Abstract
BackgroundSocioeconomic differences in diet are rarely assessed with more than one indicator. We aimed to assess differences in macro- and micro-nutrient intake in both sexes according to education, income, and occupation.MethodsWe used data from validated food frequency questionnaire measured dietary intake in 5087 participants (2157 women) from yearly adult population-based cross-sectional surveys conducted from 2005 to 2012 in the canton of Geneva, Switzerland. We used two ANOVA models: age-adjusted and multivariable adjusted simultaneously for all three socioeconomic indicators.ResultsLow-education men consumed more calcium but less vitamin D than high-education men; low-income men consumed less total and animal protein (80.9±0.9 vs 84.0±0.6 g/d; 55.6±1.0 vs 59.5±0.7 g/d) and more total carbohydrates and sugars (246±2 vs 235±2 g/d; 108±2 vs 103±1 g/d) than high-income men. Occupation and diet showed no association. Low-education women consumed less vegetable protein (20.7±0.2 vs 21.6±0.2 g/d), fibre (15.7±0.3 vs 16.8±0.2 g/d), and carotene (4222±158 vs 4870±128 μg/d) than high-education women; low-income women consumed more total carbohydrates (206±2 vs 197±1 g/d) and less monounsaturated fat (27.7±0.4 vs 29.3±0.3 g/d) than high-income women. Finally, low-occupation women consumed more total energy (1792±27 vs 1714±15 kcal/d) and total carbohydrates (206±2 vs 200±1 g/d), but less saturated fat (23.0±0.3 vs 24.4±0.2 g/d), calcium (935±17 vs 997±10 mg/d) and vitamin D (2.5±0.1 vs 2.9±0.1 μg/d), than high-occupation women.ConclusionIn Switzerland, the influence of socioeconomic factors on nutrient intake differs by sex; income and education, but not occupation, drive differences among men; among women, all three indicators seem to play a role. Interventions to reduce inequalities should consider the influence of education, income, and occupation in diet to be most effective.
Highlights
In high-income countries, socioeconomic status (SES) determines nutritional quality—people of low SES tend to follow unhealthier diets compared to people of high SES [1, 2]
Interventions to reduce inequalities should consider the influence of education, income, and occupation in diet to be most effective
It is imperative to assess the associations between SES and nutrition, but the literature remains scarce in assessing the associations between dietary intake and SES with more than one SES indicator—most reports evaluate only one SES indicator, most often education [1, 2]
Summary
In high-income countries, socioeconomic status (SES) determines nutritional quality—people of low SES tend to follow unhealthier diets compared to people of high SES [1, 2]. People of low SES tend to be disproportionally affected by these risk factors and morbidities [5, 6]. Different indicators—education, income, occupation—relate to different underlying social processes that likely influence dietary intake differently and should not be used interchangeably [1, 7]; education likely influences understanding of nutrition labels and reception of public health preventive messages; income likely impacts food purchasing behaviour; and occupation likely affects eating behaviour [1, 7]. We aimed to assess differences in macro- and micro-nutrient intake in both sexes according to education, income, and occupation
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