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Impact of living arrangements and nationality on food habits and nutrient intakes in young adults
Appetite 56 (2011) 726–731
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Research report
Impact of living arrangements and nationality on food habits and nutrient intakes in young adults§ Lynnette J. Riddell a,*, Bixia Ang a, Russell S.J. Keast a, Wendy Hunter b a b
School of Exercise and Nutrition Sciences, Deakin University, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia School of Health and Social Development, VIC 3125, Australia
A R T I C L E I N F O
A B S T R A C T
Article history: Received 16 June 2010 Received in revised form 11 February 2011 Accepted 16 February 2011 Available online 22 February 2011
The influence of living arrangements and nationality on nutrient intakes and food habits and beliefs were explored in young adults. Two hundred and thirty-two participants (20.4 2.8 years) completed a food questionnaire and two 24-h food records. Sixty-nine percent were living at home, and 72% described their nationality as Australian. Most participants performed their own food preparation (84%); those living away from home were significantly more likely to purchase and prepare their meals than those living at home, and no differences were observed between nationalities. The importance of healthy eating behaviours was recognised by over 80% of participants, with no differences observed between living arrangements or nationalities. Those living away from home and those who identified themselves as Australian consumed significantly more alcoholic drinks than those living at home and non-Australians. Eighty-four percent perceived their diets as healthy, however high saturated fat (13.4 3.9% energy) and sodium (2382 1166 mg) and low fibre (23 9 g) diets were consumed. Overall, few differences were observed between nationalities indicating assimilation of food cultures. Future interventions need to address the disconnect between nutrition knowledge and behaviour, irrespective of living arrangements and need to be appropriate for a range of nationalities. ß 2011 Elsevier Ltd. All rights reserved.
Keywords: Nutrient intakes Food-related habits Young adults Living arrangement Nationality
Introduction Chronic non-communicable diseases (NCDs) such as cardiovascular disease (CVD), diabetes mellitus and stroke are the leading causes of morbidity and mortality in Australia and are affecting the Australian population at a younger age (Australian Institute of Health & Welfare, 2006). This trend has been observed amongst other western countries and the role of a healthy diet in the prevention of these chronic NCDs has been well established (World Health Organization, 2003). As early exposures to unhealthy dietary behaviours are likely to follow on into adulthood (Mikkila, Rasanen, Raitakari, Pietinen, & Viikari, 2004; Richards, Kattelmann, & Ren, 2006), it is essential to encourage healthy eating behaviours in young adulthood to prevent the onset of chronic diseases later on in life (Georgiou et al., 1997; Satalic, Baric, & Keser, 2007; World Health Organization, 2003). However, young adults often take their
§ The authors would like to thank all of the participants for their generous donation of time. No conflicts of interest. Contributors: LJR, WH and RSJK conceived the study and study design, BA conducted data analysis. All authors contributed equally to the interpretation of results and writing of the manuscript. * Corresponding author. E-mail addresses: [email protected] (L.J. Riddell), [email protected] (Russell S.J. Keast), [email protected] (W. Hunter).
0195-6663/$ – see front matter ß 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.appet.2011.02.010
health for granted and following a healthy diet usually does not appear to be of great importance to them (Marquis, 2005). It has been argued that education is an important socioeconomic factor in determining risk of poor dietary intake (MacFarlane, Abbott, Crawford, & Ball, 2009) and this has led to an emphasis on the need to increase nutrition education programs for specific groups in the community, however other studies have shown that knowledge does not always transfer into healthy behaviour. For example, in a study of undergraduate students’ intentions to integrate the glycaemic index into their dietary behaviours, it was found that knowledge of the glycaemic index had a poor relationship with their intentions (Goodwin & Mullan, 2009). Similarly, the intentions of adolescents and young adults to smoke and consume low fat diets did not change with increased risk awareness (Scholz, Nagy, Gohner, Luszczynska, & Kliegel, 2009). Furthermore, young adulthood is also a time of considerable social change with many living independently for the first time (Papadaki, Hondros, & Kapsokefalou, 2007). Leaving home to live independently is a natural transition phase for most young adults and it is often a phase whereby they first become in charge of their own food choices (Beasley, Hackett, & Maxwell, 2004; Satalic et al., 2007; Zizza, Siega-Riz, & Popkin, 2001). For many young adults, changes in living arrangement results in undesirable alterations to their food consumption habits in terms of variety, fruit and vegetable consumption and frequency and timing of food intake
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(Beasley et al., 2004; de Castro, Bellisle, Feunekes, Dalix, & De Graaf, 1997; Papadaki et al., 2007). Based on earlier studies that looked at the eating patterns of young adults, in particular university students, the eating patterns and nutrient composition appear to be undesirable as they tend to skip meals frequently, have limited food variety (Colic Baric, Satalic, & Lukesic, 2003; Georgiou et al., 1997; Satalic et al., 2007), habitually snack on unhealthy foods (Anderson, Macintyre, & West, 1993; Belaski, 2001; Hsieh, 2004; Zizza et al., 2001), and consume meals with poor nutrient compositions (Hsieh, 2004; Irazusta et al., 2007; Kremmyda, Papadaki, Hondros, Kapsokefalou, & Scott, 2008; Papadaki et al., 2007; Satalic et al., 2007; Soriano, Molto, & Manes, 2000). If this transition phase also involves moving countries, further changes may be expected in food behaviours and nutrient intakes, with rapid acculturation observed with the host countries cuisine (Kremmyda et al., 2008). Previous studies have also shown differences in food intakes between young adults of differing nationalities, however the extent of these differences is highly variable and dependent on the level of dietary acculturation (Kremmyda et al., 2008; Nicolaou et al., 2009; Sukalakamala & Brittin, 2006; Wahlqvist, 2002). Brown, Edwards, and Hartwell (2010) explored the meanings attached to food by international students living in the UK and found these students generally preferred consuming the cuisine from their home countries as they perceived these foods as healthier and tastier than those available in the UK. Food from their own culture also provided some comfort through familiarity in an unfamiliar environment to the students. However, these students also indicated a willingness to try new foods in the early stages of their residency in the UK. A later study by the same researchers on food neophobia (fear of new food) in 228 international students found that the longer the students were in the UK the less likely they were to try new foods (Edwards, Hartwell, & Brown, 2010). Thus, it is probable that an individual’s nationality may also impact on their food-related behaviours and that the influence of nationality may be highly variable between individuals. Currently, the best Australian data available with regard to the nutrient intakes and eating habits of Australian young adults is from the 1995 National Nutritional Survey (NNS) (Mclennan & Podger, 1997). Within the NNS some exploration of the impact of nationality on dietary intake was undertaken. For persons over 19 years, intake of fibre and alcoholic beverages appeared lower in those born outside of Australia than intakes recorded for those born within Australia. However, as this data was collected fifteen years ago, many of the observations may have changed and the information on variance due to birthplace was not reported specifically for young adults (Mclennan & Podger, 1997). Additional Australian studies conducted in this area are also limited, with one study looking at the snacking habits of university students in Australia (Hsieh, 2004) and another looking at the dietary patterns and nutrient intakes of 18-year-old Australians (Milligan et al., 1998). Although a recent study conducted on Australian university students explored food motives in relation to socio-demographic factors such as living arrangement and gender, it did not explore the students’ actual eating habits nor the impact of nationality on food behaviours (Piggford, Raciti, Harker, & Hatker, 2008). It is therefore appropriate to investigate foodrelated habits and nutrient intakes in young adults and to determine the potential impact of living arrangements and nationality on these. Based on previous studies, it is hypothesised that undesirable eating habits and nutrient intakes characterised by limited food variety, high fat and sodium and low fibre intakes will be observed in this group of young adults. Further, young adults living away from home and those who identify themselves as Australian will have significantly different food behaviours and nutrient intakes
