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This thesis examines the economic and time barriers to dietary adherence for T2D patients living in Edmonton by using utility theory, household production theory and the concept of health capital. Socio-demographic, food consumption, food purchase and time use information was obtained by administering a questionnaire and a food record; collecting grocery receipts and a blood sample; conducting a telephone interview, and taking measurements. Multivariate regression analysis and correlations showed a negative association between fruit and vegetable expenditure and A1c. Diet quality was negatively associated with A1c and total food expenditure but had an inverted U-shaped association with income. While working time was negatively correlated with diet quality and positively correlated with A1c, regression analysis showed a negative association between working time and diet quality only among higher income participants. Budget constraints and time constraints appear to be the barriers to dietary adherence among low-income and high-income patients, respectively. / Agricultural and Resource Economics

Yes / The incidence of mental health problems is increasing in the United Kingdom and may be associated with lower dietary quality. Food expenditure is a marker of food insecurity with potential implications for mental health. This analysis considers data collected as part of the United Kingdom Household Longitudinal Survey (UKHLS), also known as ‘Understanding Society’ (2009-2021) (N=388,944) to determine the extent to which food expenditure within and outside the household, is associated with mental health, whilst controlling for demographic factors. Mental health was measured using the General Health Questionnaire (GHQ-12) for which responses were on a 4-point scale and reverse-scored so that a higher score represented more favourable mental health. Household food expenditure and food expenditure outside the home were the outcomes. Controlling for socioeconomic and demographic factors, fixed-effects models indicated that better mental health was associated with greater household food expenditure and with greater food expenditure outside the home and that this association persisted post-lockdown. Among those on lower incomes better mental health was associated with lower food expenditure. When people who identified as white and non-white were modelled separately, better mental health was associated with lower food expenditure within and beyond the household only in those who identified as white. These findings imply that the mental health of people residing in the UK, particularly those on lower incomes and those who identify as white, may benefit from spending less of the household budget on food. In achieving United Nations General Assembly (2012) Sustainable Development Goals related to poverty, hunger and in promoting mental health, policies are needed to render food more affordable and to reduce other aspects of expenditure that impact upon food budgeting.

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