Edited by: Adrian Meule, University of Salzburg, Austria
Reviewed by: Nicholas T. Bello, Rutgers-The State University of New Jersey, USA; Lindsay D. Wilson Barlow, VA Salt Lake City Health Care System, USA
Specialty section: This article was submitted to Eating Behavior, a section of the journal Frontiers in Nutrition
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Gender role, independent of biological sex, affects health. However, research on healthy eating that considers the importance of gender norms is scarce. People who are androgynous and have high masculinity and femininity are reported to have better health practices than other people. The present study aimed to examine the differences in health literacy (HL) and self-efficacy for healthy eating by gender role in Japanese men and women. Participants were 629 men and women aged 25–34 years, recruited via a Japanese Internet research company database. Participants were categorized into four gender role groups using the Japanese Gender Role Index. HL and self-efficacy for healthy eating were assessed using the healthy eating literacy (HEL) scale and the healthy eating and weight self-efficacy (HEWSE) scale. Analysis of variance with Bonferroni-adjusted
In general, compared with women, men lack knowledge and skills about food and nutrition, and less likely to engage in food preparation (Ministry of Health, Labour and Welfare, 1999, 2000). It has been suggested that such differences might contribute to less healthy eating behaviors and lower health status among men (
Gender role orientation represents a person’s position within the framework of masculine and feminine dimensions (
In addition, health literacy (HL) and self-efficacy are meaningful outcomes to explore in relation to gender role. It has recently been suggested that HL about diet is integral to increasing dietary knowledge and promoting healthy dietary habits (
It has been suggested that by early adulthood, people tend to have a fixed gender role, and fit their lifestyles and behaviors to it (
The present study aimed to examine the relationship between gender role orientation and HL and self-efficacy for healthy eating among Japanese in early adulthood. More specifically, two hypotheses were examined:
Among gender role orientation groups, those who are androgynous have the highest scores in both HL and self-efficacy, while those with an undifferentiated gender role have the lowest scores. Gender role orientation would better account for individual differences in HL and self-efficacy scores than biological sex.
Data for the present study were collected in September 2015, via an online survey from 629 men and women who were registered with a Japanese Internet research company database. As part-time workers and homemakers have different lifestyles from full-time workers, full-time workers were selected for the purpose of this study. In addition, white- and blue-collar workers might differ in educational attainment, income, and health status (
Japan has developed in significantly different ways from Western countries, which has influenced gender role development in Japanese people. Western measures of gender roles, such as the BSRI, are not relevant for Japanese. For example, Japanese people saw masculine stereotypes as less active than did people in other countries (
Literacy about healthy eating was assessed with the healthy eating literacy (HEL) scale (
Self-efficacy for healthy eating and weight was assessed by the healthy eating and weight self-efficacy (HEWSE) scale (
As everyday food preparation or food-related education may influence individual HL or self-efficacy for healthy eating, we asked about participants’ food-related experiences. This included meal preparation frequency, “
We collected information on age, sex, marital status, body mass index (BMI: weight in kilogram/height in square meter), self-perceived weight status (too heavy, somewhat heavy, just about right, somewhat light, or too light), educational level, occupation, and annual household income.