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compared with those living at home and those identifying themselves as non-Australian. The aims of the present study are to describe the food-related habits and beliefs, as well as to assess the nutrient intakes of young adults. The influence of living arrangement and nationality on food habits, beliefs and nutrient intakes will also be examined. Methods Subjects In 2007 and 2008, 272 university students enrolled in a food and nutrition unit completed a food and diet questionnaire, two 24-h food records and a food variety survey as part of their course work. All 272 students were invited to participate in the current study and 232 provided written consent to participate (response rate 85%). Ethical approval was obtained from Deakin University Human Research Ethics Committee (EC122007). Demographic information collected included gender, age, smoking and alcohol status, self-reported height and weight, living arrangements (living at home with parents or away from home in a shared house, with a partner or by self), and work/ study commitments. An open-ended question was used to determine nationality. Body mass index (BMI) was calculated based on self-reported height and weight and classified into three groups: underweight, normal weight, and overweight/ obese (World Health Organization, 2000). Food and diet questionnaire A food and diet questionnaire was developed based on similar questions used in previous studies investigating the eating habits of young adults (Georgiou et al., 1997; Soriano et al., 2000). The questionnaire included items asking the participants about their food shopping and preparation habits, self-perception of diet and healthy eating, and special diets. Self-perception of diet and the degree of importance placed on specific dietary activities for health were all answered on five-point Likert-type scales. The response categories for self-perception of diet were: very unhealthy, unhealthy, healthy, very healthy, and do not know. The response options indicating the importance of specific dietary activities for health were: not important, important, quite important, very important, and not sure. Nutrient intakes and eating behaviours were assessed using two 24-h food records completed over one week day and one weekend day (Karvetti & Knuts, 1992). Each individual was asked to write down everything they ate or drank as they consumed the item and record the quantity using household measures. To facilitate the recording of food and beverages, participants were provided with a printed table including prompts for recording the time of day, food or drink item, brand name and quantity. Average nutrient intake was determined using the dietary analysis program FoodWorks 2007 (Xyris Software Version 5, Qld). A checklist food variety survey (FVS) developed in Australia (Savige, Hsu-Hage, & Wahlqvist, 1997) was used to determine the variety of food consumed. This method requires minimal participant effort (Savige et al., 1997) and similar methods have been used in studies to determine the extent of dietary quality in young adults and individuals across various age groups (Drewnowski, Henderson, Driscoll, & Rolls, 1997; Steyn, Nel, Nantel, Kennedy, & Labadarios, 2006). The FVS required participants to indicate if they had eaten two tablespoons (approximately 40 g) or more of a food coming from various food groups over the last seven days and a numerical score was given for each food consumed in the checklist (Savige et al., 1997). A score of over 30 per week (out of 52) was considered ideal (Savige et al., 1997).
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Data analysis SPSS Version 15.0 software (SPSS, Chicago, IL) was used for all data analysis. Four participants provided incomplete data for living arrangements and nationality. Numerical data are expressed as means standard deviations (SD). Descriptive statistics were reported for food-related behaviours (e.g. food shopping and preparation) and specific food- and health-related beliefs (e.g. importance of consuming the recommended serves of fruit and vegetables and avoiding saturated fat in meals). Nationality was dichotomised into Australian and other for analysis. The five response categories measuring self-perception of diet were dichotomised as unhealthy (including the categories unhealthy and very unhealthy) and healthy (including the categories healthy and very healthy). The five response choices assessing beliefs about healthy eating were recategorised into three groups: not important, important (including the categories important and quite important), and very important. Responses of ‘not sure’ were excluded due to a low response. To analyse the influence of living arrangement and nationality, chisquare tests were used for categorical data (e.g. specific health beliefs) while unpaired t-tests were used for continuous data (e.g. nutrient intakes and food variety score). Statistically significant difference was set at p < 0.05.
living at home, 78% (N = 69) were Australian. Those living away from home reported having more alcoholic drinks per week compared to those living at home (p < 0.01), and those who identified themselves as Australian were more likely to consume alcohol than those of other cultures (x2 (2226) = 15.4, p < 0.001). Food shopping and preparation Although most prepared their own meals (84%), only just over a third did their own food shopping (Table 2). Most participants reported either their mothers (34%) or both their parents (59%) as the key food shoppers. For those that did not cook, food was largely prepared by their mothers (53%). With the exception of one participant, all those living away from home cooked their own meals. Those living away from home were more likely to be responsible for their own food purchasing (x2 (1228) = 99.2, p < 0.001) and preparation (x2 (1228) = 14.9, p < 0.001), compared with those living at home. On average, participants cooked 2.1 1.1 meals per week, with those living at home cooking 2.3 1.1 times per week and those living away from home cooking 1.5 0.8 times per week (p < 0.001). Food shopping and preparation behaviours did not differ between nationalities. Perceptions of diets and healthy eating
Results Participants’ characteristics A total of 232 subjects participated in this study. The majority lived at home, were female, identified themselves as Australian, were non-smokers, drank alcohol, had BMIs within the normal weight range and were engaged in paid work (Table 1). The mean age was 20.4 2.8 years old, with those living away from home significantly older (p < 0.05). Participants recorded 18 different nationalities; 72% identified themselves as Australian. Amongst the remaining 62 participants, the majority identified themselves as Asian (e.g. Vietnamese, Indian and Chinese, N = 31, 14%), or European (e.g. Italian, Greek and Polish, N = 19, 8%), and the remaining 6% of participants recorded a variety of nationalities including American, African and Middle Eastern. There were no significant differences in gender with regard to living arrangement and nationality. Of those
Eighty-four percent of the participants saw their diets as being healthy with no differences between those living at home or away from home, nor between those of differing nationalities. Participants generally recognised the importance of moderating their fat and salt intakes, as well as consuming the recommended serves of fruit, vegetables and dairy for health (Table 3). However, some participants considered avoiding saturated fat (N = 10), and eating the recommended serves of fruit (N = 7) and vegetables (N = 10) as unimportant. Fifty percent of the participants did not consider substituting red meat with white meat as important and close to 20% did not consider it important to avoid adding salt at the table. Close to 50% of the participants perceived adding salt to cooking as important or very important for their health. Although the majority felt that it was important to have wholegrain bread, less than half felt adding bran to a meal daily was important. Compared with those living at home, a greater percentage of those
Table 1 Demographic and physical characteristics of participants. Parameter
All subjects
Living at home
Living away from home
Australian
Other
n (%) Gender, n (%) Male Female Age, yearsa Smoking status, n (%) Yes No Alcohol status Non-drinker, n (%) Drinker, n (%) Alcoholic drinks/weeka BMI, kg/m2, n (%) <18.5 (underweight) 18.5–24.9 (normal weight) 25 (overweight/obese) Work commitments, n (%) Paid work No paid work
232
160 (69.0)
68 (29.3)
166 (72)
62 (27)
23 (10.5) 207 (89.5) 20.4 2.8
12 (7.5) 148 (92.5) 19.6 1.5
11 (16.2) 57 (83.8) 22.5 4.0*
17 (10.2) 149 (89.8) 20.3 2.6
5 (8.1) 57 (91.9) 20.8 3.2
9 (3.9) 223 (96.1)
6 (3.8) 154 (96.3)
3 (4.4) 65 (95.6)
7 (4.2) 159 (95.8)
2 (3.2) 60 (96.8)
43 (18.5) 185 (79.7) 3.8 4.3
31 (19.4) 126 (78.8) 3.1 3.7
12 (17.6) 56 (82.4) 5.1 5.0*
20 (12.0) 143 (86.1) 4.0 4.4
21 (33.9) 40 (64.5)** 2.8 3.3
20 (8.6) 175 (75.4) 23 (9.9)
15 (9.4) 121 (75.6) 16 (10.0)
5 (7.4) 51 (75.0) 7 (10.3)
15 (9.0) 126 (75.9) 14 (7.4)
4 (6.5) 47 (75.8) 9 (14.5)
174 (75.6) 54 (23.3)
131 (81.9) 29 (18.1)
43 (63.2) 25 (36.8)**
131 (78.9) 34 (20.5)
42 (67.7) 19 (30.6)
a * **
Living arrangement
Nationality
Data expressed as mean SD. Significantly different by living arrangement (p < 0.01) (independent t-tests). Alcohol status significantly different by nationality (p < 0.001); work commitments significantly different by living arrangement (p = 0.002) (chi-square tests).
