(P20-056-24) Social Determinants of Healthy Eating in Taiwanese Adults and Adolescents – a Machine-Learning-Based Analysis of Nutrition and Health Survey in Taiwan 2017–2020

Objectives: It is well-established that poor diet quality is closely related to malnutrition and increased risk of non-communicable diseases. Factors associated with dietary behaviors are multifaceted. This study identify social determinants associated with healthy eating among adults and adolescents using data from the Nutrition and Health Survey in Taiwan (NAHSIT).

Methods: Data of 2,789 men and women aged 13 to 64 in NAHSIT 2017-2020 were included in this machine-learning-based study. Diet quality assessed using Taiwanese Healthy Eating Index (T-HEI), a comprehensive measure of diet quality compliant with Taiwanese dietary guidance. Two-step cluster prediction model was used to group enrollees based on sociodemographic variables similarity including age, gender, educational levels, marital status, employment, dietary preference (no-restriction, ovo-lacto-vegetarian, ovo-vegetarian, lacto-vegetarian, vegan), modes (at home, school, or away from home) of breakfast, lunch, and dinner, and meal away from home frequency.

Results: Three clusters were identified in adolescents with modes of meal being the major predictors. T-HEI of adolescents who had breakfast and dinner at home but lunch at school was 45.0 ± 11.1. T-HEI of adolescents who had all meals at home was 44.0 ± 11.4, while those who had school lunch but breakfast and dinner away from home was 43.5 ± 10.9. Analysis of variables showed that T-HEI was significantly difference across clusters (F= 4.888, p= 0.008).

Clusters of “Housewives”, “Bachelors/Bachelorettes”, and “Desk Jockeys” were identified in adults based on sociodemographic similarities. T-HEI was 49.2 ± 13.2 in “Housewives” characterized by older women, lower in education, who had meals mostly at home. T-HEI was 46.9 ± 11.5 in “Bachelors/Bachelorettes” characterized by younger, single or never married, who had meals mostly away from home. T-HEI was 46.7 ± 12.0 in “Desk Jockeys” characterized by highly educated men who had dinner mostly at home. Analysis of variables showed that diet quality was significantly difference across clusters (F= 17.164, p< 0.001).

Conclusions: Social determinants of healthy eating varied between adults and adolescents which was crucial in strategy tailoring for promoting healthy eating.

Funding Sources: This work funded by HPA, MoHW, Taiwan. Content of the research may not represent the opinion of the HPA, MoHW.