Pop Art and Gemini G.E.L

Social influences involve the external impacts on behaviour from friends and family, and within the community in which we live. Food choice, cooking and eating goes beyond the individual in the acquisition of nutrients and energy; it is an event that is integrally linked with social factors. The following outlines social structures that influence eating behaviours.

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For many, most meals are consumed in the company of others, and frequently seen as pleasurable experiences. They can represent important cultural events and become the vehicle by which people make social connections (315).

Similarly, communal eating may also include workplace eating. In addition to the acquisition of nutrients, these workplace events may provide important social interactions, and be a means by which co-workers unite as a group (316). When communal eating events are lost or missing, particularly in people in mid to late adulthood, it may trigger risk factors for compromised nutritional status. For example, it has been observed that women who live alone consume fewer FV than women who live with others (317). In a systematic review of 24 studies of independently living people aged 50 years and over, lethargy and enthusiasm to shop for food, prepare, cook and eat meals, as well as lower food variety, was more common in those who lived alone (318). Newly bereaved men in particular have shown to be at nutritional risk when compared to newly widowed or single women (319). In that study it was also noted that men who ate by themselves ate more white bread and spreads, suggesting the types of foods eaten were more likely to be sandwiches or snacks (319). Limited cooking practices such as this, may result in sub-optimal nutrient levels, and lead to illness and functional limitations.

Positive dietary behaviours tend to group with other healthful behaviours, often referred to as a clustering of health behaviours. Particular clusters of individuals are more likely to adhere to recommended guidelines for diet, physical activity, alcohol consumption, and not smoking, while risky groups were more likely to

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have poor diet, be physically inactive, smoke and high higher levels of alcohol consumption (320, 321). Accordingly, Arabshahi et al. (322) have shown

Australian women who never smoked had greater gains in diet quality than those who smoked. At the same time, it was revealed that diet quality improved more in both men and women who participated in larger amounts of exercise.

However, the same study showed a reduction in food variety and cereals in older people over time. The authors’ hypothesized this may be a reflection of

unfavourable social influences.

Social capital and participation

The frequency and quality of social relationships has been identified as a major health risk for physical and mental health, for mortality and morbidity (128, 323).

There is no single definition for social capital, however the term is generally used to describe the social concepts that have positive and productive benefits at the community level. This might include engagement with religious or social groups, volunteering, sports and exercise groups (324).

A systematic review of eleven studies assessing social capital as a resource for wellbeing in older adults found that in general, social capital had favourable outcomes for mental wellbeing (325). However, it was also found that the term

‘social capital’ is an umbrella term that encompasses many different levels including social participation, networks, social cohesion and even the quality of support received by older people. The authors therefore found it difficult to summarize. It was also considered that social capital may be age related, and the concept of reverse causality may be a factor. For example, health and functional

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ability decrease with age which may impact on the ability to participate in social activities.

Even so, studies have shown that good social networks confer health benefits, and a sense of wellbeing (324, 326). The health and social capital of men and women aged 15 years and older was explored by Berry and Welsh (327) in the Household, Income and Labour Dynamics in Australia (HILDA) survey. Social capital was associated with better health, and women had higher social capital than men. Informal contact and civic engagement resulted in stronger feelings of belonging and social trust.

Social capital has shown to be age-related (328). Research on an Australian cohort of 1,208 men and women aged 18 years and over, shows that younger people aged 18 to 34 years have higher social capital than people aged 35 to 54 years. It is likely that at an earlier stage, younger people are more socially active than older groups. However, it has also been shown that 45 to 54 year olds had lower social capital scores than those 55 years and above. Researchers

hypothesized that children of the 45 to 54 year olds were becoming independent which may have diminished their social network. High physical health was

associated with high social capital and high income. These findings are consistent with another study (326).

Research has shown that greater social networks are associated with health benefits, and also with increased consumption of FV (329, 330). A study of 1220 rural living men and women aged 18 to 90 years, examined determinants of eating behaviours (331). It was found that social capital was associated with

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increased FV consumption. Findings from another study investigating social contextual factors, such as life experiences, social relationships, and societal influences, and changes in FV intake yielded similar results (332).

Family influences

In social groups where people engage in food events, that is, cooking and eating, an inherent consequence of this act is the influence of foods on others, whether through conscious means or subconscious. This is particularly the case in the domestic setting of the family home.

Historically, but not exclusively, the family meal has been the domain of women (333, 334). For some women, the act of cooking for the family is a deed heavily laden with caring and nurturing, and more so in older women. Research into the meaning of food in women aged 63 to 87 years was carried out in a cohort of urban and rurally located women (333). The underlying drive for those women was the need to provide a nutritious meal for the family, whether partner, children or grandchildren; the food was presented as a ‘gift’, and most importantly, the meal was to be enjoyed together. Of note, everyday food preparation was usually influenced by the partner’s needs and desires, rather than the women doing the preparation. For those women whose partners had died, they lacked motivation to cook a nutritious meal for themselves, but when they did, they often cooked in bulk and had the same food for several days. In that study, those at particular risk were the oldest-old widows who experienced a reduction in their nutrient levels owing to skipping mealtimes. Findings are

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consistent with other studies on marital transitions (50) and sociodemographic factors and lifestyle predictors of poor diet (335).

A European study of men and women aged 65 to 98 years investigated food habits and food involvement using a life course approach (336). In their working years, those who had been single with no family had greater food connections with friends, or work colleagues than those who were married or had family. As commensality occurred for those people at lunchtimes, retirement became a major food transition. This was not the case for people with partners whose main eating occasions took place at home during the evening meal; therefore retirement was not a transition issue for these people. In line with previous studies, women in mid-life who divorced or whose partners died felt a loss of identity as food provider (333, 336).

Other studies support the finding that family living arrangements impact on eating behaviour, resulting in poor diet quality. Data from the EPIC-Norfolk study (337) has shown partnership status, living arrangements and family/friends contact to be associated with FV variety in people over 50 years of age. Fruit variety intake reduced with a corresponding reduction in family connections in people who lived alone, and widowed people and those living alone with irregular connection to friends showed lower FV variety intake when compared to those with frequent connections with friends. A further study using the EPIC-Norfolk cohort investigated change in eating behaviour alongside a change in marital status, found a reduction in both total FV intake and FV variety in men

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who became widowed (52). However, no such associations were found in women.

Similarly, a UK study on access and isolation in men aged 65 years and older found men who lived with someone who had better developed cooking skills ate significantly larger amounts of vegetables, fish and wholegrain bread than men who lived with someone with poorer cooking skills (319).