L.J. Riddell et al. / Appetite 56 (2011) 726–731 Table 2 Food shopping and preparation habits by living arrangement. All subjects (n = 231)
Living at home (n = 160)
Living away from home (n = 68)
Food shopping Yes (%) No (%)
37.9 61.6
16.9 83.1
86.8* 13.2
Cook meals Yes (%) No (%)
84.1 15.5
78.1 21.9
98.5* 1.5
*
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Australian participants were more likely to consider it very important to eat more wholegrain bread and five serves of vegetables daily and consider it not important to add salt during cooking (p < 0.05). Nutrient intakes and food variety Mean total energy intake was 7919 2628 kJ/day and there were no differences with respect to living arrangements or nationality (Table 4). Although the percentage of energy derived from total fat was within the 20–35% range recommended to reduce chronic disease risk (National Health and Medical Research Council, Department of Health and Ageing, & Health, 2006), saturated fat intake exceeded recommendations by approximately 30%. Sodium intakes were also above (by 780 mg) and fibre intakes below (by 6 g) the national suggested dietary targets (National Health and Medical Research Council, et al., 2006). Vitamin C intake was significantly higher when living at home (p < 0.05), however there were no other observed differences in living arrangement and no differences
Significantly different by living arrangement (p < 0.001) (chi-square tests).
living away from home considered eating more wholegrain breads as important or very important (x2 (3227) = 10.284, p < 0.05) (data not shown). No other differences with respect to living arrangement and perceptions of healthy eating were observed. Nationality impacted perceptions of healthy eating; compared to participants who identified themselves as non-Australian, Table 3 Degree of importancea placed on specific dietary activities by nationality (%). All subjects (n = 230)
Australian (n = 166)
Other (n = 62)
NI
I
VI
NI
I
VI
NI
I
VI
Importance of limiting sugar intake Not adding sugar to tea/coffee Avoiding soft/fizzy drink
37.9 9.5
37.1 44.0
21.6 44.0
35.5 8.4
34.9 45.2
25.9 44.0
43.5 12.9
43.5 40.3
11.3 43.5
Importance of moderating fat intake Trimming fat from meat Substituting white meat for red meat Choosing low fat alternatives Not eating saturated fat
7.8 50.0 9.5 4.3
34.9 34.1 49.1 54.7
52.6 7.3 40.9 39.7
7.2 47.0 7.8 3.6
33.7 36.7 48.2 55.4
54.8 6.0 43.4 40.4
9.7 58.1 14.5 6.5
37.1 27.4 50.0 53.2
48.4 9.7 35.5 37.1
Importance of having cereals & grains Eating more wholegrain rather than white bread Adding bran to a meal daily
7.3 53.0
31.0 32.8
60.3 7.3
7.8 55.4
25.9 29.5
65.7 8.4
6.5 46.8
45.2 40.3
45.2* 4.8
Importance of moderating salt intake Not adding salt to food at table Adding salt to cooking
19.0 51.3
39.2 37.9
40.1 7.3
18.1 59.0
39.8 31.9
41.0 5.4
21.0 29.0
37.1 56.5
38.7 11.3*
Importance of having the recommended serves of vegetables, fruits & dairy Eating 5 serves of vegetables daily 4.3 52.2 Eating 2 serves of fruit daily 3.0 46.4 Eating 2 serves of dairy foods daily 9.1 54.3
42.7 50.9 36.6
1.8 2.4 8.4
54.2 45.2 54.2
43.4 52.4 37.3
11.3 4.8 11.3
48.4 50.0 56.5
38.7* 45.2 32.3
Importance of physical activity Being physically active each day
53.0
3.0
44.0
52.4
3.2
43.5
51.6
a *
3.0
43.1
NI, not important; I, important; VI, very important. Significantly different by nationality (p < 0.05) (chi-square tests).
Table 4 Macro- and micro-nutrient intakes estimated from two 24-h food records by living arrangement and nationality. Nutrient
Living arrangement All subjects (n = 231)
Total energy (kJ) Total fat (%) Total sat fat (%) Protein (%) CHO (%) Fibre (g) Vit C (mg) Folate (g) Na (mg) K (mg) Ca (mg) Fe (mg) Zn (mg) *
Living at home (n = 159)
Nationality Living away from home (n = 68)
Australian (n = 165)
Other (n = 62)
Mean
SD
Mean
SD
Mean
SD
Mean
SD
Mean
SD
7919 32.7 13.4 18.6 47.2 22.7 147 303 2382 3113 881 12.4 11.2
2628 7.5 3.9 5.4 8.7 8.9 98 111 1166 1114 460 4.7 5.5
7732 32.5 13.4 18.7 47.7 22.3 135 298 2326 3024 863 12.4 11.0
2476 7.5 3.9 5.5 8.7 9.1 80 112 1007 1056 416 4.9 5.5
8438 33.1 13.5 18.8 45.8 23.9 175* 320 2517 3403 951 13.0 11.9
2924 7.5 4.1 5.2 8.6 8.6 131 113 1482 1228 560 4.2 5.8
7959 32.8 13.6 18.4 47.1 23.3 145 307 2347 3143 882 12.6 11.1
2790 7.5 3.9 5.7 8.7 9.1 89 109 1025 1073 454 4.6 4.9
7834 32.8 13.0 19.2 47.1 21.1 152 290 2471 3027 85 11.7 10.9
2201 7.5 4.0 4.6 8.6 8.4 125 125 1494 1225 421 4.5 6.0
Significantly different by living arrangement (p < 0.05) (independent t-test).
