Objectives: To characterise sex differences in macronutrient intakes and adherence to dietary recommendations in the UK Biobank population.
Design: Cross-sectional population-based study.
Setting: UK Biobank Resource.
Participants: 210 106 (52.5% women) individuals with data on dietary behaviour.
Main outcome measures: Women-to-men mean differences in nutrient intake in grams and as a percentage of energy and women-to-men ORs in non-adherence, adjusting for age, socioeconomic status and ethnicity.
Results: There were sex differences in energy intake and distribution. Men had greater intakes of energy and were less likely to have energy intakes above the estimated average requirement compared with women. Small, but significant, sex differences were found in the intakes of all macronutrients. For all macronutrients, men had greater absolute intakes while women had greater intakes as a percentage of energy. Women were more likely to have intakes that exceeded recommendations for total fat, saturated fat and total sugar. Men were less likely to achieve the minimum recommended intakes for protein, polyunsaturated fat and total carbohydrate. Over 95% of men and women were non-adherent to fibre recommendations. Sex differences in dietary intakes were moderated by age and to some extent by socioeconomic status.
Conclusions: There are significant sex differences in adherence to dietary recommendations, particularly for sugar. However, given the increased focus on food groups and dietary patterns for nutritional policy, these differences alone may not be sufficient for policy and health promotion. Future studies that are able to explore the sex differences in intakes of different food groups that are risk factors for diet-related diseases are warranted to improve the current understanding of the differential impact of diet on health in women and men.
Sex differences in the association between major and modifiable risk factors with cardiovascular disease
Most of the burden of cardiovascular diseases (CVD) is explained by a composite of physiological and lifestyle factors - chiefly, elevated blood pressure, obesity, diabetes, cigarette smoking, poor diet, and physical inactivity. There is increasing evidence that some of these risk factors have stronger effects on CVD in women than men. Although preventive strategies aimed at lowering the burden of these risk factors will benefit all, a sound knowledge of whether there are meaningful sex differences in relationships between traditional chronic disease risk factors and disease outcomes should help promote development of effective, sex-specific interventions. Addressing sex differences in relationships between risk factors and CVD risk is of importance from clinical and public health perspectives. Identifying significant sex differences in how risk factors relate to CVD risk should provide an impetus for targeted interventions aimed at reducing the prevalence of disease. Moreover, sex-specific estimates of disease risks associated with modifiable risk factors are essential for accurate estimation of the burden of disease due to these factors. These findings would help to inform the decision making process to maximize the efficacy of the allocation of health care resources, both in the UK and worldwide. Sex-specific estimates for the association between common lifestyle risk factors (elevated blood pressure, obesity, diabetes, cigarette smoking and a poor diet) and the risk of incident CVD will be determined. These sex-specific estimates will be used to evaluate whether or not the risk of stroke and coronary disease associated with these risk factors is similar between women and men. Analyses will be conducted in all individuals, as well as in subgroups defined by age, so as to identify sex-specific changes with ageing (for example, post-menopause), and socioeconomic status, to explore the effects of deprivation. Baseline and follow-up data on the full cohort of women and men in the UK Biobank, except those with pre-existing CVD at baseline, are requested.
|Lead investigator:||Professor Mark Woodward|
|Lead institution:||George Institute for Global Health|