Socioeconomic inequalities in metabolic syndrome in the French West Indies

Abstract

BackgroundObesity and metabolic diseases represent a major health burden in the Caribbean, particularly since a large part of the population is disadvantaged. However, socioeconomic inequalities in chronic diseases are poorly explored in this region. We investigated the association between socioeconomic position and metabolic syndrome (MetS) prevalence and explored the contribution of diet quality to explain this association, among adults in the French West Indies.MethodsThis cross-sectional analysis included 1144 subjects (≥16 y) from a multistage sampling survey conducted in 2013–2014 on a representative sample of the Guadeloupean and Martinican population. MetS prevalence was assessed using the Joint Interim Statement. Dietary intakes were estimated from 24 h-dietary recalls, and diet quality was assessed through the Diet Quality Index-International (DQI-I). Associations between socioeconomic indicators (education, employment, social assistance benefits) and MetS prevalence, and the potential contribution of diet quality in this association were assessed using multivariable logistic regression models, adjusted for sociodemographic characteristics.ResultsMetS prevalence adjusted for age and sex was 21 and 30% among Guadeloupean and Martinican, respectively. Compared to high-educated participants, low-educated subjects were more likely to be at risk of MetS (OR = 2.4; 95%CI = [1.3–4.4], respectively), as were recipients of social assistance benefits compared to non-recipients (OR = 2.0; 95%CI = [1.0–4.0]). The DQI-I explained 10.5% of the overall variation in MetS due to education.ConclusionsSocioeconomic inequalities in MetS prevalence, reflected by education and social assistance benefits, were found. However, diet quality contributed only to socioeconomic inequalities due to education underlining that education may impact health through the ability to generate overall dietary behavior, long-term beneficial. Our work identified subgroups with higher risk of MetS, which is needed when implementing public health measures, particularly in this Caribbean population with of high poverty rates. Further prospective studies are needed to improve our understanding of the mechanisms of social inequalities in MetS in a high poverty rates context.

Caribbean nutrition transition: what can we learn from dietary patterns in the French West Indies?

“…However, the use of the illustrated booklet with more than 250 photos, corresponding to 1000 generic foods, served in seven different portion sizes, and the fact that recalls were conducted by trained dietitians have limited the bias. Also, 15% of the subjects were identified as energy underreporters and excluded from the analysis sample: compared with included subjects, the excluded participants were younger, with a higher percentage of unemployed or neveremployed individuals [51]. Finally, some other drivers of the nutrition transition, such as characteristics of the foodscape (neighborhood densities of fast-food outlets or supermarkets) and the food availability, could not be considered in our models.…”

Is Loneliness an Undervalued Pathway between Socio-Economic Disadvantage and Health?

“…× 100), where X is 2, 3, or 4) as done in previous studies [41][42][43]. This method has been shown to result in similar findings as the counterfactual framework approach [43].…”

“…All models were adjusted for the mode of survey completion (paper, internet, phone, or face-to-face) and accounted for the complex survey design through survey weights. The contributions of factors were assessed by comparing the relative risk and odds ratios, and their percentage change (( ), where X is 2, 3, or 4) as done in previous studies [ 41 , 42 , 43 ]. This method has been shown to result in similar findings as the counterfactual framework approach [ 43 ].…”

Metabolic syndrome and its associated factors in Shiraz Heart Study (A cohort-based cross-sectional study)

“…Statistical analysis has shown that if the literacy level increase, the chances of developing MetS would be decreased. Evaluating the individuals' educational level showed that this factor was closely related to MetS [14,27]. Using educational platforms can help prevent MetS by increasing people's knowledge, attitude, and as a result, change their practice.…”