730
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between nationalities. Only 67% of the participants achieved the ideal food variety score of at least 30; of these participants, 75% were living away from home. Sixty-nine percent of those that identified themselves as Australian and 63% of other nationalities had FVS above 30. The mean FVS for all participants, those living away from home and those who identified themselves as Australian were 31.7 5.6, 32.7 6.1 and 31.7 5.1, respectively. No differences in total FVS or the number of participants achieving ideal food variety was observed with respect to the participant’s living arrangement or nationality. Discussion Recent studies looking at the eating habits and nutrient intakes of Australian young adults are limited and our existing knowledge is largely drawn from studies conducted in other food environments (Colic Baric et al., 2003; Marquis, 2005; Papadaki et al., 2007; Satalic et al., 2007; Wechsler, Lee, Nelson, & Kuo, 2002), which may not be applicable to the Australian culture. This study explores the food habits and nutrient intakes of young adults living in Australia and investigates the influences of living arrangement and nationality on food-related behaviours and nutrient intakes. Within this study population, little difference was observed between living arrangements and nationality. Similar to previous publications, the majority of participants who lived at home reported their parents as the primary person responsible for their food provision (Papadaki et al., 2007). They also consumed fewer alcoholic drinks per week compared to their peers living away from home (Lau, Quadrel, & Hartman, 1990; Valliant & Scanlan, 1996; Wechsler et al., 2002). However, contrary to earlier publications (Kremmyda et al., 2008; Papadaki et al., 2007), those who lived away from home in this study did not have less desirable nutrient intakes or poorer food-related habits (except alcohol consumption) and beliefs compared with their peers living at home. Discrepancies between studies might have occurred as those living away from home in this study were significantly older than those living at home. Hence, it could be inferred that they were mature and took responsibility to try to achieve desirable dietary habits. In addition, although international studies had shown a relationship between living arrangements and eating behaviours (Beasley et al., 2004; Kremmyda et al., 2008; Papadaki et al., 2007), such a relationship might not be evidenced in Australia (Piggford et al., 2008). As the present participants were also all enrolled in university and completing a food and nutrition course, those living away from home may be more highly motivated toward healthier eating. Even though the number of alcoholic drinks consumed by those living away from home was higher than those at home, the reported intakes were still within the national guidelines (Kellett, Smith, & Schmerlaib, 1998). Those who identified themselves as Australian were more likely to be alcohol drinkers and consumed more alcoholic drinks per week than those of other nationalities. This observation is consistent with the finding in the 1995 NNS that, for adults over 19 years, those born in East Asian countries consumed lower amounts of alcohol than those born in Australia (23.4 and 28.6 g per day per consumer for those born in East Asia and Australia respectively) (Mclennan & Podger, 1997). This might indicate the possible influence of cultural expectations on alcohol consumption. However, care has to be taken when interpreting self-reported alcohol intakes as it is highly likely that alcohol consumption may be under-reported due to social desirability bias (Gibson, 2005). Current nutrient intakes in this study were comparable to those reported by young adults between 19 to 24 years old in the 1995 National Nutrition Survey (NNS) (Mclennan & Podger, 1997). With the exception of fibre and folate intakes, the current overall
nutrient intakes generally met the respective adequate intake (AI) and estimated average requirement (EAR) for individuals between 19 and 30 years old derived from the Nutrient Reference Values for Australia and New Zealand (National Health and Medical Research Council, et al., 2006). Unlike the NNS whereby less than 5% of the young adults reported following a fat modified diet (Mclennan & Podger, 1997), almost half of the participants followed low fat and/ or low sugar diets in this study. This could be due to a greater emphasis placed on moderating fat intakes and more low fat food options being available in the market over the years or a characteristic unique to this study population. Dietary guidelines have been established to help promote healthy eating and diets appropriate for chronic disease risk reduction (National Health and Medical Research Council, et al., 2006). However, earlier research has shown the Australian population to have limited understanding of these guidelines (Ball, Mishra, Thane, & Hodge, 2004; Jamison, 1995). This study population recognised the importance of a number of health behaviours consistent with the dietary guidelines with few differences observed with differing living arrangements and nationalities. Surprisingly, despite the majority showing an understanding of the guidelines, food variety was limited and saturated fat and sodium intakes were still higher than the national recommendations (National Health and Medical Research Council, et al., 2006). This supports other studies that have also observed a disconnect between knowledge and health behaviours (Goodwin & Mullan, 2009; Scholz et al., 2009). Although key contributors to saturated fat and sodium in the diets were not determined, young adults’ reliance on convenience and take-away meals had been the suggested reasons in other studies (Marquis, 2005; Milligan et al., 1998). The limited food variety observed is a cause of concern as food variety has been associated with nutrient quality amongst adults over 19 years old (Foote, Murphy, Wilkens, Basiotis, & Carlson, 2004). This study observed little difference in either food behaviours or nutrient intakes with individuals of differing nationality. These findings are consistent with previous publications showing rapid acculturation of dietary practices in migrant populations (Kremmyda et al., 2008; Nicolaou, Van Dam, & Stronks, 2006; Sukalakamala & Brittin, 2006). The reason for this similarity in diet may possibly be attributed to the extent to which the students have become acculturated (Edwards et al., 2010; Sukalakamala & Brittin, 2006). However, it is just as probable that the Australia diet has been heavily influenced by long term migration of people from Asian populations (for a review see Wahlqvist, 2002) and similar findings have been reported from the UK, with Italian and Indian foods introduced by migrants, replacing traditional British meals in popularity (Mitchell, 2006). Despite these observations, traditional food culture is a important and integral component to the identity of many individuals (Nicolaou et al., 2009) and public health nutrition messages must be culturally appropriate. In interpreting the findings, it is important to recognise the limitations that were present. In 2008, males comprised 51% of the Australian population aged 18–24 years and were thus underrepresented in the study sample (Australian Bureau of Statistics, 2008b). Additionally, while the entire study sample was enrolled in university, nationally only 39.9% of those aged 18–24 were participating in post-school education or training in 2008 (Australian Bureau of Statistics, 2008a). Moreover, as the participants were undertaking a food and nutrition course, it is possible that they have a greater interest in nutrition and food, this may result in more desirable dietary habits compared to the general young adult population (Papadaki et al., 2007). Hence, results from this study are not representative of the general young adult population in Australia. Although the sample size may appear to be small, previous overseas studies that looked at the eating habits and nutritional status of young adults have also used
