The Longitudinal Evidence on Social Ties and Fruit and Vegetable Intake among Aging Adults: A Systematic Review

CONTEXT: Social ties are associated with the mortality and morbidity of aging populations; however, the role of social ties in healthy eating practices or gender differences in this link is less understood. OBJECTIVE: The objective of this study was to examine the longitudinal evidence for the impact of changes in social ties on fruit and vegetable (FV) intakes among aging adults, with attention to gender differences. DATA SOURCES: Medline, Embase, Scopus, CINAHL, and ProQuest databases were searched until December 2022. DATA EXTRACTION: Longitudinal studies evaluating changes in living arrangement, marital status, social network, or social participation and changes in FV intake among middle- and older-age adults were included. Data from the included studies were extracted using a standardized template and analyzed using a narrative approach. DATA ANALYSIS: A total of 4956 titles were eligible after deduplication, and 75 full texts were screened. Seven studies met the inclusion criteria, and all examined marital transitions only. Five marital transitions were assessed: staying married, becoming widowed, becoming divorced, remaining unmarried, and becoming married. Both the quantity and variety of fruit and/or vegetables eaten were studied. Three of the included studies had only male or only female populations. The studies found that marital dissolution (divorce or widowhood), and remaining unmarried, were associated with reduced FV intakes in older women or men, compared with staying married. The associations were stronger in men than in women. Two studies showed that becoming married was associated with increased vegetable intakes, but 3 reported null results. The included studies were of medium quality. CONCLUSIONS: There is a paucity of longitudinal research on whether changes in social ties are associated with changes in FV intakes among aging adults. This review showed that specific marital transitions may influence healthy eating habits, especially in older men. No evidence exists on whether changes in other social ties might alter healthy eating. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration No. CRD42022365795.