Previous studies refer to the effectiveness of median split method to disentangle health effects of each group (
Table
Men ( |
Women ( |
Total ( |
||
---|---|---|---|---|
HEL (mean ± SD) | 3.34 ± 0.80 | 3.41 ± 0.75 | 3.37 ± 0.77 | 0.21 |
HEWSE (mean ± SD) | 3.19 ± 0.70 | 3.19 ± 0.67 | 3.19 ± 0.69 | 0.96 |
Age (mean ± SD, years) | 30.5 ± 2.6 | 29.5 ± 2.8 | 30.0 ± 2.8 | |
Gender type | 0.02 |
|||
Androgynous | 126 (40.3) | 104 (32.9) | 230 (36.6) | |
Feminine | 37 (11.8) | 42 (13.3) | 79 (12.6) | |
Masculine | 40 (12.7) | 31 (9.8) | 71 (11.3) | |
Undifferentiated | 110 (35.1) | 139 (44.0) | 249 (39.6) | |
Education | <0.001 |
|||
University | 221 (70.6) | 172 (54.4) | 393 (62.5) | |
Less than university | 92 (29.4) | 144 (45.6) | 236 (37.5) | |
Body mass index (mean ± SD, kg/m2) | 22.3 ± 3.4 | 20.3 ± 3.4 | 21.3 ± 3.5 | <0.001 |
<18.5 | 25 (8.0) | 82 (25.9) | 107 (17.0) | |
18.5-24.9 | 232 (74.1) | 213 (67.4) | 445 (70.7) | |
≥25.0 | 55 (17.6) | 21 (6.6) | 76 (12.1) | |
Self-perceived weight status | 0.52 |
|||
Too heavy, Somewhat heavy | 113 (36.1) | 128 (40.5) | 241 (38.3) | |
Just about right | 127 (40.6) | 118 (37.3) | 245 (39.0) | |
Too light, Somewhat light | 73 (23.3) | 70 (22.2) | 143 (22.7) | |
Marital Status | <0.001 |
|||
Married | 161 (51.4) | 108 (34.2) | 269 (42.8) | |
Not married | 152 (48.6) | 208 (65.8) | 360 (57.2) | |
Occupation | <0.001 |
|||
Administrative and managerial workers | 13 (4.2) | 2 (0.6) | 15 (2.4) | |
Professional and engineering workers | 105 (33.5) | 75 (23.7) | 180 (28.6) | |
Clerical workers | 93 (29.7) | 159 (50.3) | 252 (40.1) | |
Sales workers | 39 (12.4) | 21 (6.6) | 60 (9.5) | |
Service workers | 53 (16.9) | 59 (18.7) | 112 (17.8) | |
Security workers | 10 (3.2) | 0 (0) | 10 (1.6) | |
Income quintile | 0.002 |
|||
~3,999,999 | 85 (27.2) | 114 (36.1) | 199 (31.6) | |
4,000,000~5,999,999 | 111 (35.5) | 78 (24.7) | 189 (30.0) | |
6,000,000~9,999,999 | 95 (30.4) | 85 (26.9) | 180 (28.6) | |
~10,000,000 | 22 (7.0) | 39 (12.3) | 61 (9.7) | |
Dinner preparation frequency | <0.001 |
|||
Never | 83 (26.5) | 34 (10.8) | 106 (16.9) | |
Sometimes | 148 (47.3) | 103 (32.6) | 251 (39.9) | |
Often | 82 (26.2) | 179 (56.6) | 261 (41.5) | |
Engaged in food education | 0.23 |
|||
Yes | 24 (7.7) | 34 (10.8) | 58 (9.2) | |
No | 289 (92.3) | 282 (89.2) | 571 (90.8) |
The mean scores for the JGRI subscales were F = 3.54 (SD = 1.02) and M = 3.49 (SD = 1.35). There was no significant difference in JGRI scores between the sexes. The median scores for both subscales were 3.40. In total, 37% of participants were categorized as Androgynous, 13% as Feminine, 11% as Masculine, and 40% as Undifferentiated. This indicated that there were relatively few gender-typed individuals (Feminine and Masculine). While the percentages of men in the Androgynous group and women in the Undifferentiated group were high (androgynous 40 vs. 33%; undifferentiated 35 vs. 44% for men and women, respectively), no significant difference was observed in gender role distribution by biological sex (χ2 = 6.93, df = 3,
Androgynous ( |
Feminine ( |
Masculine ( |
Undifferentiated ( |
Total ( |
||
---|---|---|---|---|---|---|
Age (mean ± SD, years) | 29.6 ± 2.8 | 30.1 ± 2.8 | 30.3 ± 2.6 | 30.1 ± 2.8 | 30.0 ± 2.8 | |
Sex | 0.07 | |||||
Men | 126 (54.8) | 37 (46.8) | 40 (56.3) | 110 (44.2) | 313 (49.8) | |
Women | 104 (45.2) | 42 (53.2) | 31 (43.7) | 139 (55.8) | 316 (50.2) | |
Education | <0.001 | |||||
University | 143 (62.2) | 22 (27.8) | 21 (29.6) | 155 (62.2) | 236 (37.5) | |
Less than university | 87 (37.8) | 57 (72.2) | 50 (70.4) | 94 (37.8) | 393 (62.5) | |
Body mass index (kg/m2) | 0.94 | |||||
<18.5 | 40 (17.4) | 15 (19.0) | 10 (14.1) | 42 (16.9) | 107 (17.0) | |
18.5–24.9 | 166 (72.2) | 53 (67.1) | 52 (73.2) | 174 (69.9) | 445 (70.7) | |
≥25.0 | 24 (10.4) | 11 (13.9) | 9 (12.7) | 32 (12.9) | 76 (12.1) | |
Self-perceived weight status | 0.14 | |||||
Too heavy, somewhat heavy | 76 (33.0) | 32 (40.5) | 24 (33.8) | 109 (43.4) | 241 (38.3) | |
