Eva Roos

Gender, socioeconomic status and family status as determinants of food behaviour

This study examines social structural and family status factors as determinants of food behaviour. The data were derived from the FINMONICA Risk Factor Survey, collected in Finland in spring 1992. A multidimensional framework of the determinants of food behaviour was used, including social structural position, family status and gender. The associations between the determinants of food behaviour were estimated by multivariate logistic regression models, adjusted for age and regional differences. Food behaviour was measured by an index including six food items which were chosen based on Finnish dietary guidelines. In general, womens food behaviour was more in accordance with the dietary guidelines than that of men. The pattern of association between educational level and food behaviour was similar for both genders, but slightly stronger for men than women. Employment status was associated only with womens food behaviour, but the tendency was the same for men. Marital status was associated with mens as well as womens food behaviour. The food behaviour of married men and women was more in line with the dietary guidelines than the food behaviour of those who had been previously married. Parental status, however, was only associated with womens food behaviour, that is, the food behaviour of women with young children was more closely in line with the dietary guidelines than that of the rest of the women.

MULTIPLE ROLES AND HEALTH AMONG BRITISH AND FINNISH WOMEN: THE INFLUENCE OF SOCIOECONOMIC CIRCUMSTANCES *

Two contrasting hypotheses have been presented to predict womens health variations. The Multiple burden hypothesis predicts that combining a paid job, being married, and having children is likely to be detrimental to womens health. The multiple attachment hypothesis predicts that multiple roles provide attachment to the community, which is likely to be beneficial to womens health. These hypotheses are examined in Britain and Finland, which have different patterns of womens employment participation. Lone mothers form a critical case, since they have fewer attachments and greater burdens, and therefore are expected to have poorer health. The socioeconomic position of lone mothers differs in Britain and Finland, but in both societies they are likely to have fewer attachments. We assess the extent to which health variations between women with different family and parental role combinations are because of the differences in their socioeconomic status and material circumstances. Comparable surveys from Britain and Finland from 1994 were used. Perceived general health and limiting long-standing illness were analysed for working age women (20-49 years) by family type and employment status. as well as other socioeconomic variables. In both countries, women living in two parent families and having children had better health than women living in other family types or on their own. Lone mothers form a disadvantaged group and showed overall worse health in both countries. Adjusting for employment status. education and household income weakened the association between family type and poor health. The findings are broadly in accordance with the multiple attachment hypothesis. Despite the more generous welfare state and high full-time employment among Finnish women, single lone mothers report poorer health than other women in Finland as well as in Britain. However, in Britain the disadvantaged social position of lone mothers accounts for a greater proportion of their poor health than in Finland.

Increasing prevalence of underreporting does not necessarily distort dietary surveys

Objectives: To study the magnitude of and trends in energy underreporting and to compare food consumption, nutrient intake and socioeconomic characteristics of underreporters to those of other Finnish adults. Design: Cardioavscular risk factor surveys in 1982 and 1992 using a 3 d food record. Underreporting was defined as energy intake lower than 1.27*BMR, since energy intake <1.27*BMR is improbable. Setting: Four areas in Finland, both rural and urban. Subjects: 1746 men and 1921 women, aged 25–64 y. Results: Proportion of underreporters has increased from 33% in 1982 to 46% in 1992 among women and from 27% in 1982 to 42% in 1992 among men. In a logistic regression model, BMI over 25 kg/m2, female gender, age over 45 y and high educational level predicted underreporting. Shares of energy intake from fat, carbhoydrates, protein and alcohol remained the same whether or not underreporters were excluded. However, underreporters consumed significantly higher proportion of vegetables, fish, meat, potatoes, fruit and berries and less fat than others. In the 1992 data the absolute intake of most micronutrients increased and micronutrient densities decreased when underreporters were excluded. Conclusions: The proportion of underreporters has grown from 1982 to 1992. Results expressed as a percentage of energy intake are not affected by the exclusion of underreporters. In contrast, micronutrient intakes, both absolute and energy density values, were distorted by underreporting. Underreporting should be taken into account in future studies. Sponsorship: National Public Health Institute.

