Socioeconomic status and dietary patterns in children from around the world: different associations by levels of country human development?

BMC Public Health

Research Article

Vera Mikkila¹  Jose Maia²  Victor Matsudo³  Jean-Philippe Chaput⁴  Mark S. Tremblay⁴  Taru Manyanga⁴  Vincent Onywera⁵  Peter T. Katzmarzyk⁶  Stephanie T. Broyles⁶  Gang Hu⁶  Rebecca Kuriyan⁷  Anura Kurpad⁷  Pei Zhao⁸  Olga L. Sarmiento⁹  Martyn Standage^1,10  Estelle V. Lambert^1,11  Mikael Fogelholm^1,12  Catrine Tudor-Locke^1,13  Carol Maher^1,14  Timothy Olds^1,14 

[1] Academy of Finland, Health Research Unit, Helsinki, Finland;CIFI2D, University of Porto, Porto, Portugal;Center of Studies from the Physical Fitness Research Laboratory, de São Caetano do Sul, Sao Paulo, Brazil;Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, K1H 8L1, Ottawa, Canada;Kenyatta University, Nairobi, Kenya;Pennington Biomedical Research Center, Baton Rouge, USA;St. Johns Research Institute, Bangalore, India;Tianjin Women’s and Children’s Health Center, Tianjin, China;Universidad de los Andes, Bogota, Colombia;University of Bath, Bath, UK;University of Cape Town, Cape Town, South Africa;University of Helsinki, Helsinki, Finland;University of Massachusetts Amherst, Amherst, USA;Pennington Biomedical Research Center, Baton Rouge, USA;University of South Australia, Adelaide, Australia;

关键词: Unhealthy/healthy diet;    Household income;    Hdi;    Gini index;    Non-communicable diseases;   

DOI  :  10.1186/s12889-017-4383-8

 received in 2016-09-02, accepted in 2017-05-07,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAlthough ‘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.MethodsThis 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.ResultsThe 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).ConclusionsThis 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.

【 授权许可】

CC BY   
© The Author(s). 2017