A multilevel study of socio-economic inequalities in food choice behaviour and dietary intake among the Dutch population: the GLOBE study

Giskes, Katrina; Turrell, Gavin; Lenthe, Frank J. van; Brug, Johannes; Mackenbach, Johan P.

doi:10.1079/phn2005758

Cited by 85 publications

(75 citation statements)

References 39 publications

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“…These findings are broadly consistent with the results of multilevel studies conducted in the USA (14) and Scotland (15) ; however, they are at odds with multilevel research conducted in The Netherlands (18) and Brisbane, Australia (16) . Reconciling these differences, and hence being able to generalise about the relationship between area SES and diet, is difficult.…”

Section: Discussionsupporting

confidence: 85%

A multilevel study of area socio-economic status and food purchasing behaviour

Turrell

Bentley

Thomas

et al. 2009

Public Health Nutr.

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Objective: The present study examined the association between area socioeconomic status (SES) and food purchasing behaviour. Design: Data were collected by mail survey (64?2 % response rate). Area SES was indicated by the proportion of households in each area earning less than $AUS 400 per week, and individual-level socio-economic position was measured using education, occupation and household income. Food purchasing was measured on the basis of compliance with dietary guideline recommendations (for grocery foods) and variety of fruit and vegetable purchase. Multilevel regression analysis examined the association between area SES and food purchase after adjustment for individual-level demographic (age, sex, household composition) and socioeconomic factors. Setting: Melbourne city, Australia, 2003. Subjects: Residents of 2564 households located in fifty small areas. Results: Residents of low-SES areas were significantly less likely than their counterparts in advantaged areas to purchase grocery foods that were high in fibre and low in fat, salt and sugar; and they purchased a smaller variety of fruits. There was no evidence of an association between area SES and vegetable variety. Conclusions: In Melbourne, area SES was associated with some food purchasing behaviours independent of individual-level factors, suggesting that areas in this city may be differentiated on the basis of food availability, accessibility and affordability, making the purchase of some types of foods more difficult in disadvantaged areas.

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Section: Discussionsupporting

confidence: 85%

A multilevel study of area socio-economic status and food purchasing behaviour

Turrell

Bentley

Thomas

et al. 2009

Public Health Nutr.

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“…6,19,[32][33][34][35] For vegetables, Kimchi intake was higher in the low-education group, which is consistent with the results of a previous Korean study. 5 In contrast, vegetable intake without Kimchi was lower in the low-education group.…”

Section: Discussionsupporting

confidence: 82%

“…[15][16][17] Education is closely correlated with knowledge and awareness, and thus may influence food choices through nutritional knowledge and health considerations. 18,19 Given the importance of food choices to public health, the relationship between education and food choices is a highly researched area, and a disparity in FV consumption between education levels has been suggested by many studies. 15,17 The Republic of Korea has experienced enormous economic and social changes, and since the financial crisis in 1997, social inequality has deepened, as illustrated by an increase in the Gini coefficient (0.28 in 1996 to 0.34 in 2006) and the relative poverty rate (8.9% in 1996 to 17% in 2006).…”

Section: Introductionmentioning

confidence: 99%

Trends in the inequality of fruit and vegetable consumption between education levels indicated by the Korea National Health and Nutrition Examination Surveys

Hong

Kim

2012

Eur J Clin Nutr

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). The FV intakes were examined using 24-h dietary-recall surveys (n ¼ 35 725) and food frequency questionnaires (n ¼ 35 400). The relative index of inequality (RII) was used to examine the magnitude and trend of inequality in insufficient FV intake (o500 gram/day for total FV; o100 gram/day, less than once per day for fruits) between educational levels. RESULTS: The low-education group had lower intakes of total FV, vegetables excluding Kimchi and fruit (both by frequency and quantity), but higher intakes of Kimchi, in both sexes in most years in which surveys were conducted. This group also had a higher proportion of adults with insufficient total FV and fruit intakes. The inequality, as indicated by the RII, was apparent in both sexes and in each survey year. The inequality in insufficient total FV intake increased between 1998 and 2009 in both sexes (Po0.05). An increase in the inequality in fruit intake was only detected in women (Po0.0001 for frequency and P ¼ 0.0285 for quantity, from 2007 to 2009). CONCLUSION: There is a wide discrepancy in total FV and fruit consumption across education levels among Korean adults. This inequality has increased over time for total FV intake in both sexes and for fruit intake in women.

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“…These SES inequalities in diet have been documented in the literature (10,11,36) , also among older adults (12,13) . These results motivate the aim of our study to investigate the potential pathways through which these SES indicators influence dietary adherence in older adults.…”

Section: Discussionmentioning

confidence: 63%

The role of perceived barriers in explaining socio-economic status differences in adherence to the fruit, vegetable and fish guidelines in older adults: a mediation study

Dijkstra

Neter

Stralen

et al. 2014

Public Health Nutr.

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Objective: We aimed to identify barriers for meeting the fruit, vegetable and fish guidelines in older Dutch adults and to investigate socio-economic status (SES) differences in these barriers. Furthermore, we examined the mediating role of these barriers in the association between SES and adherence to these guidelines. Design: Cross-sectional. Setting: Longitudinal Aging Study Amsterdam (LASA), the Netherlands. Subjects: We used data from 1057 community-dwelling adults, aged 55-85 years. SES was measured by level of education and household income. An FFQ was used to assess dietary intake and barriers were measured with a self-reported lifestyle questionnaire. Results: Overall, 48·9 % of the respondents perceived a barrier to adhere to the fruit guideline, 40·0 % for the vegetable and 51·1 % for the fish guideline. The most frequently perceived barriers to meet the guidelines were the high price of fruit and fish and a poor appetite for vegetables. Lower-SES groups met the guidelines less often and perceived more barriers. The association between income and adherence to the fruit guideline was mediated by 'perceiving any barrier to meet the fruit guideline' and the barrier 'dislike fruit'. The association between income and adherence to the fish guideline was mediated by 'perceiving any barrier to meet the fish guideline' and the barrier 'fish is expensive'. Conclusions: Perceived barriers for meeting the dietary guidelines are common in older adults, especially in lower-SES groups. These barriers and in particular disliking and cost concerns explained the lower adherence to the guidelines for fruit and fish in lower-income groups in older adults.

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A multilevel study of socio-economic inequalities in food choice behaviour and dietary intake among the Dutch population: the GLOBE study

Cited by 85 publications

References 39 publications

A multilevel study of area socio-economic status and food purchasing behaviour

A multilevel study of area socio-economic status and food purchasing behaviour

Trends in the inequality of fruit and vegetable consumption between education levels indicated by the Korea National Health and Nutrition Examination Surveys

The role of perceived barriers in explaining socio-economic status differences in adherence to the fruit, vegetable and fish guidelines in older adults: a mediation study

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