Just about right | 104 (45.2) | 31 (39.2) | 27 (38.0) | 83 (33.3) | 245 (29.0) | |
Too light, somewhat light | 50 (21.7) | 16 (20.3) | 20 (28.2) | 57 (22.9) | 143 (22.7) | |
Marital Status | 0.15 | |||||
Married | 106 (46.1) | 35 (44.3) | 35 (49.3) | 93 (37.3) | 269 (42.8) | |
Not married | 124 (53.9) | 44 (55.7) | 36 (50.7) | 156 (62.7) | 360 (57.2) | |
Occupation | ||||||
Administrative and managerial workers | 8 (3.5) | 4 (5.1) | 1 (1.4) | 2 (0.8) | 15 (2.4) | |
Professional and engineering workers | 69 (30.0) | 20 (25.3) | 21 (29.6) | 70 (28.1) | 180 (28.6) | |
Clerical workers | 82 (35.7) | 34 (43.0) | 28 (39.4) | 108 (43.4) | 252 (40.1) | |
Sales workers | 24 (10.4) | 5 (6.3) | 9 (12.7) | 22 (8.8) | 60 (9.5) | |
Service workers | 44 (19.1) | 14 (17.7) | 9 (12.7) | 45 (18.1) | 112 (17.8) | |
Security workers | 3 (1.3) | 2 (2.5) | 3 (4.2) | 2 (0.8) | 10 (1.6) | |
Income quintile | 0.21 | |||||
~3,999,999 | 70 (30.4) | 29 (36.7) | 13 (18.3) | 87 (34.9) | 199 (31.6) | |
4,000,000~–5,999,999 | 68 (29.6) | 18 (22.8) | 28 (39.4) | 75 (30.1) | 189 (30.0) | |
6,000,000~–9,999,999 | 65 (28.3) | 26 (32.9) | 22 (31.0) | 67 (26.9) | 180 (28.6) | |
~10,000,000 | 27 (11.7) | 6 (7.6) | 8 (11.3) | 20 (8.0) | 61 (9.7) | |
Dinner preparation frequency | 0.06 | |||||
Never | 30 (13.0) | 21 (26.6) | 15 (21.1) | 51 (20.5) | 106 (16.9) | |
Sometimes | 107 (46.5) | 27 (34.2) | 23 (32.4) | 94 (37.8) | 251 (39.9) | |
Often | 93 (40.4) | 31 (39.2) | 33 (46.5) | 104 (41.8) | 261 (41.5) | |
Engaged in food education | 0.92 | |||||
Yes | 23 (10.0) | 8 (10.1) | 6 (8.5) | 21 (8.4) | 58 (9.2) | |
No | 207 (90.0) | 71 (89.9) | 65 (91.5) | 228 (91.6) | 571 (90.8) |
As shown in Table
Androgynous mean ± SD | Feminine mean ± SD | Masculine mean ± SD | Undifferentiated mean ± SD | |||
---|---|---|---|---|---|---|
HEL | 3.65 ± 0.71 | 3.27 ± 0.70 | 3.56 ± 0.81 | 3.10 ± 0.73 | <0.001 | A>F, A>U, M>U |
HEWSE | 3.45 ± 0.65 | 3.08 ± 0.64 | 3.23 ± 0.64 | 2.95 ± 0.71 | <0.001 | A>F, A>U, M>U |
Table
Step and variable | Step1 |
Step2 |
Step3 |
||||||
---|---|---|---|---|---|---|---|---|---|
β | SE | β | SE | β | SE | ||||
Sociodemographic | |||||||||
Sex | 0.047 | 0.042 | 0.26 | 0.082 | 0.040 | 0.038 | 0.060 | 0.041 | 0.14 |
Age | −0.054 | 0.041 | 0.19 | −0.027 | 0.039 | 0.49 | −0.029 | 0.039 | 0.46 |
Marital status | 0.025 | 0.041 | 0.55 | 0.001 | 0.039 | 0.99 | −0.006 | 0.039 | 0.87 |
Education | −0.002 | 0.042 | 0.95 | 0.010 | 0.039 | 0.80 | 0.015 | 0.039 | 0.70 |
Income | 0.064 | 0.041 | 0.12 | 0.040 | 0.039 | 0.30 | 0.046 | 0.039 | 0.24 |
Body perception | 0.017 | 0.040 | 0.67 | −0.002 | 0.038 | 0.95 | −0.001 | 0.038 | 0.98 |
Gender role orientation | |||||||||
Androgynous | 0.353 | 0.042 | <0.001 | 0.344 | 0.042 | <0.001 | |||
Feminine | 0.078 | 0.041 | 0.056 | 0.081 | 0.041 | 0.047 | |||
Masculine | 0.194 | 0.041 | <0.001 | 0.191 | 0.041 | <0.001 | |||
Food experiences | |||||||||
Dinner preparation | 0.065 | 0.040 | 0.11 | ||||||
Food education | 0.063 | 0.038 | 0.10 | ||||||
F | 1.07 | 9.23 | <0.001 | 8.14 | <0.001 | ||||
Multiple R | 0.010 | 0.12 | 0.13 | ||||||
Multiple Adj R2 | 0.00070 | 0.11 | 0.11 | ||||||
ΔR2 | 0.106 | <0.001 | 0.010 | 0.052 | |||||
Sociodemographic | |||||||||
Sex | −0.001 | 0.040 | 0.98 | 0.028 | 0.038 | 0.46 | −0.024 | 0.039 | 0.54 |
Age | −0.021 | 0.039 | 0.59 | 0.003 | 0.038 | 0.93 | −0.002 | 0.037 | 0.96 |
Marital status | −0.031 | 0.040 | 0.44 | −0.050 | 0.038 | 0.19 | −0.068 | 0.037 | 0.070 |
Education | −0.008 | 0.040 | 0.84 | 0.003 | 0.038 | 0.93 | 0.016 | 0.037 | 0.67 |
Income | 0.124 | 0.039 | 0.0017 | 0.107 | 0.038 | 0.0047 | 0.119 | 0.037 | 0.0013 |
Body perception | 0.269 | 0.038 | <0.001 | 0.254 | 0.037 | <0.001 | 0.256 | 0.036 | <0.001 |
Gender role orientation | |||||||||
Androgynous | 0.320 | 0.041 | <0.001 | 0.299 | 0.040 | <0.001 | |||
Feminine | 0.055 | 0.039 | 0.16 | 0.064 | 0.038 | 0.098 | |||
Masculine | 0.099 | 0.039 | 0.012 | 0.092 | 0.038 | 0.0017 | |||
Food experiences | |||||||||
Dinner preparation | 0.162 | 0.038 | <0.001 | ||||||
