Document Type

Theses, Ph.D

Rights

This item is available under a Creative Commons License for non-commercial use only

Publication Details

Thesis submitted for the award of Doctor of Philosophy from the Dublin Institute of Technology, 2008.

Abstract

Demographic, socio-economic, attitudinal, dietary, health behavioural and anthropometric data were collected from 221 “disadvantaged” and 74 “advantaged” women aged 18-35 years across Dublin, according to the provisions of a novel socio-economic sampling frame. Internal and external validation techniques established the dietary assessment method of choice and identified “valid” dietary reporters (n=216, 153 disadvantaged, 63 advantaged) among this sample. Five qualitative focus groups (n=5-8 per group) were also conducted among disadvantaged women to examine their diet and health behaviour choices. Lower intakes of fruit and vegetables (172g/d vs. 405g/d, p<0.001), breakfast cereals (4g/d vs. 29g/d, p<0.001), fish (0g/d vs. 26g/d, p<0.001) and dairy products (166g/d vs. 228g/d, p+0.001), and significantly higher intakes of meat and meat products (184g/d vs. 143g/d, p<0.001) and potatoes and potato products (165g/d vs. 77g/d, p<0.001), are observed among the disadvantaged versus the advantaged women. Non-compliance with carbohydrate (49% vs. 30%, p<0.017), fat (74% vs. 35%, p<0.001), saturated fat (89% vs. 65%, p<0.001), and sugar (60% vs. 30%, p<0.001) intake guidelines is also significantly higher among the disadvantaged women. Additionally, non-achievement of intake guidelines for folate (35% vs. 21%, p=0.050), vitamin C (31% vs. 6%, p<0.001), vitamin D (80% vs. 67%, p=0.047) and calcium (25% vs. 10%, 9=0.019) is higher among disadvantaged women, while both groups show poor compliance with iron and sodium intake guidelines. Higher smoking rates (p<0.001), higher alcohol consumption (p=0.029), lower participation in vigorous physical activity (p=0.001) and lower supplementation rates (p=0.004) are observed among the disadvantaged cohort, as are higher mean BMI (25.3 kg/m2 vs. 22.9 kg/m2, p=0.001) and waist circumference measurements (87.9 cm vs. 79.7 cm, p<0.001). Quantitative analyses suggest that differences in attitudinal factors (dietary stage of change, locus of health control) predict some of these adverse behaviours, while deficits in diet and health knowledge and health information seeking may also contribute. The qualitative study additionally highlights the importance of psycho-social stress, depression, poor knowledge and cost as further impediments to healthy diet and lifestyle among disadvantaged women. These findings demonstrate the clustering of significantly less favourable diet, nutrient intakes and health behaviours among socially disadvantaged women in Dublin, trends which argue poorly for these women’s long-term health.