Abstract
Insufficient research has explored whether sociodemographic differences in self-reported, individual-level diet quality are similarly reflected by grocery purchase quality. This cross-sectional analysis of n = 3961 U.S. households from the nationally representative Food Acquisition and Purchase Survey (FoodAPS) compared Healthy Eating Index (HEI)-2015 scores from 1 week of food-at-home acquisitions across self-reported demographic factors (race/ethnicity, Supplemental Nutrition Assistance Program (SNAP) participation, food security, and household-level obesity status). Multivariable-adjusted, survey-weighted regression models compared household HEI-2015 scores across sociodemographic groups. Respondents were primarily White and female, with a mean age of 50.6 years, 14.0% were food insecure, and 12.7% were SNAP-participating. Mean HEI-2015 scores were 54.7; scores differed across all sociodemographic exposures (p < 0.05). Interactions (p < 0.1) were detected between SNAP participation and (1) food insecurity and (2) household-level obesity, and race/ethnicity and (1) household-level obesity. HEI-2015 scores were higher among food secure, non-SNAP households than among food insecure, SNAP-participating households (53.9 ± 0.5 vs. 50.3 ± 0.7, p = 0.007); non-SNAP households without obesity had significantly higher HEI-2015 scores than other households. Household-level obesity was associated with lower HEI-2015 scores in White (50.8 ± 0.5 vs. 52.5 ± 0.7, p = 0.046) and Black (48.8 ± 1.5 vs. 53.1 ± 1.4, p = 0.018) but not Hispanic households (54.4 ± 1.0 vs. 52.2 ± 1.2, p = 0.21). Sociodemographic disparities in household HEI-2015 scores were consistent with previous research on individual-level diet quality.
Highlights
Improving diet and reducing diet-related disparities consistently observed across socioeconomic, racial/ethnic, and body weight groups [1,2] is urgently needed to reduce the burden of diet-related diseases in the U.S [3]
Healthy Eating Index (HEI)-2015 scores were higher among food secure, non-SNAP households than among food insecure, SNAP-participating households
Since these scores do not reflect FAFH, which in Food Acquisition and Purchase Survey (FoodAPS) have previously been found to have 15% lower HEI-2010 scores compared to FAH [53,54,55], 3.3
Summary
Improving diet and reducing diet-related disparities consistently observed across socioeconomic, racial/ethnic, and body weight groups [1,2] is urgently needed to reduce the burden of diet-related diseases in the U.S [3]. Used sources of dietary data rely on retrospective recalls of self-reported intake, which are impacted by systemic and random errors related to portion size estimation and omission [6,7]. Grocery purchase data may expand opportunities for ongoing dietary surveillance and evaluation of interventions targeting diet-related disparities [8]. As an alternative source of dietary data, grocery acquisition data may circumvent well-documented limitations of self-reported intake data while providing a lens into often unmeasured characteristics of local food environments (e.g., types of retailers, cost of living, access to transportation), which influence food availability in different communities [12,13,14,15,16,17,18]
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