Whose Diet Suffers When Social Ties Change? Inter-Related Socioeconomic and Gender Inequalities in the Canadian Longitudinal Study on Aging Cohort

Background: Prior cohort studies have established average associations between social ties and dietary intake among aging adults, but socioeconomic status (SES) and gender differences remain unclear. This investigation of SES modification identifies those most nutritionally vulnerable to changes in social engagement. Methods: This prospective study of three waves of the Canadian Longitudinal Study on Aging (CLSA) included 11,900 adults aged ≥45 years. Transitions in social isolation and diversity of social participation were assessed at Waves 1 and 2, and daily fruit and vegetable intake was assessed at Waves 1 and 3. SES was measured by education and income. Random-coefficient logistic regression estimated gender-specific associations by SES. Results: Overall group differences were evident only for income for associations of both exposures with loss of daily fruit intake among women. High-income women remaining less socially diverse had 43% higher odds of reduced vegetable intake, while high-educated women and men had 31% and 26% higher odds, respectively. Remaining less socially diverse was associated with reduced fruit intake among women across income groups, high-educated women, and men regardless of SES. Becoming less socially diverse was associated with reduced fruit intake among high-income and high-educated women but low-SES men. Remaining socially isolated was associated with reduced fruit intake among high-income (OR 7.59 [95% CI: 3.16, 18.19]) and low-income women (1.91 [1.06, 3.45]), high-educated women (3.09 [1.70, 5.61]), and low-income men (1.76 [1.01, 3.09]). Becoming non-isolated was associated with reduced fruit intake among high-SES women. Conclusions: Dietary benefits of social engagement are unevenly distributed, with income as a possible moderator. Tailored strategies may better target nutritionally vulnerable groups.