Objective:
To determine whether disparities exist in the nutritional quality of packaged foods and beverage purchases (PFPs) by household income, education, and race/ethnicity and if they changed over time.
Design:
We used Nielsen Homescan, a nationally representative household panel, from 2008-2018 (n=672,821 household-year observations). Multivariate, multilevel regressions were used to model the association between sociodemographic groups and a set of nutritional outcomes of public health interest, including nutrients of concern (sugar, saturated fat, sodium) and calories from specific food groups (fruits, non-starchy vegetables, processed meats, sugar-sweetened beverages and junk foods).
Setting:
Household panel survey
Participants:
Approximately 60,000 households each year from the United States.
Results:
Disparities were found by income and education for most outcomes, and widened for purchases of fruits, vegetables, and the percent of calories from sugar between 2008 and 2018. The magnitude of disparities was largest by education. Disparities between Black and White households include the consumption of processed meats and the percent calories from sugar, while no disparities between White and Hispanic households were found. Disparities have been largely persistent, as any significant changes over time have been substantively small.
Conclusions:
Policies to improve the healthfulness of packaged foods must be expanded beyond SSB taxes and future research should focus on what mediates the relationship between education and diet so as not to exacerbate disparities.