Skip to main content Accessibility help
×
Home

The association between socio-economic position and diet quality in Australian adults

  • Kathryn Backholer (a1), Elizabeth Spencer (a1), Emma Gearon (a1), Dianna J Magliano (a2), Sarah A McNaughton (a3), Jonathan E Shaw (a4) and Anna Peeters (a1)...

Abstract

Objective

We aimed to investigate the association between multiple measures of socio-economic position (SEP) and diet quality, using a diet quality index representing current national dietary guidelines, in the Australian adult population.

Design

Cross-sectional study. Linear regression analyses were used to estimate the association between indicators of SEP (educational attainment, level of income and area-level disadvantage) and diet quality (measured using the Dietary Guideline Index (DGI)) in the total sample and stratified by sex and age (≤55 years and >55 years).

Setting

A large randomly selected sample of the Australian adult population.

Subjects

Australian adults (n 9296; aged ≥25 years) from the Australian Diabetes, Obesity and Lifestyle Study.

Results

A higher level of educational attainment and income and a lower level of area-level disadvantage were significantly associated with a higher DGI score, across the gradient of SEP. The association between indicators of SEP and DGI score was consistently stronger among those aged ≤55 years compared with their older counterparts. The most disadvantaged group had a DGI score between 2 and 5 units lower (depending on the marker of SEP) compared with the group with the least disadvantage.

Conclusions

A higher level of SEP was consistently associated with a higher level of diet quality for all indicators of SEP examined. In order to reduce socio-economic inequalities in diet quality, healthy eating initiatives need to act across the gradient of socio-economic disadvantage with a proportionate focus on those with greater socio-economic disadvantage.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      The association between socio-economic position and diet quality in Australian adults
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      The association between socio-economic position and diet quality in Australian adults
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      The association between socio-economic position and diet quality in Australian adults
      Available formats
      ×

