Development of a Questionnaire to Assess the Relationship Between Weight Status and Sociocultural Factors

• Published in: Current developments in nutrition Vol. 4; no. Supplement_2; p. 1625
• Main Authors: Dao, Maria Carlota, Huart, Camille, Messer, Ellen, Thiron, Sophie, Sergeant, Camille, Conigliaro, Teresa, Sevigne, Anne, Sakaida, Kylie, Sarrat, Charlotte, Das, Sai Krupa, Clément, Karine, Gausserès, Nicolas, Roberts, Susan
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.06.2020; Oxford University Press
• Subjects: Obesity
• ISSN: 2475-2991; 2475-2991
• DOI: 10.1093/cdn/nzaa063_023

Cultural factors influence obesity risk, but this relationship has not been systematically studied due to the lack of a validated survey instrument. The objective of this project was to develop a prototype questionnaire to assess the relationship between body mass index (BMI) and sociocultural factors. Interviews and focus groups were conducted in the US (N = 24) and France (N = 25). Recordings were transcribed and analyzed (NVivo), and results informed the new questionnaire. The questionnaire was administered in two pilots using Amazon Mechanical Turk (pilot 1: N = 25 adults in France and 25 in US; pilot 2: N = 120 US adults). Demographic information was also collected. Questions were grouped by theme and scores were created from response averages within each theme. The scores were analyzed in relation to BMI, age and country (ANOVA, Spearman correlation). The scores included cultural insularity (high score = greater role of cultural identity in food choices), external eating pressures (high score = stronger perceived and overt pressures), food insecurity (high score = greater food insecurity), childhood intake control (high score = stricter parental control of eating during childhood), and nutrition knowledge (high score = better discernment of healthy vs. unhealthy foods). In France, the cultural insularity score was higher than in the US (P = 0.01) and was correlated with BMI (r = 0.5, P = 0.03). The childhood intake control score was also inversely associated with BMI in France (r = –0.5, P = 0.03). In the US, BMI was positively associated with the external eating pressures (pilot 2: r = 0.2, P = 0.03) and nutrition knowledge (pilot 2: r = 0.2, P = 0.04) scores, and was inversely associated with the food insecurity score (pilot 2: r = –0.24, P = 0.008). In both countries, age was associated with the childhood intake control score (France: r = 0.5, P = 0.03, and US pilot 1: r = 0.4, P = 0.03, pilot 2: r = 0.4, P < .0001). This approach and prototype questionnaire identified novel cultural factors associated with high BMI in France and the US. Additional research is needed to validate the prototype and identify core cultural factors associated with risk of obesity in different cultures. USDA agreement #8050–51,000-105–01S; Danone Research; Institute of Cardiometabolism and Nutrition.