Selected psychosocial variables associated with a heart healthy diet in a sample of 50 year old Cantabrians: a pilot study
Background: Cardiovascular disease (CVD) is the main cause of death of New Zealanders after cancer and the prevalence increases dramatically with increasing age. Consumption of a heart healthy diet may improve modifiable CVD risk factors. For the purpose of this research a heart healthy diet is defined as a diet in which total fat contributes less than 35 % of total energy (% TE), saturated fat contributes less than 10 % TE, dietary fibre intake is greater than 25 g per day, fruit intake is more than two servings per day and vegetable intake is more than 3 servings per day. Some international and New Zealand research has assessed the association between selected psychosocial factors and dietary intake, but limited research has assessed the association between multiple psychosocial factors and the consumption of heart healthy dietary patterns in 50 year old men and women. This is a pilot study, the aim of which is to develop and investigate hypotheses which may be tested with a larger sample. Hypotheses: 1. That the dietary intake of 50 year old men and women from Canterbury does not meet heart healthy dietary guidelines 2. That positive attitudes and beliefs around a link between food intake and risk of disease are associated with consumption of a heart healthier diet 3. That higher barriers to eating healthily are associated with consumption of a less heart healthy diet 4. That greater education, household income and standard of living (measured using the Economic Living Standard Index Short Form (ELSISF))are associated with a heart healthier diet 5. That a greater knowledge of food composition (sugar, fat, salt and fibre content) is associated with a heart healthier diet Methods: This is an observational study of a random sample of 50 year olds currently living in the Canterbury District Health Board area. The data is that of the first 63 CHALICE study participants of which 30 were male and 33 female. Quantitative data were collected questionnaires examining demographics, measures of standard of living, health beliefs, attitudes and barriers to healthy eating administered during a face-to-face interview, a 4 day estimated food and beverage diary and anthropometric measurements. Hyothesis for this thesis were based around the health belief model (HBM), cognitive behavioural therapy (CBT) and social cognitive theory (SCT). Data were analysed using multiple regression and principal component analysis. Findings: Fifty year old men and women in Canterbury do not eat a heart healthy diet, defined as a moderate fat, low saturated fat, high fibre, fruit and vegetable diet. Participants’ knowledge of the national food and nutrition guidelines and basic knowledge of the sugar, fat, fibre and salt content of common foods is poor. Ninety percent of participants believed that heart attacks, high blood pressure and type 2 diabetes mellitus are totally or sometimes preventable. Standard of living was inversely associated with consumption of total fat as a % TE. Education was inversely associated with consumption of saturated fat as a % TE and positively associated with dietary fibre intake and knowledge of food composition was positively associated with vegetable intake. Principal component analysis revealed that there was an association between consumption of a “higher CVD risk” dietary pattern in people with a “comfortable” or “good/very good” standard of living who had poor knowledge of food composition and a lower level of education; only the level of education was associated with consumption of a “CVD protective” dietary pattern. The association was strongest for those with a “comfortable” standard of living. Conclusion: The results indicate that this sample of Canterbury 50 year olds do not consume a heart healthy diet that could assist to reduce their risk of developing CVD. Psychosocial variables appear to be associated with dietary intake. More educated participants who enjoy a higher standard of living consume healthier diets than less educated participants and an increased knowledge of food composition is associated with a lower score for the “higher CVD risk” dietary pattern – lower in saturated fat and higher in fruit, vegetables and dietary fibre. These results suggest that it is important to develop public health interventions to make cheaper healthier food available to everyone and show the public how to incorporate these foods into meals. Nutritionists and dietitians can also assist with increasing people’s basic nutrition knowledge which in turn may help reduce the incidence of CVD.
Advisor: Skidmore, Paula; Gearry, Richard; Pearson, John; Parnell, Winsome
Degree Name: Master of Science
Degree Discipline: Human Nutrition
Publisher: University of Otago
Keywords: diet; heart disease; pyschosocial
Research Type: Thesis