Gender Expression and Sexual Orientation Differences in Diet Quality and Eating Habits from Adolescence to Young Adulthood



      Diet and eating habits during youth have implications on diet and eating habits during adulthood, however, little longitudinal research has examined sexual orientation and gender expression differences in diet.


      Our aim was to examine sexual orientation and gender expression differences in diet quality and eating habits from adolescence to young adulthood.


      Data across multiple time points from the longitudinal Growing Up Today Study cohorts (1997 to 2011) were used.


      Participants (n=12,880; aged 10 to 23 years) were the children of women from the Nurses’ Health Study II cohort.

      Main outcome measures

      Diet quality scores were assessed using the Alternative Healthy Eating Index-2010. In addition, breakfast consumption (≥5 days/wk) and family dinners (≥5 days/wk) were assessed.

      Statistical analyses performed

      Multivariable generalized estimating equation regression models were fit to estimate sexual orientation and gender expression differences in diet quality scores, breakfast consumption, and family dinners, stratified by sex assigned at birth over available repeated measures.


      “Gender-nonconforming” males had significantly higher diet quality scores than “very gender-conforming” males (P<0.05). Diet quality scores did not differ by gender expression among females. “Mostly heterosexual” females and gay males had higher diet quality scores than their same-sex completely heterosexual counterparts (P<0.05). Adjustment for mother’s diet quality scores attenuated effects, except for gay males (P<0.05). “Gender-nonconforming” females were less likely to consume breakfast than “very gender-conforming” females (P<0.05). Similar results were found for “mostly heterosexual” and bisexual compared to completely heterosexual females. There were no gender expression or sexual orientation differences in family dinners among males and females.


      Sexual orientation and gender expression have independent effects on diet quality scores and eating habits for both males and females. Very gender-conforming and completely heterosexual males had the lowest diet quality scores compared to other gender expression and sexual orientation groups. Additional research to explore the effects of sexual orientation and gender expression on diet-related health is needed to build upon these findings.


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      N. A. VanKim is an assistant professor, Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst.


      H. L. Corliss is a professor, Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA.


      H.-J. Jun is an adjunct assistant professor, Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA.


      J. P. Calzo is an associate professor, Division of Health Promotion and Behavioral Science, School of Public Health, San Diego State University, San Diego, CA.


      M. AlAwadhi is an assistant professor, College of Life Sciences, Kuwait University, Adaliya, Kuwait; at the time of the study, she was a doctoral candidate, Department of Nutrition, T.H. Chan Harvard School of Public Health, Boston, MA.


      S. Bryn Austin is a professor, Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, MA; an associate epidemiologist, Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; and a professor, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA.