In Australia, and other Western countries, there are marked socioeconomic inequalities in mortality from chronic, diet-related diseases. Research in these countries has shown that adults from low socioeconomic backgrounds experience greater morbidity and mortality from these conditions compared to their higher-status counterparts. In recent decades, much research has focused on factors that may contribute to these inequalities. Dietary intakes are thought to account for a large proportion of the socioeconomic variability in health, and there is some evidence suggesting that the psychosocial foundations laid down in adolescence are important influences on these dietary intakes. In Australia, however, existing research examining socioeconomic differences in dietary intakes is limited. Most previous research has looked at dietary intakes in adulthood, and have not considered examining for socioeconomic differences in adolescence. Furthermore, not much is known about the health and nutrition-related beliefs, attitudes and perceptions of adolescents that may contribute to socioeconomic differences in dietary intakes. This study examined these issues by analysing for socioeconomic differences in food and nutrient intakes among both adolescents and adults. It also investigated some health and nutrition-related beliefs, attitudes and perceptions of adolescents from different socioeconomic backgrounds. Data from a national cross-sectional survey, the 1995 Australian National Nutrition Survey, were analysed to determine socioeconomic differences in food and nutrient intakes. Qualitative interviews were undertaken with adolescents to investigate their health and nutrition-related beliefs, attitudes and perceptions. The results show that compared to adults, there is less socioeconomic inequality in food and nutrient intakes among adolescents. Intakes of some anti-oxidant vitamins and folate were directly related with socioeconomic position among adults. Adults from low socioeconomic backgrounds were less likely to consume fruits or vegetables. They consumed a lower variety of fruits and vegetables and were less likely to choose fruits and vegetables high in vitamin A, folate and vitamin C. The results showed that these differences may be due to adults from low socioeconomic backgrounds being less likely to want to increase their fruit and vegetable intakes, and perceiving price and storage as barriers to doing so. There were a small number of socioeconomic differences in adolescents' beliefs, attitudes and perceptions about nutrition and health that may contribute to dietary intake inequalities in adulthood. Adolescents from lower socioeconomic backgrounds were less likely to see health as being important for achieving goals, and identified nutrients and sleep as influencing their health less frequently. These adolescents also referred to dietary recommendations, nutrient intakes, dairy foods and avoiding school canteen foods less frequently when describing a healthy diet. A number of recommendations about the design and targeting of nutrition-promotion campaigns and interventions are discussed, as well as future directions for research on socioeconomic differences in dietary intakes.

abstract: Lay theories of healthy eating are a potentially important consideration for public health and nutrition efforts as perceptions and beliefs about “healthiness” are key determinants of dietary choices (Furst et al. 1996; Grunert, 2007). A rich body of social science literature has examined how people across cultures decide what counts as healthy eating, yet such work has focused mainly on what people think is good and bad to consume, overlooking another important aspect- how one eats. The ways one eats can include patterns and timing of meal intake, as well as mental and emotional states during eating (henceforth, “eating styles”). This dissertation aims to 1) examine whether beliefs on eating styles constitute a separate category of healthy eating perceptions, 2) describe American and Eastern European lay models of how both food characteristics and styles of eating shape health outcomes, and 2) investigate cross-cultural variation in the endorsement of eating styles as important for health in the United States and Eastern Europe. Aims 1 and 2 use pile sorts (n=48), in-person interviews (n=49), and online surveys (n=283) to elicit subjective perspectives on how different eating considerations impact health, and aim 3 involves two sets of questionnaires collected in the U.S. (n=50; n=42) and Eastern Europe (n=42; n=35) to test the hypothesis that levels of collectivism influence variation in endorsement of eating styles for health. Results demonstrate that “eating styles” is a separate category of beliefs in people’s models of healthy eating and individuals in both cultures perceive a variety of important health outcomes from how one eats- weight management, energy levels, digestive health, and overall feeling of wellbeing. These perceptions are not uniform, as participants held contrasting models of how styles of food consumption can influence weight control, and Eastern European respondents held additional views on how aspects of food timing can affect long-term health. Finally, results show that individual level of collectivism, not differences in nationality, accounts for variation in endorsement of eating styles for health. These results suggest that the holistic pattern of attention characteristic of the collectivist social orientation extends to the domain of diet. / Dissertation/Thesis / Doctoral Dissertation Anthropology 2017