title: Socioeconomic Differences in Dietary Patterns in an East African Country: Evidence from the Republic of Seychelles.
abstract: In high income countries, low socioeconomic status (SES) is related to unhealthier dietary patterns, while evidence on the social patterning of diet in low and middle income countries is scarce.
  
  
  
  In this study, we assess dietary patterns in the general population of a middle income country in the African region, the Republic of Seychelles, and examine their distribution according to educational level and income.
  
  
  
  Data was drawn from two independent national surveys conducted in the Seychelles among adults aged 25-64 years in 2004 (n = 1236) and 2013 (n = 1240). Dietary patterns were assessed by principal component analysis (PCA). Educational level and income were used as SES indicators. Data from both surveys were combined as no interaction was found between SES and year.
  
  
  
  Three dietary patterns were identified: "snacks and drinks", "fruit and vegetables" and "fish and rice". No significant associations were found between SES and the "snacks and drinks" pattern. Low vs. high SES individuals had lower adherence to the "fruit and vegetables" pattern [prevalence ratio (95% CI) 0.71 (0.60-0.83)] but a higher adherence to the traditional "fish and rice" pattern [1.58 (1.32-1.88)]. Income modified the association between education and the "fish and rice" pattern (p = 0.02), whereby low income individuals had a higher adherence to this pattern in both educational groups.
  
  
  
  Low SES individuals have a lower consumption of fruit and vegetables, but a higher consumption of traditional foods like fish and rice. The Seychelles may be at a degenerative diseases stage of the nutrition transition.
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Ana-Lucia
authors.initials: AL
authors.lastname: Mayén
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Pascal
authors.initials: P
authors.lastname: Bovet
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Helena
authors.initials: H
authors.lastname: Marti-Soler
authors.affiliation: Ministry of Health, Victoria, Republic of Seychelles.
authors.forename: Bharathi
authors.initials: B
authors.lastname: Viswanathan
authors.affiliation: Ministry of Health, Victoria, Republic of Seychelles.
authors.forename: Jude
authors.initials: J
authors.lastname: Gedeon
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Fred
authors.initials: F
authors.lastname: Paccaud
authors.affiliation: Department of Medicine, Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Pedro
authors.initials: P
authors.lastname: Marques-Vidal
authors.affiliation: Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Silvia
authors.initials: S
authors.lastname: Stringhini
mesh_terms: D000328:Adult; D000351:Africa, Eastern / Q000453:epidemiology; D001628:Beverages / Q000706:statistics & numerical data; D004032:Diet / Q000706:statistics & numerical data; D004034:Diet Surveys / Q000706:statistics & numerical data; D005247:Feeding Behavior / Q000208:ethnology; D005260:Female; D005638:Fruit; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D012750:Seychelles / Q000453:epidemiology; D012923:Social Class; D012959:Socioeconomic Factors; D014675:Vegetables