Abstract
BackgroundHealth inequalities are already present at young age and tend to vary with ethnicity and socioeconomic status (SES). Diet is a major determinant of overweight, and studying dietary patterns as a whole in relation to overweight rather than single nutrients or foods has been suggested. We derived dietary patterns at age 5 and determined whether ethnicity and SES were both related to these dietary patterns.MethodsWe analysed 2769 validated Food Frequency Questionnaires filled in by mothers of children (5.7 ± 0.5y) in the Amsterdam Born Children and their Development (ABCD) cohort. Food items were reduced to 41 food groups. Energy adjusted intake per food group (g/d) was used to derive dietary patterns using Principal Component Analysis and children were given a pattern score for each dietary pattern. We defined 5 ethnic groups (Dutch, Surinamese, Turkish, Moroccan, other ethnicities) and 3 SES groups (low, middle, high, based on maternal education). Multivariate ANOVA, with adjustment for age, gender and maternal age, was used to test potential associations between ethnicity or SES and dietary pattern scores. Post-hoc analyses with Bonferroni adjustment were used to examine differences between groups.ResultsPrincipal Component Analysis identified 4 dietary patterns: a snacking, full-fat, meat and healthy dietary pattern, explaining 21% of the variation in dietary intake. Ethnicity was related to the dietary pattern scores (p < 0.01): non-Dutch children scored high on snacking and healthy pattern, whereas Turkish children scored high on full-fat and Surinamese children on the meat pattern. SES was related to the snacking, full-fat and meat patterns (p < 0.01): low SES children scored high on the snacking and meat pattern and low on the full-fat pattern.ConclusionsThis study indicates that both ethnicity and SES are relevant for dietary patterns at age 5 and may enable more specific nutrition education to specific ethnic and low socioeconomic status target groups.
Highlights
Health inequalities are already present at young age and tend to vary with ethnicity and socioeconomic status (SES)
A number of n=2 769 Food Frequency Questionnaire (FFQ)’s were used for the present analysis n=132 excluded due to multiple pregnancy, n=92 due to a miscarriage or fetal death, n=179 lost to follow-up n=1 128 excluded due to no permission for follow-up, n=574 excluded due to lost to follow-up, n=1 673 excluded due to nonresponse and n=1 637 excluded due to no implementation of FFQ at age 5 year n=69 excluded due to ≥ 50% missing information on the FFQ and n=13 excluded due to missing SES data study by their obstetric care provider at their first prenatal care visit
Among the cohorts that evaluated the diets of children aged 3–5 years, a healthy and unhealthy pattern were most often identified [15, 17, 21, 38,39,40,41,42] with similar dietary patterns as the healthy and snacking pattern, which were observed in the present analysis
Summary
Health inequalities are already present at young age and tend to vary with ethnicity and socioeconomic status (SES). We derived dietary patterns at age 5 and determined whether ethnicity and SES were both related to these dietary patterns. Health inequalities, such as the prevalence of overweight, are already present at a young age and tend to vary on the basis of ethnicity and socioeconomic (SES) status [1,2,3]. The predominant ethnic minority groups, i.e. Turkish, Arabs (North African and Middle Eastern), Berbers and Black Africans (Afro-Caribbean and others by descent), form approximately 3% of the total European population, with the largest numbers in Western European countries [13]. Non-native groups have less often completed higher education than native borns [14] which makes observation of SES differences of interest
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