Associations of job strain and working overtime with adverse health behaviors and obesity: evidence from the Whitehall II Study, Helsinki Health Study, and the Japanese Civil Servants Study

Adverse health behaviors and obesity are key determinants of major chronic diseases. Evidence on work-related determinants of these behavioral risk factors is inconclusive, and comparative studies are especially lacking. We aimed to examine the associations between job strain, working overtime, adverse health behaviors, and obesity among 45-60-year-old white-collar employees of the Whitehall II Study from London (n=3,397), Helsinki Health Study (n=6,070), and the Japanese Civil Servants Study (n=2,213). Comparable data from all three cohorts were pooled, and logistic regression analysis was used, stratified by cohort and sex. Models were adjusted for age, occupational class, and marital status. Outcomes were unhealthy food habits, physical inactivity, heavy drinking, smoking, and obesity. In London, men reporting passive work were more likely to be physically inactive. A similar association was repeated among women in Helsinki. Additionally, high job strain was associated with physical inactivity among men in London and women in Helsinki. In London, women reporting passive work were less likely to be heavy drinkers and smokers. In Japan, men working overtime reported less smoking, whereas those with high job strain were more likely to smoke. Among men in Helsinki the association between working overtime and non-smoking was also suggested, but it reached statistical significance in the age-adjusted model only. Obesity was associated with working overtime among women in London. In conclusion, job strain and working overtime had some, albeit mostly weak and inconsistent, associations with adverse health behaviors and obesity in these middle-aged white-collar employee cohorts from Britain, Finland, and Japan.

Associations between sleeping habits and food consumption patterns among 10–11-year-old children in Finland

The increasing prevalence of overweight and obesity among children is of special concern. Inverse associations between sleep length and overweight have been found in children. Short sleeping hours result in hormonal changes, which increase perceived hunger and appetite. This could affect food intake, and consequently lead to overweight. The aim is to find out whether there is an association between adequate sleep and food consumption among 10-11-year-old school children in Finland. One thousand two hundred and sixty-five children (response rate 79 %), aged 9-11, from thirty-one schools filled in a questionnaire about their health behaviour. Inadequate sleep was measured as short sleeping hours during school nights and weekend nights, difficulties in waking up in the morning and tiredness during the day. Food consumption patterns were measured by two consumption indices, energy-rich foods and nutrient-dense foods, based on a short FFQ (sixteen items). Inadequate sleep is associated with food consumption patterns. Boys with shorter sleep duration during school nights, and who were felt tired during the day, were more likely to consume energy-rich foods. Girls with shorter sleep duration during school nights consumed more likely energy-rich foods and less likely nutrient-dense foods. Adjusting for physical activity and screen time weakened the explored associations. The associations with energy-rich foods were stronger for boys than for girls. Sleeping habits are associated with food consumption patterns. Shorter sleep duration during school nights in school children is associated with higher consumption of energy-rich foods.

Alcohol beverage drinking, diet and body mass index in a cross-sectional survey

Objective: The study was carried out to determine the associations of alcohol beverage drinking with macronutrients, antioxidants, and body mass index. Setting: Dietary subsample of the 1992 Finmonica cardiovascular risk factor survey in Finland; a cross-sectional study. Subjects: 985 women and 863 men were drawn from the population register in the four monitoring areas. All subjects were 25–64 y of age. Methods: The mailed questionnaire included questions covering socioeconomic factors, physical activity, smoking, and alcohol consumption. The diet was assessed using a three-day food record. Results: The dietary differences between abstainers and alcohol consumers were more significant than between consumers of different alcoholic beverages. Among drinkers, fat intake as a percentage of energy was higher and carbohydrate intake was lower than among abstainers. Those who preferred wine, however, had the highest vitamin C intake; female wine drinkers also had the highest carotenoid intake. With the exception of those who mainly preferred spirits, alcohol energy was not added to the diet but seemed to substitute food items both in men and women. Despite the similar total daily energy intakes, daily energy expenditure, and physical activity index, male drinkers were leaner than abstainers. In women, the proportion of underreporters of energy intake increased with increasing alcohol consumption, and the association between alcohol and body mass index was similar to that in men after the exclusion of underreporters. Conclusions: Alcohol consumers were leaner than abstainers, and wine drinkers in particular had more antioxidants in their diet. Sponsorship: The Finnish Foundation for Alcohol Studies.

Job control, job demands, or social class? The impact of working conditions on the relation between social class and health

Background: The aim of the study was to investigate (1) how much of the association between health and social class is accounted by psychosocial working conditions, and (2) whether health is related to working conditions after controlling for social class. Methods: The data derive from the surveys of the Helsinki health study, collected in 2000, 2001, and 2002 from 40–60 year old employees working for the City of Helsinki (n = 8970, response rate 67%). The study measured occupation based social class and Karasek’s demand-control model. The health outcomes were self rated health as less than good and limiting longstanding illness. Age adjusted prevalence percentages and fitted logistic regression models were calculated. Results: The individual effects of social class and psychosocial working conditions on self rated health and limiting longstanding illness were strong among both men and women. The relation between social class and both health outcomes considerably attenuated when job control was controlled for, but was reinforced when controlling for job demands. Controlling for both job control and job demands attenuated the relation between social class and self rated health and limiting longstanding illness among women, however, was reinforced among men. Conclusions: A substantial part of the relation between social class and health could be attributed to job control, however, job demands reinforced the relation. Although the effect of social class is mediated by psychosocial working conditions, both social class and working conditions were related to health after mutual adjustments.

