ABSTRACT
Background
There are persistent disparities in weight- and diet-related diseases by sexual orientation. Lesbian and bisexual females have a higher risk of obesity and cardiovascular disease compared to heterosexual females. Gay and bisexual males have a higher risk of diabetes and cardiovascular disease compared to heterosexual males. However, it remains unknown how sexual orientation groups differ in their dietary quality.
Objective
This study aimed to determine whether dietary quality differs by sexual orientation and sex among US adults.
Design
This was a cross-sectional study of 24-h dietary recall data from a nationally representative sample of adults aged 20–65 participating in the 2011–2016 National Health and Nutrition Examination Survey (NHANES). Participants/setting: Study participants were adults (n=8,851) with complete information on dietary intake, sexual orientation, and sex.
Main outcome measures
The main outcome measures were daily energy intake from 20 specific food and beverage groups and Healthy Eating Index-2015 (HEI-2015) scores for sexual orientation groups (heterosexual vs. gay/lesbian/bisexual (GLB)).
Statistical analyses performed
Ordinary least squares regressions were used to calculate adjusted means for each food and beverage group and HEI-2015, stratified by sex and controlling for covariates (e.g., age, race/ethnicity) and survey cycles (2011–2012; 2013–2014; 2015–2016).
Results
Among males, red and processed meat/poultry/seafood (p =0.01) and sandwiches (p =0.02) were smaller contributors to energy intake for gay/bisexual males compared to heterosexual males. Among females, cereals (p =0.04) and mixed dishes (p =0.02) were smaller contributors to energy intake for lesbian/bisexual females compared to heterosexual females. Gay/ bisexual males had significantly higher total HEI-2015 scores than heterosexual males (53.40 ± 1.36 vs. 49.29 ± 0.32, difference=4.14, p =0.004). Lesbian/bisexual females did not differ in total or component HEI-2015 scores from heterosexual females.
Conclusions
While GLB groups were similar for a variety of dietary outcomes compared to heterosexual groups, gay and bisexual males displayed healthier dietary quality for processed meat (by consuming smaller amounts) and overall dietary quality (according to HEI-2015) compared to heterosexual males.