Does the importance of dietary costs for fruit and vegetable intake vary by socioeconomic position?
Evidence suggests that diets meeting recommendations for fruit and vegetable (F&V) intake are more costly. Dietary costs may be a greater constraint on the diet quality of people of lower socioeconomic position (SEP). The aim of this study was to examine whether dietary costs are more strongly associated with F&V intake in lower-SEP groups than in higher-SEP groups. Data on individual participants' education and income were available from a population-based, cross-sectional study of 10 020 British adults. F&V intake and dietary costs (GBP/d) were derived from a semi-quantitative FFQ. Dietary cost estimates were based on UK food prices. General linear models were used to assess associations between SEP, quartiles of dietary costs and F&V intake. Effect modification of SEP gradients by dietary costs was examined with interaction terms. Analysis demonstrated that individuals with lowest quartile dietary costs, low income and low education consumed less F&V than individuals with higher dietary costs, high income and high education. Significant interaction between SEP and dietary costs indicated that the association between dietary costs and F&V intake was stronger for less-educated and lower-income groups. That is, socioeconomic differences in F&V intake were magnified among individuals who consumed lowest-cost diets. Such amplification of socioeconomic inequalities in diet among those consuming low-cost diets indicates the need to address food costs in strategies to promote healthy diets. In addition, the absence of socioeconomic inequalities for individuals with high dietary costs suggests that high dietary costs can compensate for lack of other material, or psychosocial resources.
1Department of Epidemiology and Biostatistics,EMGO Institute for Health and Care Research,VU University Medical Center,1081HV Amsterdam,The Netherlands.
Joreintje D
JD
Mackenbach
2Centre for Diet and Activity Research,University of Cambridge School of Clinical Medicine,Institute of Metabolic Science,Cambridge Biomedical Campus,Medical Research Council Epidemiology Unit,Cambridge CB2 0QQ,UK.
Soren
S
Brage
2Centre for Diet and Activity Research,University of Cambridge School of Clinical Medicine,Institute of Metabolic Science,Cambridge Biomedical Campus,Medical Research Council Epidemiology Unit,Cambridge CB2 0QQ,UK.
Nita G
NG
Forouhi
2Centre for Diet and Activity Research,University of Cambridge School of Clinical Medicine,Institute of Metabolic Science,Cambridge Biomedical Campus,Medical Research Council Epidemiology Unit,Cambridge CB2 0QQ,UK.
Simon J
SJ
Griffin
2Centre for Diet and Activity Research,University of Cambridge School of Clinical Medicine,Institute of Metabolic Science,Cambridge Biomedical Campus,Medical Research Council Epidemiology Unit,Cambridge CB2 0QQ,UK.
Nicholas J
NJ
Wareham
2Centre for Diet and Activity Research,University of Cambridge School of Clinical Medicine,Institute of Metabolic Science,Cambridge Biomedical Campus,Medical Research Council Epidemiology Unit,Cambridge CB2 0QQ,UK.
Pablo
P
Monsivais
D000328:Adult; D003430:Cross-Sectional Studies; D004032:Diet / Q000191:economics*; D005260:Female; D005638:Fruit / Q000191:economics*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D006113:United Kingdom; D014675:Vegetables / Q000191:economics*
Economics; F&V fruit and vegetables; Food prices; Fruit and vegetable intake; SEP socioeconomic position; Socioeconomic status