Sex Differences in Healthy Eating: Investigating the Moderating Effect of Self-Efficacy

Objectives: This study aimed to evaluate sex differences in dietary habits and the moderating effect of self-efficacy on the adoption of a healthy diet. Design: Cross-sectional study. Setting: The healthy population of Tehran, Iran. Participants: A total of 262 participants from the general population with normal health status. Main Outcome Measure: The adoption of a healthy diet was based on the Healthy Eating Index-2015 (HEI-2015) scores and the moderating effect of self-efficacy on eating behaviors. Analysis: Logistic regression analysis and multiple linear regression (moderation) analysis were conducted using PROCESS macro (version 3.5). Results: The sex-based analysis revealed that females were more likely to adopt a healthy diet vs males (adjusted odds ratio, 1.85; 95% confidence interval, 1.02-3.35). The moderation analysis showed that eating behavior self-efficacy significantly moderated the relationship between sex differences and HEI-2015 scores (?R2 = 0.01; P = 0.033). Males with low self-efficacy scores had the highest difference in HEI-2015 with females with low self-efficacy scores, whereas the difference in HEI-2015 was very small in males and females with high self-efficacy scores. Conclusions and Implications: Eating behavior self-efficacy had a significantly decreasing moderating effect on sex differences in the adoption of a healthy diet. Future research needs to clarify the impact of eating`` behavior self-efficacy in the adoption of a healthy diet, particularly in males, and to confirm the study's findings. 2021 Society for Nutrition Education and Behavior

The authors would like to express their thanks to the Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences for supporting the project.

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