Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug 24;19(1):88.
doi: 10.1186/s12937-020-00608-x.

To what extent do dietary costs explain socio-economic differences in dietary behavior?

Jody C Hoenink  1 , Joline W J Beulens  2   3 , Marjolein C Harbers  3 , Jolanda M A Boer  4 , S Coosje Dijkstra  5 , Mary Nicolaou  6 , Yvonne T van der Schouw  3 , Ivonne Sluijs  3 , W M Monique Verschuren  3   4 , Wilma Waterlander  2   6 , Joreintje D Mackenbach  2
Affiliations

To what extent do dietary costs explain socio-economic differences in dietary behavior?

Jody C Hoenink et al. Nutr J. .

Erratum in

Abstract

Background: Low socio-economic position is associated with consumption of lower quality diets, which may be partly explained by the cost of healthier diets. Therefore, we aimed to investigate the mediating role of dietary costs in the association between educational level and diet quality.

Methods: We used cross-sectional data from Dutch older adults (N = 9399) in the EPIC-NL cohort. Participants provided information about their own and their partners' highest attained educational level (as proxy for socio-economic position). Dietary behavior was assessed using a food frequency questionnaire from which we derived two diet-quality scores, including the Dutch Healthy Diet index 2015 (DHD15-index) and the Dietary Approaches to Stop Hypertension (DASH) diet. Dietary cost estimates were based on food price data from food stores, and linked to reported consumption of food items. Multiple regression analyses and bootstrapping were used examine the mediating role of dietary cost in the association between educational level and diet quality.

Results: Mean age of participants was 70 (SD: 10) years and 77% were women. Dietary costs significantly mediated the association between educational level and diet quality, except for high versus middle individual educational level and the DHD15-index. Depending on the dietary and educational indicator, dietary costs explained between 2 and 7% of the association between educational level and diet quality. Furthermore, associations were found to be modified by sex and age. For the DHD15-index, mediation effects were only present in females and adults older than 65 years, and for the DASH diet mediation effects were only present in females and strongest amongst adults older than 65 years compared to adults younger than 65 years.

Conclusion: Dietary costs seems to play a modest role in explaining educational differences in diet quality in an older Dutch population. Further research is needed to investigate which other factors may explain SEP differences in diet quality.

Keywords: Dietary quality; Food prices; Mediation analysis; Socioeconomic inequalities.

PubMed Disclaimer

Conflict of interest statement

The author(s) declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the study population
Fig. 2
Fig. 2
Pathways through which dietary cost may mediate the association between educational level and dietary quality. The c-paths are the associations between individual and household educational level and the dietary quality measures separately. The a-path is the association between the educational level variables and the potential mediator dietary cost. The b-paths and c’-paths are the associations between dietary cost and the dietary quality measures adjusted for the educational level variables (b-path) and between the educational level measures and the dietary quality measures adjusted for dietary cost (c’-path)
See this image and copyright information in PMC

References

    1. Forouzanfar M, Alexander LT, Anderson H, Bachman V, Biryukov S, Brauer M, Burnett RT, Casey DC, Coates M, Cohen A, Delwiche K. Global, regional and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the global burden of diseases study 2013. Lancet. 2015;386:2287–2323. - PMC - PubMed
    1. Collaborators GBDD Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the global burden of disease study 2017. Lancet. 2019;393:1958–1972. - PMC - PubMed
    1. Mackenbach JP, Stirbu I, Roskam AJR, Schaap MM, Menvielle G, Kunst AE. Socioeconomic inequalities in health in 22 European countries. N Engl J Med. 2008;358:2468–2481. - PubMed
    1. Marmot M. Social determinants of health inequalitie. Lancet. 2005;365:1099–1104. - PubMed
    1. Méjean C, Droomers M, van der Schouw YT, Sluijs I, Czernichow S, Grobbee DE, Beulens JW. The contribution of diet and lifestyle to socioeconomic inequalities in cardiovascular morbidity and mortality. Int J Cardiol. 2013;168:5190–5195. - PubMed

Publication types

LinkOut - more resources