Abstract
To examine differences in diet and food purchasing behaviors between Black and White older women living in urban neighborhoods. Participants were queried on diet via 24-hour recalls, food purchasing habits, their use of neighborhood resources and local travel patterns. Frequency and location of self-reported food purchasing and consumption were compared by race. In 2014 and 2015, 49 White and 44 Black older women were enrolled in the study. Compared to Whites, Blacks reported lower daily caloric intake (mean (SD) 1314 (404) vs. 1529 (448), p=0.02), with a higher percent of calories from protein and fat 1.8 (7.0), p=0.03), and a slightly higher polyunsaturated to saturated fat ratio (p=0.05). Blacks had substantially lower alternate healthy eating index (AHEI) (33.5 (10.2) vs. 43.9 (10.8) of 80 possible points, p<0.001), daily intake (grams) of total fiber (15.3 (8.1) vs. 22.9 (8.5), p<0.001), insoluble fiber (10.8 (6.9) vs. 15.9 (6.5), p<0.001), and soluble fiber (4.5 (2.0) vs. 6.9 (2.8), p<0.001). Blacks had lower intake of micronutrients, alcohol and caffeine. Blacks shopped for groceries less often (4.4 (3.0) vs. 6.2 (3.0) monthly; p=0.006) and spent a longer time traveling to stores (15.8 (9.1) vs. 11.5 (7.2) minutes per trip, p=0.02). A lower percent of Blacks walked to stores (14% vs. 40%, p=0.003) and a higher percent of Blacks rode in a car with someone else (33% vs. 6%, p<0.001). In an urban setting, food consumption and purchasing behaviors differed substantially between older Black and White women, which should be further investigated and considered to promote healthy eating in older populations.
Generated Summary
This cross-sectional observational study investigated racial differences in eating patterns and food purchasing behaviors among older women in urban neighborhoods in Washington, DC, USA. The study recruited 49 White and 44 Black older women (aged 65 and older) residing in these neighborhoods. Participants were queried on diet via 24-hour recalls, food purchasing habits, their use of neighborhood resources, and local travel patterns. The frequency and location of self-reported food purchasing and consumption were compared by race. Data collection involved 24-hour dietary recalls, a food purchasing behavior survey, and assessment of neighborhood environmental influences on healthy eating and active living. The study aimed to understand how personal characteristics and neighborhood environments impact eating patterns and food purchasing behaviors, and how these influences might vary by race/ethnicity, sex, and socioeconomic status.
Key Findings & Statistics
- Total Calorie Intake: Blacks reported lower daily caloric intake (1314 kcal) compared to Whites (1529 kcal), (p=0.02).
- Calories from Protein and Fat: Blacks had a higher percentage of calories from protein and fat (p=0.03).
- Polyunsaturated to Saturated Fat Ratio: Blacks had a slightly higher ratio (p=0.05).
- Dietary Fiber: Blacks consumed substantially lower daily intake of total fiber (15.3g) and insoluble and soluble fiber (p<0.001).
- Micronutrient Intake: Blacks had lower intake of micronutrients, alcohol, and caffeine.
- Food Purchasing Frequency: Blacks shopped for groceries less often (4.4 monthly) compared to Whites (6.2 monthly, p=0.006).
- Travel Time to Stores: Blacks spent a longer time traveling to stores (15.8 minutes per trip) compared to Whites (11.5 minutes, p=0.02).
- Transportation to Stores: A lower percent of Blacks walked to stores (14%) and a higher percent rode in a car with someone else (33%, p=0.001).
- Annual Income: Annual income of less than $50,000 was reported by 60.5% of Black participants vs. 35.4% of White participants (p = 0.02).
- Education: Years of education were significantly lower for Black participants (14.9 years) compared to White participants (17.5 years, p < 0.001).
- CESD Depression Scale: Depression scores did not significantly differ between Black and White participants (p = 0.94).
- Beck Anxiety Scale: Anxiety scores did not significantly differ between Black and White participants (p = 0.054).
- Comorbidities: The number of comorbid conditions did not significantly differ between Black and White participants (p = 0.94).
- Medications: The number of medications taken did not significantly differ between Black and White participants (p = 0.58).
- Heart or Circulatory Conditions: Heart or circulatory conditions did not significantly differ between Black and White participants (p = 0.09).
- Diabetes: Diabetes was significantly more prevalent among Black participants (34.1%) than White participants (12.2%, p = 0.01).
