Abstract

Few Australians consume diets consistent with the Australian Dietary Guidelines. A major problem is high intake of discretionary food and drinks (those not needed for health and high in saturated fat, added sugar, salt and/or alcohol). Low socioeconomic groups (SEGs) suffer particularly poor diet-related health. Surprisingly, detailed quantitative dietary data across SEGs was lacking. Analysis of the most recent national nutrition survey data produced habitual intakes of a reference household (two adults and two children) in SEG quintiles of household income. Cost and affordability of habitual and recommended diets for the reference household were determined using methods based on the Healthy Diets Australian Standardised Affordability and Pricing protocol. Low SEGs reported significantly lower intakes of healthy food and drinks yet similarly high intakes of discretionary choices to high SEGs (435 serves/fortnight). Total habitual diets of low SEGs cost significantly less than those of high SEGs (AU$751/fortnight to AU$853/fortnight). Results confirmed low SEGs cannot afford a healthy diet. Lower intakes of healthy choices in low SEGs may help explain their higher rates of diet-related disease compared to higher SEGs. The findings can inform potential policy actions to improve affordability of healthy foods and help drive healthier diets for all Australians.

Highlights

  • Published: 17 December 2021Poor diet is a leading contributor to the burden of disease in Australia and overseas, and a major risk factor for diabetes, heart disease, and several cancers [1,2,3,4,5]

  • The number of Australian Dietary Guidelines (ADG) food category serves in the habitual diet across socioeconomic groups (SEGs) quintiles for a reference household per fortnight are shown in Table 2 together with the number of ADG food category serves in the recommended diet

  • The increasing energy content of habitual diets from lowest to highest SEG was due to significantly increasing contributions from healthy food and drinks (p = 0.001)

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Summary

Introduction

Published: 17 December 2021Poor diet is a leading contributor to the burden of disease in Australia and overseas, and a major risk factor for diabetes, heart disease, and several cancers [1,2,3,4,5]. Low socioeconomic groups (SEGs) experience higher rates of diet-related disease than the general population both globally [8,9] and in the Australian population [1,2,3]. High SEGs in high-income countries are more likely to consume a healthier diet than lower. This tends to hold in low- and middle-income countries (LMICs) too; high SEGs in urban locations in LMICs tend to consume greater intakes of ultraprocessed foods than low SEGs [10]. Our recent systematic review of past studies of habitual dietary intake of low SEGs in Australia [11] confirmed that diet quality is usually lower in low SEGs compared to higher SEGs. variations in study metrics, definitions, dietary assessment methods, and granularity of data meant findings were inconsistent across

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