It is generally accepted that socioeconomic status (SES) influences dietary habits as well as human health. Three main parameters have been most often used to define SES, i.e. occupation, education and income. These characteristics cover different aspects of the socioeconomic structure of people. The aim of this review is to present the current knowledge regarding the relationships between SES, dietary habits and health-related outcomes in various parts of the world.

Background: The aims of the present work were to investigate whether dietary habits are associated with socio-economic status (SES), and if they modify the relationship between SES and CVD risk factors, in a sample of men and women free from known CVD.Methods: This population-based study was carried out in the province of Attica, where Athens is a major metropolis. During 2001-2002, information from 1528 men (18-87 years old) and 1514 women (18-89 years old) was collected (75 % participation rate). Among several sociodemographic, clinical and biological factors, adherence to the Mediterranean diet was assessed by a special diet score (Mediterranean Diet Score, MDS) that incorporated the inherent characteristics of this traditional diet. CVD risk factors were examined across the participants' educational level and annual income that defined their SES. Results: Low SES groups exhibited higher prevalence of CVD risk factors, such as obesity, hypertension, diabetes mellitus and hypercholesterolaemia (all P , 0?001). Low SES groups also showed less adherence to the Mediterranean diet than high SES groups (MDS: 23?6 (SD 8?1) v. 25?6 (SD 5?6), P , 0?001). Higher SES index was associated with lower likelihood of having hypercholesterolaemia (OR 5 0?91; 95 % CI 0?83, 1?00) and diabetes (OR 5 0?83; 95 % CI 0?72, 0?95), after adjusting for various potential confounders. However, the previously mentioned inverse relationship observed between SES and prevalence of CVD risk factors was mainly explained by the dietary habits of the participants. Conclusions: Low SES groups showed less adherence to the Mediterranean diet compared with high SES groups. This finding may, in part, explain the higher CVD risk factors profile observed among low SES participants.

Objective: The aim of the present work was to calculate the current cost of the Mediterranean diet in Greece and to evaluate the role of diet cost in the development of cardiovascular events after a 5-year follow-up. Design: Cross-sectional. Cost of diet was measured in h/week based on common Greek dietary choices, while baseline dietary habits were assessed through a semiquantitative FFQ (Greek-EPIC). The Mediterranean Diet Score (MedDietScore) was applied to assess overall adherence to this pattern using scores of eleven food variables and alcohol, according to the principles of the Mediterranean diet. Setting: Five-year follow-up of the ATTICA study, a nutrition and health survey of a representative, free-living sample of the Greek population resident in the province of Attica, where Athens is a major metropolis.

Low education seems to increase CVD risk, an observation that was partially explained by baseline clinical characteristics and unhealthy dietary choices of people belonging into this group.