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. 2017 May 16;17(1):457.
doi: 10.1186/s12889-017-4383-8.

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

Taru Manyanga  1 , Mark S Tremblay  2 , Jean-Philippe Chaput  2 , Peter T Katzmarzyk  3 , Mikael Fogelholm  4 , Gang Hu  3 , Rebecca Kuriyan  5 , Anura Kurpad  5 , Estelle V Lambert  6 , Carol Maher  7 , Jose Maia  8 , Victor Matsudo  9 , Timothy Olds  7 , Vincent Onywera  10 , Olga L Sarmiento  11 , Martyn Standage  12 , Catrine Tudor-Locke  3   13 , Pei Zhao  14 , Vera Mikkila  15 , Stephanie T Broyles  3 ; ISCOLE Research Group
Collaborators, Affiliations

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

Taru Manyanga et al. BMC Public Health. .

Abstract

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.

Keywords: Gini index; Hdi; Household income; Non-communicable diseases; Unhealthy/healthy diet.

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Figures

Fig. 1
Fig. 1
Odds of higher UDP/HDP scores for (a) lowest vs. highest income group and (b) lowest vs. highest education group in each country. Countries are arranged in descending order by HDI
See this image and copyright information in PMC

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