Living in Solidarity, Eating by Yourself Not Only Ruins your Mind but Also your Nutritional Intake

Modern Malnutrition: Younger Adults Look Forward to a Meal on their Own

These days, sweet little homes have a dinner tables for 2 or 4 persons (max), restaurants have more two seater tables than the ones that can accommodate huge groups and our menu items too have come up with tremendous changes serving even half portion gravies to satisfy the needs of those who eat alone. Eating together was a way of celebrating and there were restaurants occupied by huge groups of people who loved chitchatting through their meal. But now, there are isolated rooms to accommodate groups so that others are not disturbed by the pompous ‘noise’ and can continue to eat in peace. Eating alone has now become one of the modern trends which also has quite many reasons behind it-people travelling long distances have it on their way to office, shift jobs have made it impossible for couples to have a meal together except during weekends and there are many individuals living alone in their homes having lost their spouse and whose children stay abroad or in other cities. Also, young adults choose to live on their own renting an apartment or living together with friends to be independent, live on their earnings and move forward in life. These people rarely cook at home, grab something at the takeaway on their way back from office or simply prepare food that can be instantly done. Changing economic, social and cultural conditions have resulted in a greater number of one-person households and as per 2016 statistics, almost 13% households belong to this category. Eating together has been the universal ritual until now where meals existed as a means to connect to each other, establish relationships, improve rapport and stay happy together. But eating alone by ourselves has become normal these days and it has not only changed how and what we eat but also how we talk to ourselves about eating. Also, how we are eating and how we should be eating are in great contrast with each other and this also brings upon the question whether eating alone and rise in obesity rates have anything to do with each other?

Eating with people has been critical for determining physical and mental health of an individual but eating behaviors are also affected by cohabitation status. While people who stay all alone by themselves have minimal opportunities of eating together there are some others who eat alone just because they like to! Living alone has tremendous impact on diet intake and eating behaviors which includes eating frequency and duration, someone to share your meal with, eating out and meal types all of which have a definite say in your nutritional status and food intake. Food intake is mandatory for survival of life and adequate nutrients are compulsory to lead a healthy and good quality of life. What we eat, how we eat and when we eat has changed incredibly through the decades and the nutrients consumed too have altered. Individuals these days have become more conscious about diet quality but the tendency to eat alone has led to poorer food selections as they tend to choose those meals that are quick and simple rather than having a take from the nutritional point of view. Studies show that eating alone affects nutrition in elderly population, eating together paved way for a healthier lifestyle and when students eat together as a family, they had better dietary intake and quality. We have reached a stage where eating alone exists as a cause for modern malnutrition. While there are many studies that show how insufficient nutrients affect health there are not many which associate the effects of eating alone, socioeconomic factors and their impact on diet quality.
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Korean Study on the Effects of Eating Alone on Nutrition Health
The population for the study included 3365 (39.48%) men and 5158 (60.52%) women aged between 19 and 64 years. Nutrient adequacy ratio (NAR) for each nutrient was calculated using the formula, nutrient intake/recommended nutrient intake and dependent variable of mean adequacy ration (MAR) was used to measure the quality of the meal. MAR was calculated using the formula, sum of NAR nutrients/the number of nutrients. A NAR value close to 1 indicates that nutrient intakes are as per recommendations while a value >1 means that consumed meal is above nutrient recommendations. The meals here include both foods and beverages. Eating behavior was the main variable observed and this notifies whether the individual had company or not during the meal. All the participants were asked questions during each meal-breakfast, lunch and dinner- and the participant’s answer was either ‘yes’ or ‘no’. There were three categories observed that included ‘alone’ (indicating those who had their meals alone), ‘some together’ (some participants ate some meals together) and ‘together’ for those who ate with others for every meal. Participants were put into one of the three groups based on their eating behavior and it was observed that in the male group, 256 (7.61%) ate each of their meal alone, 1199 (35.63%) ate some meals together and 1910 (56.76%) ate all their meals together. In the female group, 502 (9.73%) ate every meal alone, 2255 (43.72%) ate some meal together and 2401 (46.55%) ate every meal together. MAR of male participants remained the same irrespective of whether or not they were living together while female participants’ MAR was influenced depending on whether or not they were living together.

