Identifying dietary differences between Scotland and England: a rapid review of the literature

Abstract

Objective: Rates of premature mortality have been higher in Scotland than in England since the 1970s. Given the known association of diet with chronic disease, the study objective was to identify and synthesise evidence on current and historical differences in food and nutrient intakes in Scotland and England. Design: A rapid review of the peer-reviewed and grey literature was carried out. After an initial scoping search, Medline, CINAHL, Embase and Web of Science were searched. Relevant grey literature was also included. Inclusion criteria were: any date; measures of dietary intake; representative populations; cross-sectional or observational cohort studies; and English-language publications. Study quality was assessed using the Quality Assessment Tool for Observational Cohort and Crosssectional Studies. A narrative synthesis of extracted information was conducted. Results: Fifty publications and reports were included in the review. Results indicated that children and adults in Scotland had lower intakes of vegetables and vitamins compared with those living in England. Higher intakes of salt in Scotland were also identified. Data were limited by small Scottish samples, difficulty in finding Englandlevel data, lack of statistical testing and adjustment for key confounders. Conclusions: Further investigation of adequately powered and analysed surveys is required to examine more fully dietary differences between Scotland and England. This would provide greater insight into potential causes of excess mortality in Scotland compared with England and suitable policy recommendations to address these inequalities.

Time to address the double inequality of differences in dietary intake between Scotland and England

“…The review conducted by Chambers et al ( 14 ) found limited comparisons of diet between Scotland and England in the published literature. The main differences were lower intakes of fruit and vegetables, fibre and water- and fat-soluble vitamins in Scotland, and higher intakes of Ca, salt and processed meat, suggesting a greater emphasis on animal- v .…”

“…A review of the literature ( 14 ) identified significant historical differences in the intake of foods and nutrients, which are likely to have health implications ( 15 ) , between Scotland and England or between Scotland and the Northern regions of England. In Scotland, there was lower fruit and vegetable consumption, lower fibre intake, lower intake of most water- and fat-soluble vitamins and a higher intake of Na.…”

“…In Scotland, there was lower fruit and vegetable consumption, lower fibre intake, lower intake of most water- and fat-soluble vitamins and a higher intake of Na. The information in these studies and reports was somewhat limited, however, by small sample sizes for Scotland ( 16 , 17 ) , lack of rigour in dietary assessment methods and lack of appropriate statistical analysis controlling for confounding factors ( 14 ) .…”

Using nutritional survey data to inform the design of sugar-sweetened beverage taxes in low-resource contexts: a cross-sectional analysis based on data from an adult Caribbean population

“…The combined response rate was 45%, comparable to that of a similar national dietary survey in the UK (47%). 37 Survey weights were used to take the population representativeness into account as much as possible and to match the age and sex distribution of the Barbados population. However, if participants differed systematically from non-participants in ways not accounted for by the survey weights, our estimates of SSB consumption may not be representative of the broader population.…”

Sugar taxation: a good start but not the place to finish

“…When the city of Glasgow expanded from a small regional town to become the second city of the empire in the 19th century, there was no food provision service, and the population demand was met with a stereotypic imported diet of white bread, jam and sugary tea, which persisted through habit and regional poverty as ship-building declined, well into the 20th century. Its upshot was widespread stunting, and a dramatic rise in heart disease in Scotland, compared to England, which even now appears to relate in part to lower fruit and vegetable consumption (9).…”