Abstract
Health disparities, including weight gain and obesity exist between urban and rural dwelling women. The primary aim was to compare diet quality in urban and rural women of reproductive age, and secondary analyses of the difference in macronutrient and micronutrient intake in urban and rural women, and the predictors of diet quality. Diet quality was assessed in urban (n = 149) and rural (n = 394) women by a modified version of the Dietary Guideline Index (DGI) energy, macronutrient and micronutrient intake from a food frequency questionnaire (FFQ) and predictors of diet quality. Diet quality did not significantly differ between urban and rural women (mean ± standard deviation (SD), 84.8 ± 15.9 vs. 83.9 ± 16.5, p = 0.264). Rural women reported a significantly higher intake of protein, fat, saturated fat, monounsaturated fat, cholesterol and iron and a higher score in the meat and meat alternatives component of the diet quality tool in comparison to urban women. In all women, a higher diet quality was associated with higher annual household income (>$Australian dollar (AUD) 80,000 vs. <$AUD80,000 p = 0.013) and working status (working fulltime/part-time vs. unemployed p = 0.043). Total diet quality did not differ in urban and rural women; however, a higher macronutrient consumption pattern was potentially related to a higher lean meat intake in rural women. Women who are unemployed and on a lower income are an important target group for future dietary interventions aiming to improve diet quality.
Highlights
Women of reproductive age are a high-risk group for progression to obesity with higher annual weight gain compared to older women and men generally [1,2]
We evaluated predictors of diet quality and report that higher income levels and working status are associated with better diet quality in all women of reproductive age
We report higher intakes of protein, total fat, saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), iron and cholesterol in rural compared to urban women, we note these differences were relatively small and may not be clinically relevant
Summary
Women of reproductive age are a high-risk group for progression to obesity with higher annual weight gain compared to older women and men generally [1,2]. Nutrients 2017, 9, 586 and higher levels of psychosocial stress [11]. Many of these health differentials are related to a higher level of socioeconomic disadvantage in rural populations [11,12], where access to health care and health promotion programs is reduced [13] and the cost of maintaining healthy behaviors including a healthy diet is higher [14]
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