Abstract
BackgroundThe positive association between education level and health outcomes can be partly explained by dietary behaviour. We investigated the associations between education and several indices of food intake and potential influencing factors, placing special emphasis on physical-activity patterns, using a representative sample of the German adult population.MethodsThe German National Health Interview and Examination Survey 1998 (GNHIES98) involved 7,124 participants aged between 18 and 79. Complete information on the exposure (education) and outcome (nutrition) variables was available for 6,767 persons. The associations between ‘education’ and indices of ‘sugar-rich food’, ‘fat-rich food’, ‘fruit-and-vegetable’ and ‘alcohol’ intake were analysed separately for men and women using multivariate logistic regression analysis. Odds ratios (OR) of education level on nutrition outcomes were calculated and adjusted for age, region (former East/West Germany), occupation, income and other influencing factors such as physical activity indicators.ResultsMen and women with only a primary education had a more frequent intake of sugar-rich and fat-rich foods and a less frequent intake of fruit and vegetables and alcohol than people with a tertiary education. ‘Physical work activity’ partly explained the associations between education and sugar-rich food intake. The interference with physical work activity was stronger among men than women. No significant associations between education and energy-dense food intake were observed in the retirement-age group of persons aged 65+ and among persons with low energy expenditure.ConclusionsIn Germany, adults with a low level of education report that they consume energy-dense foods more frequently – and fruit and vegetables and alcohol less frequently – than adults with a high education level. High levels of physical work activity among adults with a low education level may partly explain why they consume more energy-dense foods.
Highlights
A healthy diet is an important factor in the prevention and treatment of non-communicable diseases [1]
A previous analysis has shown that German adults with a low level of education are more physically active at work and have a higher level of total energy expenditure than those with a high education level [11]
This may have an influence on specific food choices, like more frequent consumption of energy-dense foods by low-educated groups, since studies have shown that a higher energy expenditure usually goes together with a higher energy intake [12]
Summary
A healthy diet is an important factor in the prevention and treatment of non-communicable diseases [1]. A previous analysis has shown that German adults with a low level of education are more physically active at work and have a higher level of total energy expenditure than those with a high education level [11]. This may have an influence on specific food choices, like more frequent consumption of energy-dense foods by low-educated groups, since studies have shown that a higher energy expenditure usually goes together with a higher energy intake [12]. We investigated the associations between education and several indices of food intake and potential influencing factors, placing special emphasis on physical-activity patterns, using a representative sample of the German adult population
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