Inequalities in education and national income are associated with poorer diet: Pooled analysis of individual participant data across 12 European countries

Rippin, Holly; Hutchinson, Jayne; Greenwood, DC; Jewell, Jo; Breda, João; Martin, Adam; Rippin, David M.; Schindler, Karin; Rust, Petra; Fagt, Sisse; Matthiessen, Jeppe; Nurk, Eha; Nelis, Keiu; Kukk, M.; Tapanainen, Heli; Valsta, Liisa; Heuer, Thorsten; Sarkadi-Nagy, Eszter; Bakacs, Márta; Tazhibayev, Shamil; Sharmanov, T Sh; Spiroski, Igor; Beukers, M.; Rossum, Caroline van; Ocké, Marga C.; Lindroos, Anna Karin; Lemming, Eva Warensjö; Cade, Janet

doi:10.1371/journal.pone.0232447

Cited by 64 publications

(48 citation statements)

References 21 publications

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“…Identification of trends and dietary inadequacies and inequalities can help inform more targeted policies and behavior-change strategies to improve population health across different socio-economic countries [ 18 ]. However, research comparing adherence to FBDGs are lacking, which may be a concern for the development of nutrition policies.…”

Section: Introductionmentioning

confidence: 99%

Adherence to Food-Based Dietary Guidelines: A Systemic Review of High-Income and Low- and Middle-Income Countries

et al. 2021

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Research comparing the adherence to food-based dietary guidelines (FBDGs) across countries with different socio-economic status is lacking, which may be a concern for developing nutrition policies. The aim was to report on the adherence to FBDGs in high-income (HIC) and low-and-middle-income countries (LMIC). A systematic review with searches in six databases was performed up to June 2020. English language articles were included if they investigated a population of healthy children and adults (7–65 years), using an observational or experimental design evaluating adherence to national FBDGs. Findings indicate that almost 40% of populations in both HIC and LMIC do not adhere to their national FBDGs. Fruit and vegetables (FV) were most adhered to and the prevalence of adhering FV guidelines was between 7% to 67.3%. HIC have higher consumption of discretionary foods, while results were mixed for LMIC. Grains and dairy were consumed below recommendations in both HIC and LMIC. Consumption of animal proteins (>30%), particularly red meat, exceeded the recommendations. Individuals from HIC and LMIC may be falling short of at least one dietary recommendation from their country’s guidelines. Future health policies, behavioral-change strategies, and dietary guidelines may consider these results in their development.

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Section: Introductionmentioning

confidence: 99%

Adherence to Food-Based Dietary Guidelines: A Systemic Review of High-Income and Low- and Middle-Income Countries

et al. 2021

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“…Besides regional differences, education is a social determinant with high impact on dietary habits. 19 More educated people tend to live in urban areas with less educated people living in rural areas. 33 Comparing the diabetes study population with the general population in DANSDA, limitations are the same (educational and regional differences) together with differences in age range.…”

Section: Discussionmentioning

confidence: 99%

Intention and Perceptions of Healthy Eating versus Actual Intake Among Patients with Type 1 and Type 2 Diabetes and the General Population

Ewers¹,

Sørensen²,

Fagt³

et al. 2021

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Purpose Intention and perceptions of healthy eating may affect diet-related behavior. We assessed the intention and perceptions of eating healthily in patients with type 1 (T1D) and type 2 diabetes (T2D) compared with the general population. Secondly, differences in diet quality were assessed in patients with diabetes perceiving their dietary habits as more or less healthy. Materials and Methods This cross-sectional study included data on socioeconomic status, dietary intake, and questions on healthy eating from adults with T1D (n=426), T2D (n=348) and from the general population (n=2899). Results Patients with T2D were less likely to perceive their dietary habits as healthy compared with T1D and the general population. Patients with T1D or T2D perceiving their dietary habits as healthy reported higher intake of vegetables, fruit, fish, fibre and protein. In addition, patients with T1D with perceived healthy versus less healthy dietary habits had lower sugar intake and higher alcohol intake. Overall, adherence to dietary guidelines in patients with T1D and T2D was too low both in self-perceived healthy and less healthy eaters. In comparison with T1D patients, patients with T2D were less likely and the general population was more likely to strive to eat a healthy diet. Conclusion Patients with T2D had poorer self-perception of their dietary healthiness and less intention of eating healthily, compared with patients with T1D and the general population. Actual diet quality was higher amongst patients with T1D and T2D perceiving their dietary habits as healthy than those perceiving their dietary habits as less healthy. But inadequate intakes were found in all groups. Health care providers should address and explore the patient’s intention and perceptions of healthy eating when discussing dietary changes in diabetes to improve nutritional support.

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“…Many countries recommend vitamin D supplementation and fortify some food products [ 28 , 29 ]. However, there is insufficient scientific evidence that a change to the typical EE model of nutrition can improve vitamin D status, excluding the population where there is a high consumption of fish and fish products [ 33 , 34 , 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

Differences in the Concentration of Vitamin D Metabolites in Plasma Due to the Low-Carbohydrate-High-Fat Diet and the Eastern European Diet—A Pilot Study

et al. 2021

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Vitamin D deficiency is a global problem with many health consequences, and it is currently recommended to supplement vitamin D. Change of diet should also be considered to ensure adequate vitamin D in the human body. The aim of this study was to assess the concentration of vitamin D metabolites in two different groups: one group on the low-carbohydrate-high-fat (LCHF) diet and the other group on the Eastern European (EE) diet. In the first stage, 817 participants declaring traditional EE diet or LCHF diet were investigated. Nutrition (self-reported 3-day estimated food record) and basic anthropometric parameters were assessed. After extra screening, 67 participants on the EE diet and 41 on the LCHF diet were qualified for the second stage. Plasma 25-hydroxycholecalciferol (25(OH)D3) and (25(OH)D2) concentration was measured by the validated HPLC—MS/MS method. Plasma 25(OH)D3 concentration was significantly higher in the group on the LCHF diet (34.9 ± 15.9 ng/mL) than in the group on the EE diet (22.6 ± 12.1 ng/mL). No statistical differences were observed in plasma 25(OH)D2 concentration between the study groups (p > 0.05). Women had a higher plasma 25(OH)D2 concentration than men regardless of diet type. The LCHF diet had a positive influence on plasma vitamin D concentration. However, long-term use of the LCHF diet remains contentious due to the high risk of cardiovascular disease. This study confirmed that the type of diet influences the concentration of vitamin D metabolites in the plasma.

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Inequalities in education and national income are associated with poorer diet: Pooled analysis of individual participant data across 12 European countries

Cited by 64 publications

References 21 publications

Adherence to Food-Based Dietary Guidelines: A Systemic Review of High-Income and Low- and Middle-Income Countries

Adherence to Food-Based Dietary Guidelines: A Systemic Review of High-Income and Low- and Middle-Income Countries

Intention and Perceptions of Healthy Eating versus Actual Intake Among Patients with Type 1 and Type 2 Diabetes and the General Population

Differences in the Concentration of Vitamin D Metabolites in Plasma Due to the Low-Carbohydrate-High-Fat Diet and the Eastern European Diet—A Pilot Study

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