Mediators of socioeconomic inequalities in dietary behaviours among youth: A systematic review

Abstract

Children and adolescents with a lower socioeconomic position have poorer dietary behaviours compared to their counterparts with a higher socioeconomic position. A better understanding of the mechanisms behind such socioeconomic inequalities is vital to identify targets for interventions aimed at tackling these inequalities. This systematic review aimed to summarize existing evidence regarding the mediators of socioeconomic differences in dietary behaviours among youth. A systematic literature search of MEDLINE, Embase, PsycINFO, and Web of Science databases yielded 20 eligible studies. The dietary behaviours included in the reviewed studies were the intake of fruit and vegetables, sugar-sweetened beverages, unhealthy snacks/fast food and breakfast. The consistent mediators of the effects of socioeconomic position on dietary behaviours among youth were: self-efficacy, food preferences and knowledge at the intrapersonal level; and availability and accessibility of food items at home, food rules and parental modelling at the interpersonal level. Few studies including mediators at the organisational, community or policy levels were found.Our review found several modifiable factors at the intrapersonal and interpersonal levels that could be targeted in interventions aimed at combating inequalities in dietary behaviours among youth. Rigorous studies exploring organisational, community and policy level mediators are warranted.dietary behaviours, inequality, mediators, youth 1 | BACKGROUND Socioeconomic inequalities in children and adolescents' dietary behaviours have long been recognised as a public health problem. 1-6 Children and adolescents (hereafter called youth) with a low socioeconomic position (SEP) have a lower intake of fruit and vegetables (FV), 7-9 a higher intake of energy-dense food, 2,10-12 a higher intake of sugar-sweetened beverages (SSB), 9,13 and a higher likelihood for skipping a meal 14 than their counterparts with a high SEP.Social inequalities in dietary behaviours among youth could be among the contributing factors for the continued widening of social inequalities in health outcomes including overweight/obesity. 15 Dietary behaviours established in childhood and adolescence could not only have an impact on the health of youth but can also influence adult dietary behaviours and health outcomes 16 through tracking over time 17,18 and through child morbid conditions that ultimately increase disease risk in later life. Thus, public health interventions aimed at tackling social inequalities in dietary behaviours among youth are vital. In order to inform such interventions, identifying the mechanisms explaining SEP differences in dietary intake is crucial.The social-ecological model (SEM) postulates that there are multiple levels of influence on health behaviours. 19 Accordingly, complex multilevel interacting determinants at the intrapersonal, interpersonal, community, institution, and macro/policy levels could influence dietary behaviours. Studies have found different correlates of dietary behaviours...

The mismatch between teaching practices and curriculum goals in Norwegian Home Economics classes: a missed opportunity

“…For students to achieve the competences described in the FH curriculum, it requires they possess in-depth knowledge of food and nutrition. The importance of nutrition and food knowledge is also supported by literature regarding adolescent food literacy and dietary behaviour (Amin et al, 2019;Mekonnen et al, 2020;Ronto et al, 2016). Therefore, nutrition education should get a higher priority in FH classes.…”

“…They found knowledge of food systems, cooking, and nutrition, cooking skills and self-efficacy regarding eating to be important food literacy domains. A recent systematic review found self-efficacy and knowledge to modify socioeconomic differences in dietary behaviour among youths (Mekonnen et al, 2020). Also, according to an Australian study (Ronto, Ball, Pendergast, & Harris, 2016), adolescents ranked food and nutrition knowledge to be the most important aspect impacting their dietary behaviour.…”

Knowledge, Attitudes, and Barriers towards Dietary Pulse Consumption in Women with Polycystic Ovary Syndrome Participating in a Multi-Disciplinary Lifestyle Intervention to Improve Women’s Health

“…Our intervention groups were comparable in their socio-economic and educational levels (data not shown). However, we do not preclude any potential favourable influence of privileged socio-economic and educational status on the baseline and changes in our participants' pulse-consumption behaviours, as these factors are known to affect dietary behaviours [59,60]. Therefore, our observations may be skewed toward women with a higher degree of self-awareness about their health at baseline and need to be replicated across cohorts with different socio-demographic backgrounds.…”

Social Inequalities in Changes in Diet in Adolescents during Confinement Due to COVID-19 in Spain: The DESKcohort Project

“…Instead, students with a disadvantaged position may benefit more from a healthy food environment at school [ 43 ]. Improving nutritional knowledge (school and family), establishing routines or rules related to meals, promoting home food availability of fruits and less healthful alternatives can be valuable ways of promoting healthy eating and reducing inequalities in dietary behaviors in adolescents [ 44 ]. Greater economic and educational resources can contribute to healthier dietary behavior through increased food budgets, nutritional knowledge, planning food purchases, and cooking skills [ 45 , 46 , 47 , 48 ].…”