title: Social inequality in adolescents' healthy food intake: the interplay between economic, social and cultural capital.
abstract: Current explanations of health inequalities in adolescents focus on behavourial and economic determinants and rarely include more meaningful forms of economic, cultural, and social capital. The aim of the study was to investigate how the interplay between capitals constitutes social inequalities in adolescent healthy food intake.
  
  
  
  Data were collected in the 2013/14 Flemish Health Behavior among School-aged Children (HBSC) survey, which is part of the international WHO HBSC survey. The total sample included 7266 adolescents aged 12-18. A comprehensive set of 58 capital indicators was used to measure economic, cultural and social capital and a healthy food index was computed from a 17-item food frequency questionnaire (FFQ) to assess the consumption frequency of healthy food within the overall food intake.
  
  
  
  The different forms of capital were unequally distributed in accordance with the subdivisions within the education system. Only half of the capital indicators positively related to healthy food intake, and instead 17 interactions were found that both increased or reduced inequalities. Cultural capital was a crucial component for explaining inequalities such that social gradients in healthy food intake increased when adolescents participated in elite cultural practices ( P < 0.05), and were consequently reduced when adolescents reported to have a high number of books at home ( P < 0.05).
  
  
  
  A combination of selected resources in the form of economic, cultural and social capital may both increase or reduce healthy food intake inequalities in adolescents. Policy action needs to take into account the unequal distribution of these resources within the education system.
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, Academical Hospital, 4K3, De Pintelaan, 185, Ghent, Belgium.
authors.forename: Bart
authors.initials: B
authors.lastname: De Clercq
authors.affiliation: Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Abel
authors.affiliation: Institute of Medical Sociology, Martin Luther University, Halle (Saale), Germany.
authors.forename: Irene
authors.initials: I
authors.lastname: Moor
authors.affiliation: Institute for Health and Social Policy and Douglas Institute, McGill University, Montreal, Quebec, Canada.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Elgar
authors.affiliation: Faculty of Political and Social Sciences, Department of Sociology, Ghent University, Ghent, Belgium.
authors.forename: John
authors.initials: J
authors.lastname: Lievens
authors.affiliation: Faculty of Bioscience Engineering, Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Sioen
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, Academical Hospital, 4K3, De Pintelaan, 185, Ghent, Belgium.
authors.forename: Lutgart
authors.initials: L
authors.lastname: Braeckman
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, Academical Hospital, 4K3, De Pintelaan, 185, Ghent, Belgium.
authors.forename: Benedicte
authors.initials: B
authors.lastname: Deforche
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001530:Belgium; D002648:Child; D002755:Choice Behavior; D003469:Culture; D000072001:Diet, Healthy / Q000706:statistics & numerical data*; D005247:Feeding Behavior; D005260:Female; D005518:Food Preferences; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D066270:Social Capital; D012923:Social Class; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires