Socio-economic inequalities in diet and body weight: evidence, causes and intervention options

Abstract

Socioeconomic inequalities in diet and body weight: evidence, causes and intervention options Diets low in fruits, vegetables and whole grains, and high in saturated fat, salt and sugar, are the major contributors to the burden of chronic diseases globally (1). Previous research, and studies in this issue of Public Health Nutrition, show that unhealthy diets are more commonly observed among socioeconomically disadvantaged groups and are key contributors to their higher rates of chronic disease (2-4). Most research examining socioeconomic inequalities in diet and body weight has been descriptive and has focused on identifying the nature, extent and direction of the inequalities. These types of studies are clearly necessary and important. We need, however, to move beyond description of the problem and focus much more on the question of why inequalities in diet and body weight exist. Furthering our understanding of this question will provide the necessary evidence base to develop effective interventions to reduce the inequalities. The challenge of tackling dietary inequalities, however, does not finish here: a maximally effective approach will also require equity-based policies that address the unequal population distribution of social and economic resources, which is the fundamental rootcause of dietary and body weight inequalities. Current evidence on socioeconomic inequalities in diet and body weight

Socioeconomic differences in overweight and weight-related behaviors across adolescence and young adulthood: 10-year longitudinal findings from Project EAT

“…13 This study did not examine if environmental factors (e.g. food availability) explained or mediated socioeconomic disparities, but previous studies have found neighborhood and school-level disadvantage to be independent predictors of obesity, suggesting that both physical and social systems in which individuals operate greatly impact their health risk.…”

“…10,12 These conditions may be further exacerbated by stress, social norms and low social support leading to less favorable weight-related behaviors among low SES adolescents. 13 …”

A systematic review of psychosocial explanations for the relationship between socioeconomic status and body mass index

“…The same applies for factors regarding the physical and social environment which explained part of the association between low SES and BMI. Thus, besides targeting health interventions to individuals themselves, structural interventions or policy-changes such as environmental modifications, or food procurement policies need to be considered (Turrell & Vandevijvere, 2015). Important to keep in mind are possible discrepancies between objectively measured economic or social constraints and subjective experiences of these constraints (Powell-Wiley et al, 2014).…”

Interventions promoting healthy eating as a tool for reducing social inequalities in diet in low- and middle-income countries: a systematic review

“…Thus, in HICs there is no “one-fits-all” approach. Several authors have proposed the two perspectives are compatible [15, 16] and should not be mutually exclusive but complementary [25] because focusing only on agentic interventions does not reduce the unequal population distribution of social and economic resources which cause dietary inequalities [54]. …”