Religion and Healthy Eating among Seventh-Day Adventists in West Malaysia

Introduction: Religion/Spirituality has been shown to be salutary on health, and a possible link between religion and positive health outcomes is diet. Research has shown that religiosity is associated with better diet but most studies were conducted in a multi-denominational context, which might be confounded with theological differences. Thus, the first aim of this study was to examine the relationship between individual religiosity and diet within a homogenous group of believers. <br> Neighbourhood characteristics have an effect on health above and beyond the effect of the individual characteristics of those living in the neighbourhood. Neighbourhood might affect the health of its residents by influencing the adoption and maintenance of health behaviours. People of the same faith often practice religious activities together and religious congregation could be considered a community of faith and similar to neighbourhoods. Thus, the characteristics of a religious congregation might influence the health behaviour and health of the congregants. The second aim of this study was to examine whether congregational conservativeness would be significantly associated with the diet of congregants even after taking account of their demographics and individual levels of religiosity. <br> This study also examined whether social gradient exists in a group of health-conscious Christian and whether health behaviours (dietary habits, alcohol consumption and exercise) mediate the relationship between religiosity and health outcomes (systolic and diastolic blood pressure and blood glucose level).<br> Methods: The study population was all Seventh-Day Adventists residing in West Malaysia, aged 18-80. This study used a cross-sectional, multilevel survey design. There were two surveys; the first was congregational and the second, individual. In the first survey, 45 congregations returned questionnaires about congregational conservativeness. In the second survey, 574 Adventists returned questionnaires about religiosity, diet, lifestyle, self-reported history of diseases and demographics. One hundred of the 574 Adventists also participated in a healthy screening where their blood pressure, blood glucose level, weight and height, and waist and hip circumferences were measured.<br> To examine the relationship between individual religiosity and diet and whether social gradient existed in the diet of the participants, multiple regressions were conducted. Multilevel linear regressions were conducted to determine whether congregational conservativeness was significantly associated with the diet of the congregants above and beyond individual factors. To examine whether health behaviours mediated the relationship between religiosity and health outcomes, path analysis was conducted. <br> Results: While none of the religious variables were significantly associated with fruit and vegetable intake, a higher level of religiosity was associated with better dietary habits and vegetarian status. Congregational conservativeness predicted individual dietary habit above and beyond individual characteristics; a higher congregational conservativeness was positively associated with better individual dietary habits scores. None of the religious variables were associated with fruit and vegetable intake at individual and congregational level. Social gradient still existed in the dietary habits of the participants. Health behaviours did not mediate the relationship between religiosity and health outcomes; the direct effect of religiosity on health outcomes was more important than the indirect effect. <br> Conclusions: The finding supports the role of religion as a potential channel to promote health by encouraging the believers to adopt a healthy diet