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similar sample sizes and obtained conclusive results (Irazusta et al., 2007; Papadaki et al., 2007). The observed disconnect between knowledge and behaviour is consistent with previous observations in a range of different health issues (Goodwin & Mullan, 2009; Scholz et al., 2009). This reluctance to accept changes to food intake may also be influenced by food neophobia for international students (Edwards et al., 2010). Thus, these results further add to the literature acknowledging that enhancing nutrition knowledge will not by itself necessarily result in improved dietary behaviours. Understanding changes required to translate knowledge into action is of fundamental importance if dietary improvements are to be made. Outcomes from initiatives such as those investigating the impact of altering the food environment to better support healthy choices (Swinburn et al., 2008) and investigating the value placed on healthy eating changes in young adults should help add to our understanding of how best improve dietary intake. Future work should focus on what it would take for young adults to understand the association between their own disease risk and dietary intake and what would best motivate them to engage in lifelong eating habits that support optimal health. References Anderson, A., Macintyre, S., & West, P. (1993). Adolescent meal patterns. Grazing habits in the west of Scotland. Health Bulletin, 51, 158–165. Australian Bureau of Statistics. (2008a). Education and work, Australia (ABS Cat no. 6227.0). Canberra, Australia: ABS. Australian Bureau of Statistics. (2008b). Population by age and sex, Australian states and territories, Jun 2008 (ABS Cat no. 3201.0). Canberra, Australia: ABS. 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Kellett, E., Smith, A., & Schmerlaib, Y. (1998). The Australian guide to healthy eating. Canberra, Australia: Commonwealth of Australia. Kremmyda, L. S., Papadaki, A., Hondros, G., Kapsokefalou, M., & Scott, J. A. (2008). Differentiating between the effect of rapid dietary acculturation and the effect of living away from home for the first time, on the diets of Greek students studying in Glasgow. Appetite, 50(2–3), 455–463. Lau, R. R., Quadrel, M. J., & Hartman, K. A. (1990). Development and change of young adults’ preventive health beliefs and behavior. Influence from parents and peers. Journal of Health and Social Behavior, 31(3), 240–259. MacFarlane, A. M., Abbott, G. R., Crawford, D. A., & Ball, K. (2009). Sociodemographic and behavioural correlates of weight status among women with children living in socioeconomically disadvantaged neighbourhoods. International Journal of Obesity (London), 33(11), 1289–1298. Marquis, M. (2005). Exploring convenience orientation as a food motivation for college students living in residence halls. International Journal of Consumer Studies, 29(1), 55–63. Mclennan, W., & Podger, A. (1997). National Nutrition Survey: selected highlights. Australia: Australia Bureau of Statistics. Mikkila, V., Rasanen, L., Raitakari, O., Pietinen, P., & Viikari, J. (2004). Longitudinal changes in diet from childhood into adulthood with respect to risk of cardiovascular diseases. The cardiovasular risk in young finns study. European Journal of Clinical Nutrition, 58, 1038–1045. Milligan, R. A., Burke, V., Beilin, L. J., Dunbar, D. L., Spencer, M. J., Balde, E., et al. (1998). Influence of gender and socio-economic status on dietary patterns and nutrient intakes in 18-year-old Australians. Australian and New Zealand Journal of Public Health, 22(4), 485–493. Mitchell, J. (2006). Food acceptance and acculturation. Journal of Food Service, 17, 77– 83. National Health and Medical Research Council, Department of Health and Ageing, & Health, M.o.. (2006). Nutrient reference values for Australia and New Zealand: including dietary recommended intakes. Canberra: NHMRC Publications. Nicolaou, M., Doak, C., van Dam, R. M., Brug, J., Stronks, K., & Seidell, J. C. (2009). Cultural and social influences on food consumption in Dutch residents of Turkish and Moroccan origin. A qualitative study. Journal of Nutrition Education and Behavior, 41, 232–241. Nicolaou, M., Van Dam, R. M., & Stronks, K. (2006). Acculuration and education level in relation to quality of the diet. A study of Surinamese South Asian and AfroCaribbean residents of the Netherlands. Journal of Human Nutrition and Dietetics, 19, 383–393. Papadaki, A., Hondros, G., J.A.S., & Kapsokefalou, M. (2007). Eating habits of university students living at, or away from home in Greece. Appetite, 49(1), 169– 176. Piggford, T., Raciti, M., Harker, D., & Hatker, M. (2008). Young adults’ food motives. An Australian social marketing perspective. Young Consumers: Insight and Ideas for Responsible Marketers 9(17–28). Richards, A., Kattelmann, K. K., & Ren, C. (2006). Motivating 18- to 24-year-olds to increase their fruit and vegetable consumption. Journal of the American Dietetic Association, 106(9), 1405–1411. Satalic, Z., Baric, I. C., & Keser, I. (2007). Diet quality in Croatian university students. Energy, macronutrient and micronutrient intakes according to gender. International Journal of Food Sciences and Nutrition, 58(5), 398–410. Savige, G., Hsu-Hage, B., & Wahlqvist, M. (1997). Food variety as nutritional therapy. Current Therapy, 3, 57–67. Scholz, U., Nagy, G., Gohner, W., Luszczynska, A., & Kliegel, M. (2009). Changes in selfregulatory cognitions as predictors of changes in smoking and nutrition behaviour. Psychology & Health, 24(5), 545–561. Soriano, J. M., Molto, J. C., & Manes, J. (2000). Dietary intake and food pattern among university students. Nutrition Research, 20(9), 1249–1258. Steyn, N. P., Nel, J. H., Nantel, G., Kennedy, G., & Labadarios, D. (2006). Food variety and dietary diversity scores in children. Are they good indicators of dietary adequacy? Public Health Nutrition, 9(5), 644–650. Sukalakamala, S., & Brittin, H. (2006). Food practices, changes, preferences, and acculturation of Thais in the United States. Journal of the American Dietetic Association 106(103–108). Swinburn, B., Sacks, G., Lobstein, T., Rigby, N., Baur, L. A., Brownell, K. D., et al. (2008). The ‘Sydney Principles’ for reducing the commercial promotion of foods and beverages to children. Public Health Nutrition, 11(9), 881–886. Valliant, P. M., & Scanlan, P. (1996). Personality, living arrangements, and alcohol use by first year university students. Social Behavior and Personality, 24(2), 151– 156. Wahlqvist, M. (2002). Asian migration to Australia. Food and health consequences. 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Research report
Impact of living arrangements and nationality on food habits and nutrient intakes in young adults§ Lynnette J. Riddell a,*, Bixia Ang a, Russell S.J. Keast a, Wendy Hunter b a b
School of Exercise and Nutrition Sciences, Deakin University, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia School of Health and Social Development, VIC 3125, Australia
A R T I C L E I N F O
A B S T R A C T
Article history: Received 16 June 2010 Received in revised form 11 February 2011 Accepted 16 February 2011 Available online 22 February 2011
The influence of living arrangements and nationality on nutrient intakes and food habits and beliefs were explored in young adults. Two hundred and thirty-two participants (20.4 2.8 years) completed a food questionnaire and two 24-h food records. Sixty-nine percent were living at home, and 72% described their nationality as Australian. Most participants performed their own food preparation (84%); those living away from home were significantly more likely to purchase and prepare their meals than those living at home, and no differences were observed between nationalities. The importance of healthy eating behaviours was recognised by over 80% of participants, with no differences observed between living arrangements or nationalities. Those living away from home and those who identified themselves as Australian consumed significantly more alcoholic drinks than those living at home and non-Australians. Eighty-four percent perceived their diets as healthy, however high saturated fat (13.4 3.9% energy) and sodium (2382 1166 mg) and low fibre (23 9 g) diets were consumed. Overall, few differences were observed between nationalities indicating assimilation of food cultures. Future interventions need to address the disconnect between nutrition knowledge and behaviour, irrespective of living arrangements and need to be appropriate for a range of nationalities. ß 2011 Elsevier Ltd. All rights reserved.
Keywords: Nutrient intakes Food-related habits Young adults Living arrangement Nationality
Introduction Chronic non-communicable diseases (NCDs) such as cardiovascular disease (CVD), diabetes mellitus and stroke are the leading causes of morbidity and mortality in Australia and are affecting the Australian population at a younger age (Australian Institute of Health & Welfare, 2006). This trend has been observed amongst other western countries and the role of a healthy diet in the prevention of these chronic NCDs has been well established (World Health Organization, 2003). As early exposures to unhealthy dietary behaviours are likely to follow on into adulthood (Mikkila, Rasanen, Raitakari, Pietinen, & Viikari, 2004; Richards, Kattelmann, & Ren, 2006), it is essential to encourage healthy eating behaviours in young adulthood to prevent the onset of chronic diseases later on in life (Georgiou et al., 1997; Satalic, Baric, & Keser, 2007; World Health Organization, 2003). However, young adults often take their
§ The authors would like to thank all of the participants for their generous donation of time. No conflicts of interest. Contributors: LJR, WH and RSJK conceived the study and study design, BA conducted data analysis. All authors contributed equally to the interpretation of results and writing of the manuscript. * Corresponding author. E-mail addresses: [email protected] (L.J. Riddell), [email protected] (Russell S.J. Keast), [email protected] (W. Hunter).
0195-6663/$ – see front matter ß 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.appet.2011.02.010
health for granted and following a healthy diet usually does not appear to be of great importance to them (Marquis, 2005). It has been argued that education is an important socioeconomic factor in determining risk of poor dietary intake (MacFarlane, Abbott, Crawford, & Ball, 2009) and this has led to an emphasis on the need to increase nutrition education programs for specific groups in the community, however other studies have shown that knowledge does not always transfer into healthy behaviour. For example, in a study of undergraduate students’ intentions to integrate the glycaemic index into their dietary behaviours, it was found that knowledge of the glycaemic index had a poor relationship with their intentions (Goodwin & Mullan, 2009). Similarly, the intentions of adolescents and young adults to smoke and consume low fat diets did not change with increased risk awareness (Scholz, Nagy, Gohner, Luszczynska, & Kliegel, 2009). Furthermore, young adulthood is also a time of considerable social change with many living independently for the first time (Papadaki, Hondros, & Kapsokefalou, 2007). Leaving home to live independently is a natural transition phase for most young adults and it is often a phase whereby they first become in charge of their own food choices (Beasley, Hackett, & Maxwell, 2004; Satalic et al., 2007; Zizza, Siega-Riz, & Popkin, 2001). For many young adults, changes in living arrangement results in undesirable alterations to their food consumption habits in terms of variety, fruit and vegetable consumption and frequency and timing of food intake
L.J. Riddell et al. / Appetite 56 (2011) 726–731
(Beasley et al., 2004; de Castro, Bellisle, Feunekes, Dalix, & De Graaf, 1997; Papadaki et al., 2007). Based on earlier studies that looked at the eating patterns of young adults, in particular university students, the eating patterns and nutrient composition appear to be undesirable as they tend to skip meals frequently, have limited food variety (Colic Baric, Satalic, & Lukesic, 2003; Georgiou et al., 1997; Satalic et al., 2007), habitually snack on unhealthy foods (Anderson, Macintyre, & West, 1993; Belaski, 2001; Hsieh, 2004; Zizza et al., 2001), and consume meals with poor nutrient compositions (Hsieh, 2004; Irazusta et al., 2007; Kremmyda, Papadaki, Hondros, Kapsokefalou, & Scott, 2008; Papadaki et al., 2007; Satalic et al., 2007; Soriano, Molto, & Manes, 2000). If this transition phase also involves moving countries, further changes may be expected in food behaviours and nutrient intakes, with rapid acculturation observed with the host countries cuisine (Kremmyda et al., 2008). Previous studies have also shown differences in food intakes between young adults of differing nationalities, however the extent of these differences is highly variable and dependent on the level of dietary acculturation (Kremmyda et al., 2008; Nicolaou et al., 2009; Sukalakamala & Brittin, 2006; Wahlqvist, 2002). Brown, Edwards, and Hartwell (2010) explored the meanings attached to food by international students living in the UK and found these students generally preferred consuming the cuisine from their home countries as they perceived these foods as healthier and tastier than those available in the UK. Food from their own culture also provided some comfort through familiarity in an unfamiliar environment to the students. However, these students also indicated a willingness to try new foods in the early stages of their residency in the UK. A later study by the same researchers on food neophobia (fear of new food) in 228 international students found that the longer the students were in the UK the less likely they were to try new foods (Edwards, Hartwell, & Brown, 2010). Thus, it is probable that an individual’s nationality may also impact on their food-related behaviours and that the influence of nationality may be highly variable between individuals. Currently, the best Australian data available with regard to the nutrient intakes and eating habits of Australian young adults is from the 1995 National Nutritional Survey (NNS) (Mclennan & Podger, 1997). Within the NNS some exploration of the impact of nationality on dietary intake was undertaken. For persons over 19 years, intake of fibre and alcoholic beverages appeared lower in those born outside of Australia than intakes recorded for those born within Australia. However, as this data was collected fifteen years ago, many of the observations may have changed and the information on variance due to birthplace was not reported specifically for young adults (Mclennan & Podger, 1997). Additional Australian studies conducted in this area are also limited, with one study looking at the snacking habits of university students in Australia (Hsieh, 2004) and another looking at the dietary patterns and nutrient intakes of 18-year-old Australians (Milligan et al., 1998). Although a recent study conducted on Australian university students explored food motives in relation to socio-demographic factors such as living arrangement and gender, it did not explore the students’ actual eating habits nor the impact of nationality on food behaviours (Piggford, Raciti, Harker, & Hatker, 2008). It is therefore appropriate to investigate foodrelated habits and nutrient intakes in young adults and to determine the potential impact of living arrangements and nationality on these. Based on previous studies, it is hypothesised that undesirable eating habits and nutrient intakes characterised by limited food variety, high fat and sodium and low fibre intakes will be observed in this group of young adults. Further, young adults living away from home and those who identify themselves as Australian will have significantly different food behaviours and nutrient intakes
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compared with those living at home and those identifying themselves as non-Australian. The aims of the present study are to describe the food-related habits and beliefs, as well as to assess the nutrient intakes of young adults. The influence of living arrangement and nationality on food habits, beliefs and nutrient intakes will also be examined. Methods Subjects In 2007 and 2008, 272 university students enrolled in a food and nutrition unit completed a food and diet questionnaire, two 24-h food records and a food variety survey as part of their course work. All 272 students were invited to participate in the current study and 232 provided written consent to participate (response rate 85%). Ethical approval was obtained from Deakin University Human Research Ethics Committee (EC122007). Demographic information collected included gender, age, smoking and alcohol status, self-reported height and weight, living arrangements (living at home with parents or away from home in a shared house, with a partner or by self), and work/ study commitments. An open-ended question was used to determine nationality. Body mass index (BMI) was calculated based on self-reported height and weight and classified into three groups: underweight, normal weight, and overweight/ obese (World Health Organization, 2000). Food and diet questionnaire A food and diet questionnaire was developed based on similar questions used in previous studies investigating the eating habits of young adults (Georgiou et al., 1997; Soriano et al., 2000). The questionnaire included items asking the participants about their food shopping and preparation habits, self-perception of diet and healthy eating, and special diets. Self-perception of diet and the degree of importance placed on specific dietary activities for health were all answered on five-point Likert-type scales. The response categories for self-perception of diet were: very unhealthy, unhealthy, healthy, very healthy, and do not know. The response options indicating the importance of specific dietary activities for health were: not important, important, quite important, very important, and not sure. Nutrient intakes and eating behaviours were assessed using two 24-h food records completed over one week day and one weekend day (Karvetti & Knuts, 1992). Each individual was asked to write down everything they ate or drank as they consumed the item and record the quantity using household measures. To facilitate the recording of food and beverages, participants were provided with a printed table including prompts for recording the time of day, food or drink item, brand name and quantity. Average nutrient intake was determined using the dietary analysis program FoodWorks 2007 (Xyris Software Version 5, Qld). A checklist food variety survey (FVS) developed in Australia (Savige, Hsu-Hage, & Wahlqvist, 1997) was used to determine the variety of food consumed. This method requires minimal participant effort (Savige et al., 1997) and similar methods have been used in studies to determine the extent of dietary quality in young adults and individuals across various age groups (Drewnowski, Henderson, Driscoll, & Rolls, 1997; Steyn, Nel, Nantel, Kennedy, & Labadarios, 2006). The FVS required participants to indicate if they had eaten two tablespoons (approximately 40 g) or more of a food coming from various food groups over the last seven days and a numerical score was given for each food consumed in the checklist (Savige et al., 1997). A score of over 30 per week (out of 52) was considered ideal (Savige et al., 1997).
L.J. Riddell et al. / Appetite 56 (2011) 726–731
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Data analysis SPSS Version 15.0 software (SPSS, Chicago, IL) was used for all data analysis. Four participants provided incomplete data for living arrangements and nationality. Numerical data are expressed as means standard deviations (SD). Descriptive statistics were reported for food-related behaviours (e.g. food shopping and preparation) and specific food- and health-related beliefs (e.g. importance of consuming the recommended serves of fruit and vegetables and avoiding saturated fat in meals). Nationality was dichotomised into Australian and other for analysis. The five response categories measuring self-perception of diet were dichotomised as unhealthy (including the categories unhealthy and very unhealthy) and healthy (including the categories healthy and very healthy). The five response choices assessing beliefs about healthy eating were recategorised into three groups: not important, important (including the categories important and quite important), and very important. Responses of ‘not sure’ were excluded due to a low response. To analyse the influence of living arrangement and nationality, chisquare tests were used for categorical data (e.g. specific health beliefs) while unpaired t-tests were used for continuous data (e.g. nutrient intakes and food variety score). Statistically significant difference was set at p < 0.05.
