Ten-Year Changes in Healthy Eating Attitudes in the SUN Cohort

ABSTRACT

Objective: The objective of this study was to assess the within-subject longitudinal changes in self-perceived healthy eating attitudes after 10 years of follow-up and to identify predictors of long-term changes in a middle-aged adult cohort.

Methods: Four thousand five hundred seventy-two participants completed a validated food frequency questionnaire (FFQ) at baseline and after 10 years of follow-up. The FFQ was expanded with a brief 10-item questionnaire about eating attitudes with 2 possible answers: yes or no. A baseline score and a 10-year score were calculated with these 10 items (range from 0 to 10). Participants were categorized into 3 groups according to this score. Linear and logistic regressions were used to examine changes at follow-up and associations between baseline characteristics and improvement in the score.

Results: After 10 years of follow-up, a statistically significant favorable change (p < 0.001) was achieved in all questions about eating attitudes, particularly in these items: “Do you try to eat less sweets and pastries?” (12%), “Do you try to eat less meat?” (11.1%), and “Do you try to reduce your fat intake?” (10%). Being female (odds ratio [OR] = 1.19, 95% confidence interval [CI], 1.02–1.39), being 35–50 or ≥ 50 years old (OR = 1.24, 95% CI, 1.07–1.44 and OR = 1.74, 95% CI, 1.38–2.18, respectively), a high level of physical activity (OR for third vs first tertile = 1.20, 95% CI, 1.02–1.41), and a higher Mediterranean diet score (OR for second and third tertiles = 1.18, 95% CI, 1.01–1.37 and OR = 1.26, 95% CI, 1.04–1.52, respectively) were associated with a higher probability of improving the eating attitudes score, while a low body mass index (BMI; OR = 0.71, 95% CI, 0.51–1.00) and snacking between meals (OR = 0.84, 95% CI, 0.73–0.97) were associated with a lower probability of improving their score.

Conclusions: The eating attitudes of the participants in the Seguimiento Universidad de Navarra (SUN) cohort became more favorable after 10 years of follow-up. Certain sociodemographic or clinical variables may predict a positive change.

KEYWORDS:

• Attitudes
• behaviors
• food consumption
• cohort
• brief questionnaire
• eating habits

Acknowledgments

We thank the participants of the SUN cohort for their continuous involvement in the project and all members of the SUN study for their support and collaboration.

Funding

The Seguimiento Universidad de Navarra (SUN) Project has received funding from the Spanish Ministry of Health and European Regional Development Fund (FEDER; Grants PI10/02993, PI10/02658, PI13/00615, PI14/01668, PI14/01798, PI14/01764, RD06/0045, G03/140), the Navarra Regional Government (45/2011, 122/2014), and the University of Navarra.