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Title: A social epidemiology of foodwork and home-prepared food
Author: Clifford Astbury, Chloe
ISNI:       0000 0004 9348 2802
Awarding Body: University of Cambridge
Current Institution: University of Cambridge
Date of Award: 2020
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A significant amount of energy and resource has been devoted to promoting home food preparation, based on the hypothesis that it is an important, modifiable determinant of diet composition and quality. Ideas about the importance of home food preparation to good nutrition have permeated into policy, with a number of countries emphasising home food preparation and home-prepared food in their dietary guidelines and food guides. These policies encourage individuals to maintain ‘traditional’ domestic food practices in order to eat healthily, even while the food system, along with other dimensions of life such as working hours and leisure activities, are undergoing substantial change. Interventions have often focused on boosting skills, guided in part by public and academic discourse that posits that people are cooking less than they did in the past because they no longer know how. This idea persists despite evidence that most people feel their skill set to be adequate to their needs, and cite other barriers, including, notably, a lack of time. Concerns have been raised surrounding both the effectiveness of encouraging home food preparation as a strategy to improve dietary quality, and its repercussions for equity, with foodwork still being predominantly undertaken by women, and with those who are time-poor being potentially less able to adopt time-intensive approaches to food provisioning. Further, there is a certain lack of clarity surrounding what is being encouraged: not all foodwork produces foods that might be defined as ‘home-prepared’. This thesis aims to present a social epidemiology of foodwork and home-prepared food consumption, using nationally representative data from UK adults to: 1) Investigate how a ‘lack’ of time, in the form of competing demands on and other uses for time, is associated with time allocated to foodwork; and 2) Explore the association between home-prepared food consumption and diet quality. First, analysis of three waves of cross-sectional UK time use surveys, spanning three decades, demonstrated that both participation in foodwork and time spent on foodwork continued to decrease. A compositional data analysis approach was used to put this in the context of other daily activities, examining how time spent on activities such as work, sleep and leisure has evolved in tandem with time spent on foodwork. Results suggest that time devoted to work, paid and unpaid, has not increased substantially over this period. Instead, more time is spent on sleep and screen time. Second, analysis of the most recent wave of the UK time use survey compared how participants who did no foodwork, some foodwork, or a lot of foodwork allocated their time differently. Participants who spent more time on foodwork also spent less time on sleep, although not on screen time. Foodwork was predominantly done by women, and women who did more foodwork increased time spent on work (both paid and unpaid) and reduced time spent on leisure and personal care activities more substantially than their male counterparts. Third, a measure of home-prepared food consumption based on food diaries was developed using data from the UK National Diet and Nutrition Survey, and compared to a more orthodox measure: self-reported frequency of meals being prepared at home in participants’ households. These measures were significantly associated with one another, and this association did not vary systematically between most socioeconomic and demographic groups. Fourth, the food diary-based measure of home-prepared food was deployed to estimate consumption levels in the UK population (around a third of energy intake), and to determine the association between home-prepared food consumption and dietary quality. A moderate, though significant, association was found between the two. However, there was limited variation in the consumption of home-prepared food or its association with diet quality between different socio-demographic groups, suggesting that other components of diet may be responsible for consistently reported inequalities in diet quality. Finally, we explored the possibility of eating healthily where extensive foodwork was not possible or desirable by identifying individuals who ate healthily with minimal reliance on home-prepared food, describing their intake in terms of food and nutrients, as well as their socio-demographic characteristics. As a whole, this work suggests that, while foodwork and home food preparation continue to play a role in how people in the UK spend their time and provision their food, other ways of eating also play an important, and potentially growing, role, and may not always necessarily be detrimental to health. Interventions that seek to improve dietary quality at the population level must take a full account of contemporary life, supporting individuals in eating healthily through a diverse range of approaches to food.
Supervisor: Adams, Jean ; Penney, Tarra L. Sponsor: Medical Research Council
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
Keywords: home-prepared food ; home food preparation ; cooking ; nutrition ; dietary public health ; social epidemiology