living at home, 78% (N = 69) were Australian. Those living away from home reported having more alcoholic drinks per week compared to those living at home (p < 0.01), and those who identified themselves as Australian were more likely to consume alcohol than those of other cultures (x2 (2226) = 15.4, p < 0.001). Food shopping and preparation Although most prepared their own meals (84%), only just over a third did their own food shopping (Table 2). Most participants reported either their mothers (34%) or both their parents (59%) as the key food shoppers. For those that did not cook, food was largely prepared by their mothers (53%). With the exception of one participant, all those living away from home cooked their own meals. Those living away from home were more likely to be responsible for their own food purchasing (x2 (1228) = 99.2, p < 0.001) and preparation (x2 (1228) = 14.9, p < 0.001), compared with those living at home. On average, participants cooked 2.1 1.1 meals per week, with those living at home cooking 2.3 1.1 times per week and those living away from home cooking 1.5 0.8 times per week (p < 0.001). Food shopping and preparation behaviours did not differ between nationalities. Perceptions of diets and healthy eating
Results Participants’ characteristics A total of 232 subjects participated in this study. The majority lived at home, were female, identified themselves as Australian, were non-smokers, drank alcohol, had BMIs within the normal weight range and were engaged in paid work (Table 1). The mean age was 20.4 2.8 years old, with those living away from home significantly older (p < 0.05). Participants recorded 18 different nationalities; 72% identified themselves as Australian. Amongst the remaining 62 participants, the majority identified themselves as Asian (e.g. Vietnamese, Indian and Chinese, N = 31, 14%), or European (e.g. Italian, Greek and Polish, N = 19, 8%), and the remaining 6% of participants recorded a variety of nationalities including American, African and Middle Eastern. There were no significant differences in gender with regard to living arrangement and nationality. Of those
Eighty-four percent of the participants saw their diets as being healthy with no differences between those living at home or away from home, nor between those of differing nationalities. Participants generally recognised the importance of moderating their fat and salt intakes, as well as consuming the recommended serves of fruit, vegetables and dairy for health (Table 3). However, some participants considered avoiding saturated fat (N = 10), and eating the recommended serves of fruit (N = 7) and vegetables (N = 10) as unimportant. Fifty percent of the participants did not consider substituting red meat with white meat as important and close to 20% did not consider it important to avoid adding salt at the table. Close to 50% of the participants perceived adding salt to cooking as important or very important for their health. Although the majority felt that it was important to have wholegrain bread, less than half felt adding bran to a meal daily was important. Compared with those living at home, a greater percentage of those
Table 1 Demographic and physical characteristics of participants. Parameter
All subjects
Living at home
Living away from home
Australian
Other
n (%) Gender, n (%) Male Female Age, yearsa Smoking status, n (%) Yes No Alcohol status Non-drinker, n (%) Drinker, n (%) Alcoholic drinks/weeka BMI, kg/m2, n (%) <18.5 (underweight) 18.5–24.9 (normal weight) 25 (overweight/obese) Work commitments, n (%) Paid work No paid work
232
160 (69.0)
68 (29.3)
166 (72)
62 (27)
23 (10.5) 207 (89.5) 20.4 2.8
12 (7.5) 148 (92.5) 19.6 1.5
11 (16.2) 57 (83.8) 22.5 4.0*
17 (10.2) 149 (89.8) 20.3 2.6
5 (8.1) 57 (91.9) 20.8 3.2
9 (3.9) 223 (96.1)
6 (3.8) 154 (96.3)
3 (4.4) 65 (95.6)
7 (4.2) 159 (95.8)
2 (3.2) 60 (96.8)
43 (18.5) 185 (79.7) 3.8 4.3
31 (19.4) 126 (78.8) 3.1 3.7
12 (17.6) 56 (82.4) 5.1 5.0*
20 (12.0) 143 (86.1) 4.0 4.4
21 (33.9) 40 (64.5)** 2.8 3.3
20 (8.6) 175 (75.4) 23 (9.9)
15 (9.4) 121 (75.6) 16 (10.0)
5 (7.4) 51 (75.0) 7 (10.3)
15 (9.0) 126 (75.9) 14 (7.4)
4 (6.5) 47 (75.8) 9 (14.5)
174 (75.6) 54 (23.3)
131 (81.9) 29 (18.1)
43 (63.2) 25 (36.8)**
131 (78.9) 34 (20.5)
42 (67.7) 19 (30.6)
a * **
Living arrangement
Nationality
Data expressed as mean SD. Significantly different by living arrangement (p < 0.01) (independent t-tests). Alcohol status significantly different by nationality (p < 0.001); work commitments significantly different by living arrangement (p = 0.002) (chi-square tests).
L.J. Riddell et al. / Appetite 56 (2011) 726–731 Table 2 Food shopping and preparation habits by living arrangement. All subjects (n = 231)
Living at home (n = 160)
Living away from home (n = 68)
Food shopping Yes (%) No (%)
37.9 61.6
16.9 83.1
86.8* 13.2
Cook meals Yes (%) No (%)
84.1 15.5
78.1 21.9
98.5* 1.5
*
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Australian participants were more likely to consider it very important to eat more wholegrain bread and five serves of vegetables daily and consider it not important to add salt during cooking (p < 0.05). Nutrient intakes and food variety Mean total energy intake was 7919 2628 kJ/day and there were no differences with respect to living arrangements or nationality (Table 4). Although the percentage of energy derived from total fat was within the 20–35% range recommended to reduce chronic disease risk (National Health and Medical Research Council, Department of Health and Ageing, & Health, 2006), saturated fat intake exceeded recommendations by approximately 30%. Sodium intakes were also above (by 780 mg) and fibre intakes below (by 6 g) the national suggested dietary targets (National Health and Medical Research Council, et al., 2006). Vitamin C intake was significantly higher when living at home (p < 0.05), however there were no other observed differences in living arrangement and no differences
Significantly different by living arrangement (p < 0.001) (chi-square tests).
living away from home considered eating more wholegrain breads as important or very important (x2 (3227) = 10.284, p < 0.05) (data not shown). No other differences with respect to living arrangement and perceptions of healthy eating were observed. Nationality impacted perceptions of healthy eating; compared to participants who identified themselves as non-Australian, Table 3 Degree of importancea placed on specific dietary activities by nationality (%). All subjects (n = 230)
Australian (n = 166)
Other (n = 62)
NI
I
VI
NI
I
VI
NI
I
VI
Importance of limiting sugar intake Not adding sugar to tea/coffee Avoiding soft/fizzy drink
37.9 9.5
37.1 44.0
21.6 44.0
35.5 8.4
34.9 45.2
25.9 44.0
43.5 12.9
43.5 40.3
11.3 43.5
Importance of moderating fat intake Trimming fat from meat Substituting white meat for red meat Choosing low fat alternatives Not eating saturated fat
7.8 50.0 9.5 4.3
34.9 34.1 49.1 54.7
52.6 7.3 40.9 39.7
7.2 47.0 7.8 3.6
33.7 36.7 48.2 55.4
54.8 6.0 43.4 40.4
9.7 58.1 14.5 6.5
37.1 27.4 50.0 53.2
48.4 9.7 35.5 37.1
Importance of having cereals & grains Eating more wholegrain rather than white bread Adding bran to a meal daily
7.3 53.0
31.0 32.8
60.3 7.3
7.8 55.4
25.9 29.5
65.7 8.4
6.5 46.8
45.2 40.3
45.2* 4.8
Importance of moderating salt intake Not adding salt to food at table Adding salt to cooking
19.0 51.3
39.2 37.9
40.1 7.3
18.1 59.0
39.8 31.9
41.0 5.4
21.0 29.0
37.1 56.5
38.7 11.3*
Importance of having the recommended serves of vegetables, fruits & dairy Eating 5 serves of vegetables daily 4.3 52.2 Eating 2 serves of fruit daily 3.0 46.4 Eating 2 serves of dairy foods daily 9.1 54.3
42.7 50.9 36.6
1.8 2.4 8.4
54.2 45.2 54.2
43.4 52.4 37.3
11.3 4.8 11.3
48.4 50.0 56.5
38.7* 45.2 32.3
Importance of physical activity Being physically active each day
53.0
3.0
44.0
52.4
3.2
43.5
51.6
a *
3.0
43.1
NI, not important; I, important; VI, very important. Significantly different by nationality (p < 0.05) (chi-square tests).