- Osteoarthritis: Osteoarthritis was significantly more prevalent among White participants (30.6%) than Black participants (13.6%, p = 0.05).
- Osteoporosis: Osteoporosis was significantly more prevalent among White participants (18.4%) than Black participants (2.3%, p = 0.01).
- Alcohol Consumption: Black participants reported significantly lower alcohol consumption (p < 0.001).
- Physical Activity: Physical activity (daily steps) was significantly lower among Black participants (p < 0.001).
- Weekly Exercise: Weekly exercise frequency was significantly lower among Black participants (p = 0.02).
- Healthy Eating Index (AHEI): Blacks had significantly lower AHEI scores (33.5) compared to Whites (43.9), (p < 0.001).
- Vegetables: Blacks had a significantly lower vegetables score (p = 0.04).
- Fruits: Blacks had a significantly lower fruits score (p = 0.002).
- Nuts and Legumes: Blacks had a significantly lower nuts and legumes score (p < 0.001).
- Cereal Fiber: Blacks had a significantly lower cereal fiber score (p = 0.02).
- Trans Fats: Blacks had a significantly lower trans fats score (p < 0.001).
- Travel Minutes to Store: Blacks had a significantly higher travel minutes to the usual food store (p = 0.02).
- Frequency of Food Shopping: Blacks reported a lower monthly frequency of food shopping (p = 0.006).
- Store Accessibility: Black women rated store accessibility by public transportation as more important than White women (p=0.03).
- Store Safety: Black women rated the safe location of the store as more important than White women (p=0.02).
- Convenience: Black women rated the store being close to businesses and places as more important than White women (p=0.06).
- Store Cleanliness: Black women rated store cleanliness as more important than White women (p=0.02).
- Store Features: Black women rated organized aisles and ease of finding items and items on shelves as more important than White women (p = 0.001).
- Sales/Promotions: Black women rated sales/promotion items more important than White women (p = 0.001).
- Low Fat Dairy: Black women rated low fat dairy products as less important than White women (p=0.08).
- Lean/Reduced Fat Meats: Black women rated lean/reduced fat meats as more important than White women (p=0.004).
- Low Salt Meat Products: Black women rated low salt meat products as more important than White women (p<0.001).
- Food Purchasing: Blacks were more likely to ride in a car with someone else when shopping at the store (p < 0.001).
Other Important Findings
- Food Store Preferences: Compared to Whites, Blacks assigned more importance to many store features, including accessibility by public transportation, safe location, and a comfortable shopping environment. They were also more concerned about the availability of price incentives and an adequate supply of healthy foods in stores.
- Nutritional Rating Systems: Blacks were more aware of nutritional rating systems (e.g., Nuval, Guiding Star) at their stores than Whites.
- Eating at Restaurants: Black participants reported a lower monthly frequency of eating at restaurants compared to White participants (p=0.010).
- Mode of Transportation: Blacks were less likely to walk to stores and more likely to ride in a car with someone else compared to Whites when going to the food store.
Limitations Noted in the Document
- Sample Size: The study was limited by its small sample size.
- Geographic Location: The study was conducted in a single geographic location.
- Study Design: The cross-sectional nature of the study limits the ability to establish causality.
- Data Source: Reliance on self-report data is subject to recall and social desirability bias.
- Dietary Intake: The use of three 24-hour recalls of dietary intake within a week may not fully capture a person’s habitual intake.
- Population: Study focused only on older women.
- Environment: Lack of observed data on food store environments.
Conclusion
The findings from this study indicate that eating patterns and food purchasing behaviors differ significantly between older Black and White women in urban settings. Black women demonstrated a lower caloric intake, but also consumed less fiber and had lower diet quality scores, which is indicated by the AHEI scores. The differences in food purchasing behaviors, such as the frequency of shopping and mode of transportation, further highlight these disparities. These differences persisted even after adjusting for age, income, education, and other factors. The study’s findings underscore the need for targeted interventions to promote healthy eating among older adults. The fact that Black women are more aware of store features related to cost, convenience, and transportation suggests a need to address these factors in interventions. Furthermore, understanding the social and economic factors influencing food choices is crucial. Further research should explore the causes and mechanisms behind these differences, including the impact of neighborhood environments and access to healthy foods. Future studies should also consider longitudinal designs and include a wider range of participants to get a comprehensive view. The implication of these findings are meaningful to health promotion in older women.