMed
Mackenbach, JP, Kunst, AE, Cavelaars, AE, Groenhof, F & Geurts, JJ (1997) Socioeconomic inequalities in morbidity and mortality in western Europe. The EU Working Group on Socioeconomic Inequalities in Health. Lancet 349, 16551659.Google Scholar
Mæland, JG & Aarø, LE (1993) The theoretical basis for health education in medical practice. Tidskrift for Den Norske Lægeforening 113, 5155.Google Scholar
Margetts, BM & Jackson, AA (1993) Interactions between people's diet and their smoking habits: the dietary and nutritional survey of British adults. British Medical Journal 307, 13811384.Google Scholar
Marmot, MG, Smith, GD & Stansfeld, S (1991) Health inequalities among British civil servants: the Whitehall study. Lancet 337, 13871392.Google Scholar
Ministry of Health and Social Affairs (1992) Report No. 37 to the Storting (1992–93). Challenges in Health Promotion and Prevention Strategies. Oslo: Ministry of Health and Social Affairs.Google Scholar
National Nutrition Council (1996) Trends in Norwegian Dietary Habits (in Norwegian). Oslo: National Nutrition Council.Google Scholar
Nes, M, Frost, Andersen L, Solvoll, K, Sandstad, B, Hustvedt, BE Løvø A & Drevon, CA (1992) Accuracy of a quantitative food-frequency questionnaire applied in elderly Norwegian women. European Journal of Clinical Nutrition 42, 809821.Google Scholar
Osler, M & Schroll, M (1992) Differences between participants and non-participants in a population study on nutrition and health in the elderly. European Journal of Clinical Nutrition 46, 289295.Google Scholar
Pietinen, P, Uusitalo, U, Vartiainen, E & Tuomilehto, J (1988) Dietary survey of the FINMONICA project in 1982. Acta Medica Scandinavica 28, Suppl. 7, 169177.CrossRefGoogle Scholar
Prättälä, R, Karisto, A & Berg, M-A (1994) Consistency and variation in unhealthy behaviour among Finnish men, 1982–1990. Social Science and Medicine 39, 115122.Google Scholar
Rogers, EM (1995) Lessons for guidelines from the diffusion of innovations. Joint Commission Journal on Quality Improvement 7, 324328.Google Scholar
Roos, E, Prättälä, R, Lahelma, E, Kleemola, P & Pietinen, P (1996) Modern and healthy?: socioeconomic differences in the quality of diet. European Journal of Clinical Nutrition 50, 753760.Google Scholar
Smith, AM & Baghurst, KI (1992) Public health implications of dietary differences between social status and occupational category groups. Journal of Epidemiology and Community Health 46, 409416.Google Scholar
Smith, AM & Owen, N (1992) Associations of social status and health-related beliefs with dietary fat and fiber densities. Preventive Medicine 21, 735745.Google Scholar
Solvoll, K, Lund-Larsen, K, Søyland, E, Sandstad, B & Drevon, CA (1993) A quantitative food-frequency questionnaire evaluated in a group of dermatologic outpatients. Scandinavian Journal of Nutrition 37, 150155.Google Scholar
Solvoll, K, Selmer, R, Løken, EB, Foss, OP & Trygg, K (1989) Coffee, dietary habits, and serum cholesterol among men and women 35–49 years of age. American Journal of Epidemiology 129, 12771288.Google Scholar
Statistics Norway (1993) Omnibus Survey. Technical Report June, September and November 1993, March 1994 (in Norwegian). Oslo: Statistics Norway.Google Scholar
Statistics Norway (1994) Standard Classification of Municipalities. Official Statistics of Norway, C 192. Oslo: Kongsvinger.Google Scholar
Statistics Norway (1995) Statistical Yearbook 1995. Official Statistics of Norway, C 247. Oslo: Kongsvinger.Google Scholar
Subar, AS, Heimendinger, J, Krebs-Smith, SM, Patterson, B, Kessler, R & Pivonka, E (1992) 5-A-DAY for Better Health: A Baseline Study of American's Fruit and Vegetable Consumption. Bethesda, MD: National Cancer Institute.Google Scholar
Trygg, K, Lund-Larsen, K, Sandstad, B, Hoffman, HJ, Jacobsen, G & Bakketeig, LS (1995) Do pregnant smokers eat differently from pregnant non-smokers?. Paediatric and Perinatal Epidemiology 9, 307319.CrossRefGoogle ScholarPubMed
Thürmer, H (1993) Risk factors for, and 13-year mortality from, cardiovascular disease by socioeconomic status. Thesis, National Health Screening Service, Oslo and Institute of Community Medicine, University of Tromsø, Norway.Google Scholar
Turrell, G & Najman, JM (1995) Collecting food-related data from low socioeconomic groups: how adequate are our current research designs?. Australian Journal of Public Health 19, 410416.CrossRefGoogle ScholarPubMed
Wandel, M (1995) Dietary intake of fruit and vegetables in Norway: influence of life phase and socio-economic factors. International Journal of Food Sciences and Nutrition 46, 291301.Google Scholar
Westlund, K (1971) The variation in incidence of coronary infarction (Norwegian). Nordisk Medicin 85, 458474.Google Scholar
Winkleby, MA, Jatulis, DE, Frank, E & Fortmann, SP (1992) Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. American Journal of Public Health 82, 816820.CrossRefGoogle ScholarPubMed
Witte, DJ, Skinner, JD & Carruth, BR (1991) Relationship of self-concept to nutrient intake and eating patterns in young women. Journal of the American Dietetic Association 9, 10681073.Google Scholar
World Cancer Research Fund/American Institute for Cancer Research (1997) Food, Nutrition and the Prevention of Cancer: A Global Perspective. Washington, DC: World Cancer Research Fund and American Institute for Cancer Research.Google Scholar
World Health Organization (1990) Diet, Nutrition, and the Prevention of Chronic Diseases. Report of a WHO Study Group. Technical Report Series no. 797. Geneva: WHO.Google Scholar