The role of health-based food choice motives in explaining the relationship between lower socioeconomic position and higher BMI in UK and US adults

Abstract

Background/objectives: Lower socioeconomic position (SEP) is associated with increased risk of higher BMI and developing obesity. No research to date has directly examined whether SEP differences in health-based food choice motives or executive function explain why lower SEP is associated with higher BMI.

Subjects/methods: We analysed observational data from large samples of UK (N = 4130) and US (N = 1898) adults which included measures of SEP (education level, household income and subjective social status) and self-reported BMI. Participants also completed validated self-report measures on the extent to which their day-to-day food choices were motivated by health and weight control, as well as completing computerized tasks measuring inhibitory control (Stroop task) and working memory (Digit span task).

Results: Across both UK and US adults, the relationship between indicators of lower SEP and higher BMI were consistently explained by participants from lower SEP backgrounds reporting being less motivated by health when making food choices, which accounted for 18-28% of the association between lower SEP and higher BMI. There was no evidence that measures of executive function explained associations between SEP and BMI or moderated relations between food choice motives and higher BMI.

Conclusions: SEP differences in health-based food choice motives may play an important role in explaining why lower SEP is associated with an increased risk of higher BMI.

Fig. 1. Indirect effect analyses for UK sample.

Mediation models between individual measures of SEP and BMI, values are regression coefficients, ***p < 0.001, SSS subjective social status, BMI body mass index.