Having lunch at a staff canteen is associated with recommended food habits

OBJECTIVE To describe the characteristics of employees having lunch at staff canteens and to examine the association between workplace lunch and recommended food habits. DESIGN A mailed questionnaire including data on lunch pattern, food habits, sociodemographic background, work-related factors and body weight. Logistic regression models including food habits as dependent variables and lunch pattern, sociodemographic factors, work-related factors and body mass index as independent variables. SETTING Helsinki Health Study survey data, collected in spring 2001. SUBJECTS Employees from the City of Helsinki reaching 40, 45, 50, 55 and 60 years. The data included 2474 women and 591 men; the response rate was 68%. RESULTS About half of those with a staff canteen at work had lunch there. Those with higher educational level were more likely to have lunch at the staff canteen, as also were women with pre-school children and normal-weight men. Those having lunch at staff canteens were more likely to follow recommended food habits, compared with other subjects. Having lunch at the staff canteen seemed to increase the consumption frequency of vegetables and fish. CONCLUSIONS Having lunch at staff canteens is associated with the quality of the diet. To serve a cooked meal including vegetables during working time may be an efficient way to improve diet among adult employees. More emphasis should be put on increasing the possibility for employees to have lunch at staff canteens.

Associations of work–family conflicts with food habits and physical activity

OBJECTIVE This study examines the relationship between family-work conflicts with food habits and physical activity, and whether the relationship is dependent on family structure and work-related factors. DESIGN AND SETTING Cross-sectional postal surveys were carried out in 2001 and 2002 among employees of the City of Helsinki, Finland, aged 40-60 years (n = 5346, response rate 66%; for women 70% and for men 60%). Dependent variables in logistic regression analyses were nationally recommended food habits and physical activity. Independent variables were work-family conflicts and family-work conflicts. Covariates included age, marital status, number of children, occupational class, working hours, time travelling to work, and physical and mental work load. RESULTS Women reporting strong work-family conflicts were more likely to follow recommended food habits (odds ratio (OR) and 95% confidence intervals 1.49 (1.19-1.86)), but this relationship weakened when adjusting for work-related factors (OR 1.20 (0.93-1.55)). Women and men with strong family-work conflicts were less likely to report recommended food habits after adjusting for family structure and work-related factors (women OR 0.75 (0.61-0.92), men OR 0.57 (0.34-0.96)). Women and men with strong work-family conflicts were less likely to follow the recommended amount of physical activity (women OR 0.76 (0.60-0.96), men OR 0.54 (0.34-0.87)). Additionally, women with strong family-work conflicts were less likely to follow the recommended amount of physical activity (OR 0.77 (0.63-0.94)). Adjusting for family and work-related factors did not affect these associations. CONCLUSIONS Conflicts between paid work and family life are likely to constitute barriers for a physically active lifestyle and possibly also for healthy food habits. Improving the balance between work and family may provide a route for promoting health-related behaviours.

Do computer use, TV viewing, and the presence of the media in the bedroom predict school-aged children’s sleep habits in a longitudinal study?

BackgroundElectronic media use is becoming an increasingly important part of life for today’s school-aged children. At the same time, concern of children’s sleep habits has arisen, and cross-sectional studies have shown that electronic media use is associated with short sleep duration and sleep disturbances. The purpose of this longitudinal study was to investigate whether baseline electronic media use and media presence in a child’s bedroom predicted sleep habits as well as changes in these sleep habits 18 months later among 10- to 11-year-old children in Finland.MethodsThe school-aged children (n=353, 51% girls) from 27 schools answered a questionnaire in 2006 and again 2008 in the Helsinki region of Finland. Electronic media use was measured by computer use and TV viewing. Media presence in a child’s bedroom means the presence of a TV or a computer in a child’s bedroom. Sleep habits were measured by bedtimes on school days and at the weekend days, sleep duration, discrepancy of bedtimes, and discrepancy of sleep duration between school days and weekends. Linear regression analyses were used to examine whether electronic media use and media presence predicted sleep habits with adjustments for grade, family structure, and baseline sleep. Gender differences were also examined.ResultsThe children used a computer for one hour per day and watched TV over one hour a day in 2006. They slept over nine hours on school days and over ten hours at the weekends in 2008. Computer use and television viewing predicted significantly shorter sleep duration (p<0.001, p<0.05 respectively) and later bedtimes (p<0.001, p<0.01, respectively). Computer use also predicted unfavourable changes in sleep duration (p<0.001) and bedtimes on school days (p<0.001) and weekends (p<0.01). Among boys, media presence in the bedroom predicted poorer sleep habits and irregularity of sleep habits.ConclusionsComputer use, TV viewing, and the presence of media in children’s bedrooms may reduce sleep duration, and delay bedtimes.