Abstract
Worldwide, there are socioeconomic inequalities in health and diet. We studied the relationship between education and nutrient intake in 11,302 women and men aged 40–96 years who participated in the seventh survey of the population-based Tromsø Study (2015–2016), Norway (attendance 65%). Diet was assessed using a validated food-frequency questionnaire. We examined the association between education and intake of total energy and macronutrients by sex using linear and logistic regression models adjusted for age, body mass index, leisure time physical activity and smoking. The intake of macronutrients was compared with the Nordic Nutrition Recommendations 2012. There was a positive association between education and intake of fiber and alcohol, and a negative association between education and intake of total carbohydrates and added sugar in both women and men. Participants with long tertiary education had higher odds of being compliant with the recommended intake of fiber and protein and the maximum recommended level for added sugar and had lower odds of being compliant with the recommended intake of total carbohydrates and the maximum recommended level for alcohol, compared to participants with primary education. Overall, we found that participants with higher education were more compliant with the Nordic Nutrition Recommendations 2012.
Highlights
Socioeconomic factors cause inequalities in health worldwide [1]
Median intakes of energy and macronutrients found in this study were similar to what was observed in the Norwegian national dietary survey NORKOST 3 from 2010–2011, the data collection method and sample age range differed [10]
We found a positive association between education level and reported intake of fiber and alcohol in both women and men, and for energy intake, total fat and MUFAs in women
Summary
Socioeconomic factors cause inequalities in health worldwide [1]. Those with lower socioeconomic status (SES) have higher overall mortality, morbidity and prevalence of risk factors compared to those with higher SES [1,2,3,4,5,6]. Reduction in social inequality in health is central to the United Nation’s Sustainable Development Goals [7] and World Health Organization’s Global Action Plan for the Prevention and Control of Non-Communicable Diseases 2013–2020 [8]. In 2017, 27% of all worldwide deaths related to non-communicable diseases were attributable to dietary risk factors [9]. It is important to reduce social inequality in diet, and population surveillance surveys are crucial to evaluate progress and propose actions towards the goal. Dietary surveys from Nordic countries have previously shown a positive association between education and the intake of vegetables, fruits and berries, grain products, fiber and alcohol, and a negative association with the intake of red meat and total fat [10,11,12,13]
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