Food education | 0.115 | 0.036 | 0.0014 | ||||||
F | 10.61 | <0.001 | 14.79 | <0.001 | 15.51 | <0.001 | |||
Multiple R | 0.093 | 0.18 | 0.22 | ||||||
Multiple Adj R2 | 0.084 | 0.17 | 0.20 | ||||||
ΔR2 | 0.081 | <0.001 | 0.038 | <0.001 |
The present study explored the association between gender role orientation and HL and self-efficacy for healthy eating among Japanese in early adulthood. In the present study, majority of the participants were categorized as non-gender-typed personalities (i.e., androgynous and undifferentiated), which is consistent with a recent study in Japan (
It is noteworthy that in addition to the Androgynous group, the Masculine group had high HL and self-efficacy scores. Contrary to our findings, masculinity has been suggested to play a role in risk behaviors not only for men but also sometimes for women (
Food itself has a number of implicit meanings (
Individual gender role orientation and gender norms in society interact with each other. Social concepts of gender are produced and reproduced through underlying social norms of how people think and behave (
There are several limitations in the present study. First, homemakers were not included in the study sample, which might have affected women’s scores for HL and self-efficacy. In addition, because the sample consisted of white-collar workers and was recruited via an online survey company, the findings have limited generalizability. Second, because this was a cross-sectional study, the relationship between gender role orientation and health outcome was only observed at one point. However, gender role orientation and behavior patterns become relatively stable by the early adulthood (
In summary, the present study showed that gender role orientation rather than biological sex had significant effects on HL and self-efficacy for healthy eating among Japanese in early adulthood. Directing attention to individual gender role orientation and gender norms in society may enhance more effective prevention and health education. Diverse approaches are necessary because gender norms in society are the result of continuous reproduction of many relationships, including family, couples, workplace, school, and the media. For example, research suggests that gender role development stems from the family context and may be influenced by parenting (
Overall, it is not pursuit of traditional gender role for each sex, but support of psychological development toward androgyny in both sexes that is important to promote healthy eating attitudes at the population level. In modern society, it is required that both sexes acquire the genderless behavioral traits to be able to manage their own dietary behaviors.
The present study, gender role orientation, was associated with HL and self-efficacy for healthy eating among Japanese in early adulthood, even after controlling for sociodemographic variables, including biological sex. The findings support those of previous research that people who are androgynous have better health practices. However, people in the Masculine group also had better HL and self-efficacy. There are still a limited number of studies considering gender norms as determinants of healthy eating, although numerous studies have explored “gender (biological sex)” differences in health. Further investigation of gender norms and eating behaviors would help improve individuals’ healthy eating.
CH conceived the research, collected the data, conducted statistical analyses, and drafted the manuscript; HI conceived the research, interpreted the results, and revised the manuscript; MO, MK, and TO interpreted the results; TK interpreted the results and supervised each process of the study; All authors read and approved the final manuscript.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Thanks to the graduate students in the Department of Health Communication at The University of Tokyo for academic comments.
This work was supported by the Japan Society for the Promotion of Science under Grant number [24390163 to HI].