Motives underlying food selection and socioeconomic disparities in vegetable/fruit intake: a 7-year population-based prospective study

Abstract

Background: A better understanding on the factors that underlie socioeconomic disparities in food intake is needed to develop more effective dietary change interventions. We used a population-based prospective study to examine whether changes in various motives for food choice varied according to the level of education, and whether these motives mediated the association between education and vegetable/fruit intake during a 7-year follow-up. Methods: The participants were Finnish men and women aged 25-74 years who took part in the DILGOM study at baseline in 2007 and follow-up in 2014 (N=3735). A shortened Food Choice Questionnaire was used to assess nine motivational dimensions. Vegetable/fruit intake was measured with a validated Food Frequency Questionnaire. Mediation models were adjusted for age, gender and vegetable/fruit intake at baseline. Findings: The absolute and relative importance of price motive (P≤0.001) increased more in individuals with lower education than in their higher educated counterparts. However, changes in familiarity, health, weight control, ethical concern, natural content, convenience, mood or sensory appeal motives did not vary according to educational qualification. Lower education predicted less frequent vegetable/fruit intake at follow-up, and higher relative importance of price and familiarity at baseline partly mediated (P=0.004 and P=0.010 for the indirect effects) the effect of education on subsequent vegetable/fruit intake. Discussion: The relative importance of price and familiarity motives partly explained socioeconomic disparities in food intake over time. Nutrition promotion interventions among socioeconomically disadvantaged individuals may benefit from targeting affordability as well as familiarity or habitual intake of vegetables/fruit.