Socioeconomic status and dietary patterns in children from around the world: different associations by levels of country human development?.pdf (563.06 kB)
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Socioeconomic status and dietary patterns in children from around the world: different associations by levels of country human development?

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journal contribution
posted on 04.05.2018, 15:32 by T. Manyanga, M. S. Tremblay, J-P. Chaput, P. T. Katzmarzyk, M. Fogelholm, G. Hu, R. Kuriyan, A. Kurpad, E. V. Lambert, C. Maher, J. Maia, V. Matsudo, T. Olds, V. Onywera, O. L. Sarmiento, M. Standage, C. Tudor-Locke, P. Zhao, V. Mikkila, S. T. Broyles, ISCOLE Research Group, Deirdre Harrington
BACKGROUND: Although 'unhealthy' diet is a well-known risk factor for non-communicable diseases, its relationship with socio-economic status (SES) has not been fully investigated. Moreover, the available research has largely been conducted in countries at high levels of human development. This is the first study to examine relationships among dietary patterns and SES of children from countries spanning a wide range of human development. METHODS: This was a multinational cross-sectional study among 9-11 year-old children (n = 6808) from urban/peri-urban sites across 12 countries. Self-reported food frequency questionnaires were used to determine the children's dietary patterns. Principal Components Analysis was employed to create two component scores representing 'unhealthy' and 'healthy' dietary patterns. Multilevel models accounting for clustering at the school and site level were used to examine the relationships among dietary patterns and SES. RESULTS: The mean age of participants in this study (53.7% girls) was 10.4 years. Largest proportions of total variance in dietary patterns occurred at the individual, site, and school levels (individual, school, site: 62.8%; 10.8%; 26.4% for unhealthy diet pattern (UDP) and 88.9%; 3.7%; 7.4%) for healthy diet pattern (HDP) respectively. There were significant negative 'unhealthy' diet-SES gradients in 7 countries and positive 'healthy' diet-SES gradients in 5. Within country diet-SES gradients did not significantly differ by HDI. Compared to participants in the highest SES groups, unhealthy diet pattern scores were significantly higher among those in the lowest within-country SES groups in 8 countries: odds ratios for Australia (2.69; 95% CI: 1.33-5.42), Canada (4.09; 95% CI: 2.02-8.27), Finland (2.82; 95% CI: 1.27-6.22), USA (4.31; 95% CI: 2.20-8.45), Portugal (2.09; 95% CI: 1.06-4.11), South Africa (2.77; 95% CI: 1.22-6.28), India (1.88; 95% CI: 1.12-3.15) and Kenya (3.35; 95% CI: 1.91-5.87). CONCLUSIONS: This study provides evidence of diet-SES gradients across all levels of human development and that lower within-country SES is strongly related to unhealthy dietary patterns. Consistency in within-country diet-SES gradients suggest that interventions and public health strategies aimed at improving dietary patterns among children may be similarly employed globally. However, future studies should seek to replicate these findings in more representative samples extended to more rural representation.

History

Citation

BMC Public Health, 2017, 17, 457

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Diabetes Research Centre

Version

VoR (Version of Record)

Published in

BMC Public Health

Publisher

BioMed Central

eissn

1471-2458

Acceptance date

07/05/2017

Available date

04/05/2018

Publisher version

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4383-8

Language

en