Geography of Diet in the UK Women’s Cohort Study: A Cross-Sectional Analysis

Abstract

Diet can influence health outcomes and chronic disease risk, therefore a better understanding
of factors influencing diet is important in promotion of healthier dietary choices.
Many factors influence food choice, including the environment in which we live. This study
aims to explore differences in dietary pattern consumption by two spatial measures: Government
Office Region (a large regional unit of geography) and Output Area Classification (a small
area geography combined with demographic characteristics). A cross-sectional analysis using
data from the UK Women’s Cohort Study was carried out. This cohort included ~35000 middle
aged women recruited between 1995 and 1999. Dietary patterns were derived using a k-means
cluster analysis from diet data collected using a validated 217 item Food Frequency Questionnaire.
Multinomial logit regression was used to test whether the area in which the women live,
predicts their dietary pattern consumption. Results show that dietary patterns vary significantly
by both spatial measures. The Government Office Region, the North West of England has
the highest proportion of individuals consuming the least healthy, monotonous diets, while
Greater London has the highest proportion of vegetarian diets. Individuals living in Supergroups
‘Countryside’ and ‘Prospering Suburbs’ consume healthier, more diverse diets. Those
in ‘Constrained by Circumstance’ and ‘Blue Collar Communities’ consume monotonous, less
healthy diets. Using a combination of spatial scales such as Government Office Region and
Output Area Classification Supergroup could have a beneficial impact on targeting of public
health dietary interventions and subsequent health.