Marital Transitions and Associated Changes in Fruit and Vegetable Intake: Findings from the Population-based Prospective EPIC-Norfolk Cohort, UK

Background: Diet is critical to health and social relationships are an important determinant of diet. We report the association between transitions in marital status and healthy eating behaviours in a UK population.

Methods: Longitudinal study of middle-age and older adults 39-78y (n = 11 577) in EPIC-Norfolk, a population-based cohort, who completed food frequency questionnaires in 1993-97 and 1998-2002. Multivariable linear regression analyses assessed gender-specific associations between five categories of marital transitions and changes in quantity (g/d), and variety (no/month) of fruits or vegetables.

Results: In 3.6 years of follow-up and relative to men who stayed married, widowed men showed significant declines (mean difference, 95% CI) in all four indicators of healthy eating including fruit quantity (-47.7, -80.6 to -14.9 g/d), fruit variety (-0.6, -1.1 to -0.2 no/month), vegetable quantity (-27.7, -50.5 to -4.9 g/d), and vegetable variety (-1.6, -2.2 to -0.9 no/month). Men who were separated or divorced or who remained single also showed significant declines in three of the indicators. Among women, only those who became separated/divorced or stayed single showed declines in one indicator, vegetable variety.

Conclusion: Unhealthy changes to diet accompanying divorce, separation and becoming widowed may be more common among men than women. Moreover, deterioration in fruit and vegetable intakes was more apparent for variety rather than quantity consumed. Programmes to promote healthy eating among older adults need to recognise these social determinants of diet and consider prioritising people who live alone and in particular men who have recently left relationships or who have been widowed.