Copyright

Corresponding author

* Corresponding author: Email anna.peeters@bakeridi.edu.au

References

Hide All
1. Stringhini, S, Sabia, S, Shipley, M et al. (2010) Association of socioeconomic position with health behaviors and mortality. JAMA 303, 11591166.
2. World Health Organization (2003) Diet, Nutrition and the Prevention of Chronic Diseases. Joint WHO/FAO Expert Consultation. WHO Technical Report Series no. 916. Geneva: WHO.
3. Darmon, N & Drewnowski, A (2008) Does social class predict diet quality? Am J Clin Nutr 87, 11071117.
4. Worsley, A, Blasche, R, Ball, K et al. (2003) Income differences in food consumption in the 1995 Australian National Nutrition Survey. Eur J Clin Nutr 57, 11981211.
5. Worsley, A, Blasche, R, Ball, K et al. (2004) The relationship between education and food consumption in the 1995 Australian National Nutrition Survey. Public Health Nutr 7, 649663.
6. Hu, FB (2002) Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 13, 39.
7. Russell, J, Flood, V, Rochtchina, E et al. (2012) Adherence to dietary guidelines and 15-year risk of all-cause mortality. Br J Nutr 109, 547555.
8. Alkerwi, A (2014) Diet quality concept. Nutrition 30, 613618.
9. Mullie, P, Clarys, P, Hulens, M et al. (2010) Dietary patterns and socioeconomic position. Eur J Clin Nutr 64, 231238.
10. Loughrey, K, Basiotis, P & Zizza, C (2001) Profiles of selected target audiences: promoting the Dietary Guidelines for Americans. Fam Econ Nutr Rev 13, 314.
11. Dynesen, AW, Haraldsdottir, J, Holm, L et al. (2003) Sociodemographic differences in dietary habits described by food frequency questions – results from Denmark. Eur J Clin Nutr 57, 15861597.
12. McNaughton, SA, Ball, K, Crawford, D et al. (2008) An index of diet and eating patterns is a valid measure of diet quality in an Australian population. J Nutr 138, 8693.
13. Collins, CE, Young, AF & Hodge, A (2008) Diet quality is associated with higher nutrient intake and self-rated health in mid-aged women. J Am Coll Nutr 27, 146157.
14. Dunstan, DW, Zimmet, PZ, Welborn, TA et al. (2002) The Australian Diabetes, Obesity and Lifestyle Study (AusDiab) – methods and response rates. Diabetes Res Clin Pract 57, 119129.
15. Black, A (2000) Critical evaluation of energy intake using the Goldberg cut-off for energy intake:basal metabolic rate. A practical guide to its calculation, use and limitations. Int J Obes Relat Metab Disord 24, 11191130.
16. De Vos, K & Zaidi, MA (1997) Equivalence scale sensitivity of poverty statistics for the member states of the European Community. Rev Income Wealth 43, 319333.
17. Trewin, D (2001) Information Paper – Census of Population and Housing: Socio-Economic Indexes for Areas Australia 2001. Canberra: Australian Bureau of Statistics.
18. Hodge, A, Patterson, AJ, Brown, WJ et al. (2000) The Anti Cancer Council of Victoria FFQ: relative validity of nutrient intakes compared with weighed food records in young to middle-aged women in a study of iron supplementation. Aust N Z J Public Health 24, 576583.
19. National Health and Medical Research Council (2003) Dietary Guidelines for Australian Adults. http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n33.pdf (accessed May 2013).
20. McNaughton, SA, Dunstan, DW, Ball, K et al. (2009) Dietary quality is associated with diabetes and cardio-metabolic risk factors. J Nutr 139, 734742.
21. Smith, AS, Kellett, E & Schmerlaib, Y (1998) Australian Guide to Healthy Eating. Canberra: Commonwealth Department of Health and Family Services.
22. Australian Institute of Health and Welfare (2003) The Active Australia Survey: A Guide and Manual for Implementation, Analysis and Reporting. Canberra: AIHW.
23. Armstrong, T, Bauman, A & Davies, J (2000) Physical Activity Patterns of Australian Adults. Results of the 1999 National Physical Activity Survey. Canberra: AIHW.
24. National Health and Medical Research Council & Department of Health (2001) Australian Guide to Healthy Eating. https://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating (accessed May 2013).
25. Martelin, T (1994) Mortality by indicators of socioeconomic status among the Finnish elderly. Soc Sci Med 38, 12571278.
26. Galobardes, B, Shaw, M, Lawlor, DA et al. (2006) Indicators of socioeconomic position (part 2). J Epidemiol Community Health 60, 95101.
27. Malon, A, Deschamps, V, Salanave, B et al. (2010) Compliance with French nutrition and health program recommendations is strongly associated with socioeconomic characteristics in the general adult population. J Am Diet Assoc 110, 848856.
28. Le, J, Dallongeville, J, Wagner, A et al. (2013) Attitudes toward healthy eating: a mediator of the educational level–diet relationship. Eur J Clin Nutr 67, 808814.
29. Wardle, J, Parmenter, K & Waller, J (2000) Nutrition knowledge and food intake. Appetite 34, 269275.
30. Caraher, M, Dixon, P, Lang, T et al. (1998) Access to healthy foods: part I. Barriers to accessing healthy foods: differentials by gender, social class, income and mode of transport. Health Educ J 57, 191201.
31. Ball, K, Crawford, D & Mishra, G (2006) Socio-economic inequalities in women’s fruit and vegetable intakes: a multilevel study of individual, social and environmental mediators. Public Health Nutr 9, 623630.
32. Drewnowski, A & Darmon, N (2005) Food choices and diet costs: an economic analysis. J Nutr 135, 900904.
33. Turrell, G & Kavanagh, AM (2006) Socio-economic pathways to diet: modelling the association between socio-economic position and food purchasing behaviour. Public Health Nutr 9, 375383.
34. Oakes, ME & Slotterback, CS (2002) The good, the bad, and the ugly: characteristics used by young, middle-aged, and older men and women, dieters and non-dieters to judge healthfulness of foods. Appetite 38, 9197.
35. Wardle, J, Haase, AM, Steptoe, A et al. (2004) Gender differences in food choice: the contribution of health beliefs and dieting. Ann Behav Med 27, 107116.
36. Baker, AH & Wardle, J (2003) Sex differences in fruit and vegetable intake in older adults. Appetite 40, 269275.
37. Michels, KB & Schulze, MB (2005) Can dietary patterns help us detect diet–disease associations? Nutr Res Rev 18, 241248.
38. McNaughton, SA (2010) Dietary patterns and diet quality: approaches to assessing complex exposures in nutrition. Australas Epidemiol 17, 3537.
39. Giskes, K, Lenthe, Fv F, Brug, HJ et al. (2004) Dietary intakes of adults in the Netherlands by childhood and adulthood socioeconomic position. Eur J Clin Nutr 58, 871880.
40. Groth, MV, Fagt, S & Brondsted, L (2001) Social determinants of dietary habits in Denmark. Eur J Clin Nutr 55, 959966.
41. Mishra, G, Ball, K, Arbuckle, J et al. (2002) Dietary patterns of Australian adults and their association with socioeconomic status: results from the 1995 National Nutrition Survey. Eur J Clin Nutr 56, 687693.
42. Park, SY, Murphy, SP, Wilkens, LR et al. (2005) Dietary patterns using the Food Guide Pyramid groups are associated with sociodemographic and lifestyle factors: the multiethnic cohort study. J Nutr 135, 843849.
43. Robinson, SM, Crozier, SR, Borland, SE et al. (2004) Impact of educational attainment on the quality of young women’s diets. Eur J Clin Nutr 58, 11741180.
44. Lazarou, C & Newby, PK (2011) Use of dietary indexes among children in developed countries. Adv Nutr 2, 295303.
45. Cade, J, Thompson, R, Burley, V et al. (2002) Development, validation and utilization of food frequency questionnaires – a review. Public Health Nutr 5, 567587.
46. Clifton, PM, Chan, L, Moss, CL et al. (2011) Beverage intake and obesity in Australian children. Nutr Metab 8, 87.
47. Waijers, PM, Feskens, EJ & Ocke, MC (2007) A critical review of predefined diet quality scores. Br J Nutr 97, 219231.
48. Arvaniti, F & Panagiotakos, DB (2008) Healthy indexes in public health practice and research: a review. Crit Rev Food Sci Nutr 48, 317327.
49. Ludwig, DS & Friedman, MI (2014) Increasing adiposity: consequence or cause of overeating? JAMA 311, 21672168.
50. Mozaffarian, D (2012) Nutrition and cardiovascular disease. In Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine , 9th ed., Chapter 48 [RO Bonow, DL Mann, DP Zipes et al., editors]. Philadelphia, PA: Elsevier/Saunders.
51. Ekholm, O, Gundgaard, J, Rasmussen, NK et al. (2010) The effect of health, socio-economic position, and mode of data collection on non-response in health interview surveys. Scand J Public Health 38, 699706.
52. Marmot, M, Goldblatt, P, Boyce, T et al. (2010) Fair Society, Healthy Lives. London: Department of Health.
53. Beauchamp, A, Backholer, K, Magliano, DJ et al. (2014) The effect of obesity prevention interventions according to socioeconomic position: a systematic review. Obes Rev 15, 541554.

Keywords

The association between socio-economic position and diet quality in Australian adults

  • Kathryn Backholer (a1), Elizabeth Spencer (a1), Emma Gearon (a1), Dianna J Magliano (a2), Sarah A McNaughton (a3), Jonathan E Shaw (a4) and Anna Peeters (a1)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed