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Differences in diet quality and socioeconomic patterning of diet quality across ethnic groups: cross-sectional data from the HELIUS Dietary Patterns study.

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Peer-reviewed

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Article

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Abstract

BACKGROUND/OBJECTIVES: Socioeconomic inequalities in diet quality are consistently reported, but few studies have investigated whether and how such inequalities vary across ethnic groups. This study aimed to examine differences in diet quality and socioeconomic patterning of diet quality across ethnic groups. SUBJECTS/METHODS: Cross-sectional data from the HELIUS study were used. Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan adults (aged 18-70 years) were randomly sampled, stratified by ethnicity. Dietary intake was estimated among a subsample (n = 4602) from 200-item, ethnic-specific food frequency questionnaires, and diet quality was assessed using the Dutch Healthy Diet Index 2015 (DHD15-Index). Wald tests were used to compare non-Dutch and Dutch participants. Adjusted linear regression models were used to examine differences in DHD15-Index by three indicators of socioeconomic position: educational level, occupational status and perceived financial difficulties. All analyses were stratified by sex. RESULTS: Dutch participants had lower median DHD15-Index than most ethnic minority participants (P < 0.001). Lower educational level was associated with lower DHD15-Index among Dutch men (Ptrend < 0.0001), South-Asian Surinamese men (Ptrend = 0.01), Dutch women (Ptrend = 0.0001), African Surinamese women (Ptrend = 0.002) and Moroccan women (Ptrend = 0.04). Lower occupational status was associated with lower DHD15-Index in Dutch men, β -7.8 (95% CI -11.7, -3.9) and all women (β -4.4 to -8.8), except Turkish women. DHD15-Index was not associated with perceived financial difficulties in most groups. CONCLUSIONS: We observed variations in diet quality across ethnic groups. Low socioeconomic position was not consistently associated with poor diet quality in all ethnic groups. This may be due to ethnicity-specific retention of traditional diets, irrespective of socioeconomic position.

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Keywords

Adult, Cross-Sectional Studies, Diet, Educational Status, Ethnicity, Female, Ghana, Humans, Male, Minority Groups, Netherlands, Prevalence

Journal Title

Eur J Clin Nutr

Conference Name

Journal ISSN

0954-3007
1476-5640

Volume Title

74

Publisher

Springer Science and Business Media LLC

Rights

All rights reserved
Sponsorship
Medical Research Council (MR/K023187/1)
Wellcome Trust (087636/Z/08/Z)
Economic and Social Research Council (ES/G007462/1)
The HELIUS study is conducted by the Academic Medical Center Amsterdam and the Public Health Service of Amsterdam. Both organisations provided core support of HELIUS. The HELIUS study is also funded by the Dutch Heart Foundation, the Netherlands Organization for Health Research and Development (ZonMw), the European Union (FP-7), and the European Fund for the Integration of non-EU immigrants (EIF). The HELIUS-Dietary Pattern study is funded by Netherlands Organization for Health Research and Development (ZonMw; Project number: 50-51600-98-031). This work was undertaken by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from Cancer Research UK, the British Heart Foundation, the Economic and Social Research Council, the Medical Research Council, the National Institute for Health Research, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. The funders had no role in the study design, data collection, analysis, interpretation, or writing, nor in the decision to submit the article for publication.