Socioeconomic status and dietary patterns in children from around the world: different associations by levels of country human development?

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dc.contributor.authorManyanga, Taru
dc.contributor.authorTremblay, Mark S
dc.contributor.authorChaput, Jean-Philippe
dc.contributor.authorKatzmarzyk, Peter T
dc.contributor.authorFogelholm, Mikael
dc.contributor.authorHu, Gang
dc.contributor.authorKuriyan, Rebecca
dc.contributor.authorKurpad, Anura
dc.contributor.authorLambert, Estelle V
dc.contributor.authorMaher, Carol
dc.contributor.authorMaia, Jose
dc.contributor.authorMatsudo, Victor
dc.contributor.authorOlds, Timothy
dc.contributor.authorOnywera, Vincent
dc.contributor.authorSarmiento, Olga L
dc.contributor.authorStandage, Martyn
dc.contributor.authorTudor-Locke, Catrine
dc.contributor.authorZhao, Pei
dc.contributor.authorMikkila, Vera
dc.contributor.authorBroyles, Stephanie T
dc.date.accessioned2017-05-22T13:36:08Z
dc.date.available2017-05-22T13:36:08Z
dc.date.issued2017-05-16
dc.date.updated2017-05-21T03:31:13Z
dc.description.abstractBackground: Although ‘unhealthy’ diet is a well-known risk factor for non-communicable diseases, its relationship with socio-economic status (SES) has not been fully investigated. Moreover, the available research has largely been conducted in countries at high levels of human development. This is the first study to examine relationships among dietary patterns and SES of children from countries spanning a wide range of human development. Methods: This was a multinational cross-sectional study among 9–11 year-old children (n = 6808) from urban/ peri-urban sites across 12 countries. Self-reported food frequency questionnaires were used to determine the children’s dietary patterns. Principal Components Analysis was employed to create two component scores representing ‘unhealthy’ and ‘healthy’ dietary patterns. Multilevel models accounting for clustering at the school and site level were used to examine the relationships among dietary patterns and SES. Results: The mean age of participants in this study (53.7% girls) was 10.4 years. Largest proportions of total variance in dietary patterns occurred at the individual, site, and school levels (individual, school, site: 62.8%; 10.8%; 26.4% for unhealthy diet pattern (UDP) and 88.9%; 3.7%; 7.4%) for healthy diet pattern (HDP) respectively. There were significant negative ‘unhealthy’ diet-SES gradients in 7 countries and positive ‘healthy’ diet-SES gradients in 5. Within country diet-SES gradients did not significantly differ by HDI. Compared to participants in the highest SES groups, unhealthy diet pattern scores were significantly higher among those in the lowest within-country SES groups in 8 countries: odds ratios for Australia (2.69; 95% CI: 1.33–5.42), Canada (4.09; 95% CI: 2.02–8.27), Finland (2.82; 95% CI: 1.27–6.22), USA (4.31; 95% CI: 2.20–8.45), Portugal (2.09; 95% CI: 1.06–4.11), South Africa (2.77; 95% CI: 1.22–6.28), India (1.88; 95% CI: 1.12–3.15) and Kenya (3.35; 95% CI: 1.91–5.87). Conclusions: This study provides evidence of diet-SES gradients across all levels of human development and that lower within-country SES is strongly related to unhealthy dietary patterns. Consistency in within-country diet-SES gradients suggest that interventions and public health strategies aimed at improving dietary patterns among children may be similarly employed globally. However, future studies should seek to replicate these findings in more representative samples extended to more rural representation.
dc.identifier.apacitationManyanga, T., Tremblay, M. S., Chaput, J., Katzmarzyk, P. T., Fogelholm, M., Hu, G., ... Broyles, S. T. (2017). Socioeconomic status and dietary patterns in children from around the world: different associations by levels of country human development?. http://hdl.handle.net/11427/24383en_ZA
dc.identifier.chicagocitationManyanga, Taru, Mark S Tremblay, Jean-Philippe Chaput, Peter T Katzmarzyk, Mikael Fogelholm, Gang Hu, Rebecca Kuriyan, et al "Socioeconomic status and dietary patterns in children from around the world: different associations by levels of country human development?." (2017) http://hdl.handle.net/11427/24383en_ZA
dc.identifier.citationManyanga, T., Tremblay, M. S., Chaput, J. P., Katzmarzyk, P. T., Fogelholm, M., Hu, G., ... & Maia, J. (2017). Socioeconomic status and dietary patterns in children from around the world: different associations by levels of country human development?. BMC Public Health, 17(1), 457.
