Journal article
Inequalities in education and national income are associated with poorer diet: Pooled analysis of individual participant data across 12 European countries
University of Leeds1
Max Rubner Institut2
Agricultural Biotechnology Center Godollo3
Kazakh Academy of Nutrition4
Institute of Public Health of Republic of Macedonia5
National Institute of Public Health and the Environment6
National Food Agency7
World Health Organization8
University of York9
University of Vienna10
Research group for Nutrition and Health Promotion, National Food Institute, Technical University of Denmark11
National Food Institute, Technical University of Denmark12
National Institute for Health Development13
University of Oslo14
National Institute for Health and Welfare15
...and 5 moreBackground Malnutrition linked to noncommunicable diseases presents major health problems across Europe. The World Health Organisation encourages countries to conduct national dietary surveys to obtain data to inform public health policies designed to prevent noncommunicable diseases. Methods Data on 27334 participants aged 19-64y were harmonised and pooled across national dietary survey datasets from 12 countries across the WHO European Region.
Weighted mean nutrient intakes were age-standardised using the Eurostat 2013 European Standard Population. Associations between country-level Gross Domestic Product (GDP) and key nutrients and nutrient densities were investigated using linear regression. The potential mitigating influence of participant-level educational status was explored.
Findings Higher GDP was positively associated with total sugar intake (5.0% energy for each 10% increase in GDP, 95% CI 0.6, 9.3). Scandinavian countries had the highest vitamin D intakes. Participants with higher educational status had better nutritional intakes, particularly within lower GDP countries.
A 10% higher GDP was associated with lower total fat intakes (-0.2% energy, 95% CI -0.3, -0.1) and higher daily total folate intakes (14μg, 95% CI 12, 16) in higher educated individuals. Interpretation Lower income countries and lower education groups had poorer diet, particularly for micronutrients.
We demonstrate for the first time that higher educational status appeared to have a mitigating effect on poorer diet in lower income countries. It illustrates the feasibility and value of harmonising national dietary survey data to inform European policy regarding access to healthy diets, particularly in disadvantaged groups.
It specifically highlights the need for strong policies supporting nutritional intakes, prioritising lower education groups and lower income countries.
Language: | English |
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Publisher: | Public Library of Science |
Year: | 2020 |
Pages: | e0232447 |
ISSN: | 19326203 |
Types: | Journal article |
DOI: | 10.1371/journal.pone.0232447 |
ORCIDs: | Fagt, Sisse , Matthiessen, Jeppe , 0000-0002-8879-3978 , 0000-0001-7035-3096 and 0000-0003-3421-0121 |