Socio-economic inequalities in diet in UK adults

The December Nutrition Society Paper of the Month is from British Journal of Nutrition and is entitled “Socio-economic dietary inequalities in UK adults: an updated picture of key food groups and nutrients from national surveillance data”.

Study written in the British Journal of Nutrition found that those higher up on the socio-economic ladder are generally healthier and are less likely to be obese, and what people eat varies across different social groups.  It’s a reasonable assumption that these two phenomena are connected, but in the UK social inequalities in diet have not been comprehensively assessed in recent years.  While plenty of studies have documented socioeconomic differences in fruit and vegetable consumption, less is known about other food groups and nutrients, including fish and processed meat.  We also need to better understand the extent to which inequalities in diet differ across different indicators of socioeconomic position such as income, education and occupation.  This matters because unless we can understand the social and economic pattern of diet we will struggle to find the right strategies to improve public health for everyone.

Our study examined foods and nutrients eaten in a nationally-representative sample of 1491 UK adults stratified by socioeconomic position (SEP).  Data came from the rolling programme of the National Diet and Nutrition Survey 2008-2011. We calculated average intakes of five foods and nutrients across three indicators of SEP: equivalised household income, occupational social class, and highest educational qualification. The choice of foods and nutrients for this study was informed by the Scientific Advisory Committee on Nutrition’s (SACN) 2008 report on the nutritional status of the British population. This report expressed concern over whether people in the UK were eating enough fruit, vegetables and oily fish; and whether they were eating too much red and processed meat, sugar and saturated fat.

We found that, not only did the sample as a whole not meet recommended intakes, those of a lower SEP fared the worst.  For the food groups, the least educated adults ate 128grams a day less fruit and vegetables than the most educated; the lowest occupational class consumed 26grams a day more red and processed meat than those in higher managerial occupations; and the highest income group were four times more likely than the lowest to have consumed any oily fish.  The amount of calories from sugars (non-milk extrinsic sugars) was around two percentage points higher in the lower SEP groups. No pattern of saturated fat consumption was found for any of the socio-economic indicators.

So, what does this mean for action to tackle health inequalities?  Our study provides up-to-date evidence about specific food groups  that are of concern for public health nutrition, and is a reminder of the importance of monitoring dietary trends in a time of entrenched and rising inequality. It also adds important detail in terms of how different aspects of life experience and social position can affect what we eat. For instance, income or occupation may affect our material ability to access a healthy diet, or education may equip us to make healthier choices. When developing policies and interventions to tackle unhealthy diet, it is vital to take into account these different aspects of our lives.

This paper is freely available for one month via the following link: journals.cambridge.org/ns/dec14

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