Individuals without Spouses Often Exclusively Eat Alone

Results showed that:

1. When ‘some together’ and ‘alone’ categories were compared the ‘alone’ group’s diet quality was far lower than the ‘together’ group.
2. Male participants always had higher MAR compared to females
3. Association between MAR−stress and MAR−age showed positive correlation between male participants while it showed negative correlation among female participants.
4. Those participants who consumed nutritional supplements for more than 2 weeks per year had higher MAR value than those who did not take supplements.
5. Male participants (completed tertiary education, earns lower or higher incomes and mentions occupational status as ‘others’) who live together and eat alone show inadequate diet with lower MAR than those who eat together within the same categories. The same applies to female participants (completed primary/secondary education, works in pink-collar/blue-collar industry) who live together but eat alone-they have insufficient nutrient intake.

​In 2015 alone, Korea had more than a quarter (27.2%) of the population living in one-person households and the numbers are only expected to grow with a greater number of elderly people making it well into their 70s and 80s. Solitary eating has become prevalent and this leads to modern malnutrition as people are eating foods that are high in fat, sugar, sodium and soda all of which have a greater potential to cause obesity and metabolic syndromes. Eating a meal alone also is an indication of isolation that can disrupt mental health. But when those who live alone supplement their meals with products that help in rendering balanced meals and also go through lifestyle changes it definitely becomes beneficial. People who live together but eat their meals alone feel that it is way better than living alone and those with higher social stratum are better equipped to take care of their health by themselves. We need to improve health awareness to lower socioeconomic class people and also ensure that diet quality does improve for any individual belonging to any class.

Eating Behavior & Risk of Metabolic Syndrome
Metabolic syndrome (MetS) has become of the main causes for global health burden increasing risk of mortality and affecting up to 30% of the adult population. The food we eat plays a definite role in causing MetS-irregular meal timings, skipped meals and eating out frequently play a critical role in laying the foundation for MetS. While effects of eating behavior have been explored on various groups of people including children and elderly adults we don’t have studies that look into different groups of population simultaneously. The study below considers people <65 years and also >65 years in a Korean population, their dietary intake and risk of MetS.

Living arrangements were noted by asking questions such as “How many family members are living with you?” to know whether they lived alone (response as ‘zero’ confirmed that the individual stayed alone) and “Did you usually have [breakfast, lunch, or dinner] with others in the past year?” (if answer was ‘no’ they were categorized as exclusively eating alone and when answer was ‘yes’ they were categorized as eating with others). Four categories were created: Living with others (LW) and eating with others (EW) [LW*EW], living with others (LW) and exclusively eating alone (EA) [LW*EA], living alone and eating with others [LA*EW] and living alone and exclusively eating alone [LA*EA]. Dietary intake was calculated based on seven dietary factors including total energy intake, total carbohydrate intake, total protein intake, total fat intake and percentage of energy derived from each of carbohydrates, protein and fat. Of the 16,015 participants who were involved in the study results showed that:

1. There were great changes in dietary intake observed by living arrangement and eating behavior in young adults and the LA*EA group consumed maximum carbohydrates.
2. In the elderly population, there was no changes in dietary factor that differed greatly due to living arrangements and eating behavior.
3. For all groups, the percentage of energy consumed from carbohydrates and fat exceeded the acceptable macronutrient distribution ranges (AMDRs), almost by 65% for carbs and lower than 15% for lipids.
4. Difference in risk factors for MetS by living arrangements and eating behavior was seen in younger adults and the risk was highest in LA*EA group who also faced highest risk of abdominal obesity, high blood pressure and high fasting blood glucose. MetS risk was lowest among older adults in the LW*EW group while this population faced highest risk of abdominal obesity and low HDL cholesterol when they were living alone
5. Living alone and eating alone increased risk of high blood glucose levels in younger adults (LA*EW) and the risk was highest in the LA*EA group. Risk was high also in the LW*EA group and LA*EA group
6. There was no significant relationship between MetS among older adults and living arrangements or eating behavior

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This study clearly shows that younger adults are at a greater risk of MetS due to different eating behaviors compared to older adults.