Table 4 Macro- and micro-nutrient intakes estimated from two 24-h food records by living arrangement and nationality. Nutrient
Living arrangement All subjects (n = 231)
Total energy (kJ) Total fat (%) Total sat fat (%) Protein (%) CHO (%) Fibre (g) Vit C (mg) Folate (g) Na (mg) K (mg) Ca (mg) Fe (mg) Zn (mg) *
Living at home (n = 159)
Nationality Living away from home (n = 68)
Australian (n = 165)
Other (n = 62)
Mean
SD
Mean
SD
Mean
SD
Mean
SD
Mean
SD
7919 32.7 13.4 18.6 47.2 22.7 147 303 2382 3113 881 12.4 11.2
2628 7.5 3.9 5.4 8.7 8.9 98 111 1166 1114 460 4.7 5.5
7732 32.5 13.4 18.7 47.7 22.3 135 298 2326 3024 863 12.4 11.0
2476 7.5 3.9 5.5 8.7 9.1 80 112 1007 1056 416 4.9 5.5
8438 33.1 13.5 18.8 45.8 23.9 175* 320 2517 3403 951 13.0 11.9
2924 7.5 4.1 5.2 8.6 8.6 131 113 1482 1228 560 4.2 5.8
7959 32.8 13.6 18.4 47.1 23.3 145 307 2347 3143 882 12.6 11.1
2790 7.5 3.9 5.7 8.7 9.1 89 109 1025 1073 454 4.6 4.9
7834 32.8 13.0 19.2 47.1 21.1 152 290 2471 3027 85 11.7 10.9
2201 7.5 4.0 4.6 8.6 8.4 125 125 1494 1225 421 4.5 6.0
Significantly different by living arrangement (p < 0.05) (independent t-test).
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between nationalities. Only 67% of the participants achieved the ideal food variety score of at least 30; of these participants, 75% were living away from home. Sixty-nine percent of those that identified themselves as Australian and 63% of other nationalities had FVS above 30. The mean FVS for all participants, those living away from home and those who identified themselves as Australian were 31.7 5.6, 32.7 6.1 and 31.7 5.1, respectively. No differences in total FVS or the number of participants achieving ideal food variety was observed with respect to the participant’s living arrangement or nationality. Discussion Recent studies looking at the eating habits and nutrient intakes of Australian young adults are limited and our existing knowledge is largely drawn from studies conducted in other food environments (Colic Baric et al., 2003; Marquis, 2005; Papadaki et al., 2007; Satalic et al., 2007; Wechsler, Lee, Nelson, & Kuo, 2002), which may not be applicable to the Australian culture. This study explores the food habits and nutrient intakes of young adults living in Australia and investigates the influences of living arrangement and nationality on food-related behaviours and nutrient intakes. Within this study population, little difference was observed between living arrangements and nationality. Similar to previous publications, the majority of participants who lived at home reported their parents as the primary person responsible for their food provision (Papadaki et al., 2007). They also consumed fewer alcoholic drinks per week compared to their peers living away from home (Lau, Quadrel, & Hartman, 1990; Valliant & Scanlan, 1996; Wechsler et al., 2002). However, contrary to earlier publications (Kremmyda et al., 2008; Papadaki et al., 2007), those who lived away from home in this study did not have less desirable nutrient intakes or poorer food-related habits (except alcohol consumption) and beliefs compared with their peers living at home. Discrepancies between studies might have occurred as those living away from home in this study were significantly older than those living at home. Hence, it could be inferred that they were mature and took responsibility to try to achieve desirable dietary habits. In addition, although international studies had shown a relationship between living arrangements and eating behaviours (Beasley et al., 2004; Kremmyda et al., 2008; Papadaki et al., 2007), such a relationship might not be evidenced in Australia (Piggford et al., 2008). As the present participants were also all enrolled in university and completing a food and nutrition course, those living away from home may be more highly motivated toward healthier eating. Even though the number of alcoholic drinks consumed by those living away from home was higher than those at home, the reported intakes were still within the national guidelines (Kellett, Smith, & Schmerlaib, 1998). Those who identified themselves as Australian were more likely to be alcohol drinkers and consumed more alcoholic drinks per week than those of other nationalities. This observation is consistent with the finding in the 1995 NNS that, for adults over 19 years, those born in East Asian countries consumed lower amounts of alcohol than those born in Australia (23.4 and 28.6 g per day per consumer for those born in East Asia and Australia respectively) (Mclennan & Podger, 1997). This might indicate the possible influence of cultural expectations on alcohol consumption. However, care has to be taken when interpreting self-reported alcohol intakes as it is highly likely that alcohol consumption may be under-reported due to social desirability bias (Gibson, 2005). Current nutrient intakes in this study were comparable to those reported by young adults between 19 to 24 years old in the 1995 National Nutrition Survey (NNS) (Mclennan & Podger, 1997). With the exception of fibre and folate intakes, the current overall
nutrient intakes generally met the respective adequate intake (AI) and estimated average requirement (EAR) for individuals between 19 and 30 years old derived from the Nutrient Reference Values for Australia and New Zealand (National Health and Medical Research Council, et al., 2006). Unlike the NNS whereby less than 5% of the young adults reported following a fat modified diet (Mclennan & Podger, 1997), almost half of the participants followed low fat and/ or low sugar diets in this study. This could be due to a greater emphasis placed on moderating fat intakes and more low fat food options being available in the market over the years or a characteristic unique to this study population. Dietary guidelines have been established to help promote healthy eating and diets appropriate for chronic disease risk reduction (National Health and Medical Research Council, et al., 2006). However, earlier research has shown the Australian population to have limited understanding of these guidelines (Ball, Mishra, Thane, & Hodge, 2004; Jamison, 1995). This study population recognised the importance of a number of health behaviours consistent with the dietary guidelines with few differences observed with differing living arrangements and nationalities. Surprisingly, despite the majority showing an understanding of the guidelines, food variety was limited and saturated fat and sodium intakes were still higher than the national recommendations (National Health and Medical Research Council, et al., 2006). This supports other studies that have also observed a disconnect between knowledge and health behaviours (Goodwin & Mullan, 2009; Scholz et al., 2009). Although key contributors to saturated fat and sodium in the diets were not determined, young adults’ reliance on convenience and take-away meals had been the suggested reasons in other studies (Marquis, 2005; Milligan et al., 1998). The limited food variety observed is a cause of concern as food variety has been associated with nutrient quality amongst adults over 19 years old (Foote, Murphy, Wilkens, Basiotis, & Carlson, 2004). This study observed little difference in either food behaviours or nutrient intakes with individuals of differing nationality. These findings are consistent with previous publications showing rapid acculturation of dietary practices in migrant populations (Kremmyda et al., 2008; Nicolaou, Van Dam, & Stronks, 2006; Sukalakamala & Brittin, 2006). The reason for this similarity in diet may possibly be attributed to the extent to which the students have become acculturated (Edwards et al., 2010; Sukalakamala & Brittin, 2006). However, it is just as probable that the Australia diet has been heavily influenced by long term migration of people from Asian populations (for a review see Wahlqvist, 2002) and similar findings have been reported from the UK, with Italian and Indian foods introduced by migrants, replacing traditional British meals in popularity (Mitchell, 2006). Despite these observations, traditional food culture is a important and integral component to the identity of many individuals (Nicolaou et al., 2009) and public health nutrition messages must be culturally appropriate. In interpreting the findings, it is important to recognise the limitations that were present. In 2008, males comprised 51% of the Australian population aged 18–24 years and were thus underrepresented in the study sample (Australian Bureau of Statistics, 2008b). Additionally, while the entire study sample was enrolled in university, nationally only 39.9% of those aged 18–24 were participating in post-school education or training in 2008 (Australian Bureau of Statistics, 2008a). Moreover, as the participants were undertaking a food and nutrition course, it is possible that they have a greater interest in nutrition and food, this may result in more desirable dietary habits compared to the general young adult population (Papadaki et al., 2007). Hence, results from this study are not representative of the general young adult population in Australia. Although the sample size may appear to be small, previous overseas studies that looked at the eating habits and nutritional status of young adults have also used
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