dc.identifier.ris TY - Journal Article AU - Manyanga, Taru AU - Tremblay, Mark S AU - Chaput, Jean-Philippe AU - Katzmarzyk, Peter T AU - Fogelholm, Mikael AU - Hu, Gang AU - Kuriyan, Rebecca AU - Kurpad, Anura AU - Lambert, Estelle V AU - Maher, Carol AU - Maia, Jose AU - Matsudo, Victor AU - Olds, Timothy AU - Onywera, Vincent AU - Sarmiento, Olga L AU - Standage, Martyn AU - Tudor-Locke, Catrine AU - Zhao, Pei AU - Mikkila, Vera AU - Broyles, Stephanie T AB - Background: Although ‘unhealthy’ diet is a well-known risk factor for non-communicable diseases, its relationship with socio-economic status (SES) has not been fully investigated. Moreover, the available research has largely been conducted in countries at high levels of human development. This is the first study to examine relationships among dietary patterns and SES of children from countries spanning a wide range of human development. Methods: This was a multinational cross-sectional study among 9–11 year-old children (n = 6808) from urban/ peri-urban sites across 12 countries. Self-reported food frequency questionnaires were used to determine the children’s dietary patterns. Principal Components Analysis was employed to create two component scores representing ‘unhealthy’ and ‘healthy’ dietary patterns. Multilevel models accounting for clustering at the school and site level were used to examine the relationships among dietary patterns and SES. Results: The mean age of participants in this study (53.7% girls) was 10.4 years. Largest proportions of total variance in dietary patterns occurred at the individual, site, and school levels (individual, school, site: 62.8%; 10.8%; 26.4% for unhealthy diet pattern (UDP) and 88.9%; 3.7%; 7.4%) for healthy diet pattern (HDP) respectively. There were significant negative ‘unhealthy’ diet-SES gradients in 7 countries and positive ‘healthy’ diet-SES gradients in 5. Within country diet-SES gradients did not significantly differ by HDI. Compared to participants in the highest SES groups, unhealthy diet pattern scores were significantly higher among those in the lowest within-country SES groups in 8 countries: odds ratios for Australia (2.69; 95% CI: 1.33–5.42), Canada (4.09; 95% CI: 2.02–8.27), Finland (2.82; 95% CI: 1.27–6.22), USA (4.31; 95% CI: 2.20–8.45), Portugal (2.09; 95% CI: 1.06–4.11), South Africa (2.77; 95% CI: 1.22–6.28), India (1.88; 95% CI: 1.12–3.15) and Kenya (3.35; 95% CI: 1.91–5.87). Conclusions: This study provides evidence of diet-SES gradients across all levels of human development and that lower within-country SES is strongly related to unhealthy dietary patterns. Consistency in within-country diet-SES gradients suggest that interventions and public health strategies aimed at improving dietary patterns among children may be similarly employed globally. However, future studies should seek to replicate these findings in more representative samples extended to more rural representation. DA - 2017-05-16 DB - OpenUCT DO - 10.1186/s12889-017-4383-8 DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2017 T1 - Socioeconomic status and dietary patterns in children from around the world: different associations by levels of country human development? TI - Socioeconomic status and dietary patterns in children from around the world: different associations by levels of country human development? UR - http://hdl.handle.net/11427/24383 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1186/s12889-017-4383-8
dc.identifier.urihttp://hdl.handle.net/11427/24383
dc.identifier.vancouvercitationManyanga T, Tremblay MS, Chaput J, Katzmarzyk PT, Fogelholm M, Hu G, et al. Socioeconomic status and dietary patterns in children from around the world: different associations by levels of country human development?. 2017; http://hdl.handle.net/11427/24383.en_ZA
dc.language.isoen
dc.publisherBioMed Central
dc.publisher.departmentMRC/UCT RU for Exercise and Sport Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rights.holderThe Author(s).
dc.subject.otherUnhealthy/healthy diet
dc.subject.otherHousehold income
dc.subject.otherHdi
dc.subject.otherGini index
dc.subject.otherNon-communicable diseases
dc.titleSocioeconomic status and dietary patterns in children from around the world: different associations by levels of country human development?
dc.typeJournal Article
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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