Effect on Older Adults
A Japanese study on elderly adults determined how eating alone resulted not only in obesity but also underweight. A total of 106,460 participants were involved in the and they were categorized as obese, overweight, normal or underweight depending on their BMI value. Dietary factors were noted by means of a self-reported questionnaire:
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1. How many meals do you have in a day? The response was ‘one’, ‘two’, ‘three’ or ‘four or more often’ which helped to determine whether or not the subject ate meals.
2. Frequency of fruit and vegetable intake was assessed by asking the question ‘How often did you eat vegetables and fruits in the past one month?’. The response were ‘not at all’, ‘less than once a week’, ‘once a week’, ‘two or three times a week’, ‘four to six times a week’, ‘once a day’ or ‘at least twice a day’. Those participants who had produce less than once a day were categorized as having low frequency of intake.
3. Eating status was assessed with questions such as ‘Who do you actually have meals with?’ and the options were no one, spouse, kids, grandchildren, friends and others. Eating status was one of the 3-eat with others (when answer was spouse, children, grandchildren, friends and others), sometimes eat alone (when response was no one together with spouse, children, grandkids, friends and others) or exclusively eat alone (if the response was no one). Eating and living status was classified into six categories that include: eat with others and live with others;  eat with others and live alone; sometimes eat alone and live with others; sometimes eat alone and live alone; exclusively eat alone and live with others; and exclusively eat alone and live alone. Cohabitation status was further divided into four categories: living only with the spouse; living with both the spouse and children and/or grandchildren; living only with children and/or grandchildren; and living alone.

Results show that:
Overall, 16% men and 28% reported eating alone exclusively or sometimes. Among those who exclusively ate alone, 56% men and 68% women lived alone. Among men and women who sometimes ate alone, 10% men and 31% women lived alone. Those who ate with others and lived together, 90% men and 74% women lived with spouses while 38% men and 46% women lived with kids. Those who exclusively ate alone and lived with others, 52% men and 21% women lived with spouses, and 55% men and 66% women lived with kids. Among those who ate with others and lived alone, 23% of men and 40% of women ate with children, and 22% of men and 27% of women ate with friends. Among subjects who sometimes ate alone and lived alone, 28% of men and 45% of women ate with children, and 63% of men and 66% of women ate with friends.

Men who exclusively ate alone were 3.74 times likelier to skip meals than men who ate with others and women who ate alone were 2.69 times likelier to skip meals than women who ate with others. It was also seen that compared to women who lived alone those who lived with a spouse and kids and/or grandkids were likelier to skip meals. Participants who ate alone were 1.59 times likelier to have low frequency of vegetable and fruit intake compared to those who ate with others. Low intake of produce was seen in women who lived with a spouse and kids/grandkids compared to women who lived alone. Men who exclusively ate and lived alone were 1.34 times likelier to be obese than men who ate and lived with others and men who exclusively ate alone were 1.22 times likelier to be underweight than men who ate with others.
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References
Association between Eating Behavior & Diet Quality: Eating Alone Versus Eating with Others: https://nutritionj.biomedcentral.com/articles/10.1186/s12937-018-0424-0
Influence of Eating Arrangements & Eating Behavior on the Risk of Metabolic Syndrome: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6466134/
Combined Effects of Eating Alone & Living Alone on Unhealthy Dietary Behaviors, Obesity & Underweight in Older Japanese Adults: https://www.sciencedirect.com/science/article/pii/S0195666315002925

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