Stress-Related Poor Diet Quality Does Not Explain Socioeconomic Inequities in Health: A Structural Equation Mediation Analysis of Gender-Specific Pathways

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dc.contributor.authorOlstad, Dana Lee
dc.contributor.authorNejatinamini, Sara
dc.contributor.authorKirkpatrick, Sharon I
dc.contributor.authorVanderlee, Lana
dc.contributor.authorLivingstone, Katherine M
dc.contributor.authorCampbell, David J T
dc.contributor.authorTang, Karen
dc.contributor.authorMinaker, Leia M
dc.contributor.authorHammond, David
dc.date.accessioned2022-03-09T22:34:28Z
dc.date.available2022-03-09T22:34:28Z
dc.date.issued2021-10-07
dc.description.abstractPsychosocial stress and diet quality individually mediate associations between socioeconomic position (SEP) and health; however, it is not known whether they jointly mediate these associations. This is an important question because stress-related unhealthy eating is often invoked as an explanation for diet-related health inequities, particularly among women, seemingly with no empirical justification. Objective: This study examined whether psychosocial stress and diet quality jointly mediated associations between SEP and self-rated health in women and men. Design: Multiple mediating pathways were modeled using data from the cross-sectional International Food Policy Study. Participants and setting: Data were collected from 5,645 adults (aged 18 years or older) in Canada during 2018 and 2019. Main outcome measures: Participants reported SEP using indicators of materialist (educational attainment and perceived income adequacy) and psychosocial pathways (subjective social status), along with psychosocial stress, dietary intake (to assess overall diet quality via Healthy Eating Index-2015 scores), and self-rated health. Statistical analyses performed: Structural equation modeling modeled pathways linking SEP (ie, educational attainment, perceived income adequacy, and subjective social status) with self-rated health mediated by psychosocial stress and diet quality, stratified by gender. Results: There was no evidence that psychosocial stress and diet quality jointly mediated associations between SEP and self-rated health in women or men. Diet quality mediated associations between educational attainment and self-rated health in women and men, with some evidence that it mediated associations between subjective social status and self-rated health in men (P = 0.051). Psychosocial stress mediated associations between perceived income adequacy and self-rated health in women and men, and between subjective social status and self-rated health in women. Conclusions: Although often invoked as an explanation for diet-related health inequities, stress-related poor diet quality did not mediate associations between SEP and self-rated health in women or men. Psychosocial stress and diet quality individually mediated some of these associations, with some differences by gender.en_US
dc.description.grantingagencyCanadian Institutes of Health Research (CIHR)en_US
dc.identifier.citationOlstad, D. L., Nejatinamini, S., Kirkpatrick, S. I., Vanderlee, L., Livingstone, K. M., Campbell, D. J., ... & Hammond, D. (2022). Stress-related poor diet quality does not explain socioeconomic inequities in health: A structural equation mediation analysis of gender-specific pathways. Journal of the Academy of Nutrition and Dietetics, 122(3), 541-554.en_US
dc.identifier.doihttp://dx.doi.org/10.1016/j.jand.2021.09.018en_US
dc.identifier.urihttp://hdl.handle.net/1880/114455
dc.identifier.urihttps://doi.org/10.11575/PRISM/43856
dc.language.isoengen_US
dc.publisherElsevieren_US
dc.publisher.departmentCommunity Health Sciencesen_US
dc.publisher.facultyCumming School of Medicineen_US
dc.publisher.hasversionacceptedVersionen_US
dc.publisher.institutionUniversity of Calgaryen_US
dc.publisher.policyhttps://www.elsevier.com/open-accessen_US
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0en_US
dc.subjectDiet qualityen_US
dc.subjectHealth inequitiesen_US
dc.subjectMaterialist perspectiveen_US
dc.subjectPsychosocial perspectiveen_US
dc.subjectPsychosocial stressen_US
dc.titleStress-Related Poor Diet Quality Does Not Explain Socioeconomic Inequities in Health: A Structural Equation Mediation Analysis of Gender-Specific Pathwaysen_US
dc.typejournal articleen_US
ucalgary.item.requestcopytrueen_US
ucalgary.scholar.levelFacultyen_US
ucalgary.scholar.levelGraduateen_US
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