Early Life Nutrition and Lifelong Health - Derbyshire Local Medical ...

BMA Board of Sciencebalanced meals. Although the diets of children in food insecure households were comparable withthose of children in food secure households, this was not the case for women. Women in foodinsecure households had typically less healthy diets, with lower consumption of fruit, wholemealbread, meat and meat dishes and fish and fish dishes. Drewnowski and Specter 255 describe aninverse relationship between the energy density of foods and energy cost – so that high-fatenergy-dense diets may be more affordable than prudent diets based on lean meats, fish and freshfruit and vegetables. This may partly explain the link between food insecurity and greater levels ofobesity observed in some studies, particularly among women. 256Key messageEducational attainment is a key influence on the quality of young women’s diets.While a number of studies have examined the associations between diet and socio-demographicfactors, there are important environmental and contextual influences on food choice that are lesscommonly considered. These include:• the effects of the physical environment, such as the distance between home and shops that maydetermine the accessibility and affordability of foods, and the ability to store and cook food at home• the nature of the contexts within which food is bought and eaten that may impact directly onpurchasing patterns and foods consumed• structural differences in families and households that define the nature of shared meals• the wider influences of food advertising and the promotion of foods.Increases in fruit and vegetable consumption have been observed following the building of newsuperstores in areas of poor retail provision, 257 and purchasing patterns of confectionery can bechanged by altering its location in a cafeteria. 258 Interventions to change aspects of the foodenvironment, so that consumers are encouraged to choose healthier foods, may offer importantopportunities to achieve change in eating habits.The choice of foods eaten is influenced by individual factors. Some of these have been extensivelyresearched with a view to predicting and understanding food choices. They include variations inpersonal taste preferences, differences in knowledge, attitudes and beliefs as well as psychologicalfactors such as matters of control and self-esteem.There are complex interactions between socio-demographic, environmental and individual influencesthat act to determine food choice – and these influences must also underlie the reasons why currentdietary recommendations are not met. To address the dietary and nutritional inequalities that existacross the general population we need to identify the primary influences on food choice. With thisunderstanding, effective interventions can be defined to achieve dietary change.54Early life nutrition and lifelong health