A systematic review of socio-economic differences in food habits in Europe: consumption of fruit and vegetables

Abstract

Objective: To evaluate the differences in the consumption of fruit and vegetables between groups with different socio-economic status (SES) in the adult population of European countries. Design: A systematic review of published and unpublished surveys of food habits conducted between 1985 and 1999 in 15 European countries. Educational level and occupational status were used as indicators of SES. A pooled estimate of the mean difference between the highest and the lowest level of education and occupation was calculated separately for men and women, using DerSimonian and Laird's random effects model. Setting: The inclusion criteria of studies were: use of a validated method for assessing intake at the individual level; selection of a nationwide sample or a representative sample of a region; and providing the mean and standard deviation of overall fruit and vegetable consumption for each level of education or occupation, and separately for men and women. Subjects: Participants in the individual surveys had to be adults (18 ± 85 y). Results: Eleven studies from seven countries met the criteria for being included in the meta-analysis. A higher SES was associated with a greater consumption of both fruit and vegetables. The pooled estimate of the difference in the intake of fruit was 24.3 gapersonaday (95% con®dence interval (CI) 14.0 ± 34.7) between men in the highest level of education and those in the lowest level of education. Similarly, this difference was 33.6 gapersonaday for women (95% CI 22.5 ± 44.8). The differences regarding vegetables were 17.0 gapersonaday (95% CI 8.6 ± 25.5) for men and 13.4 gapersonaday (95% CI 7.1 ± 19.7) for women. The results were in the same direction when occupation instead of education was used as an indicator of SES. Conclusions: Although we cannot exclude over-reporting of intake by those with highest SES, it is unlikely that this potential bias could fully explain the differences we have found. Our results suggest that an unhealthier nutrition pattern may exist among adults belonging to lower socio-economic levels in Europe. Sponsorship: The present study was supported by the European Union's FAIR programme .

Longitudinal changes in diet from childhood into adulthood with respect to risk of cardiovascular diseases: The Cardiovascular Risk in Young Finns Study

“…Surprisingly, level of education had no significant influence on the quality of diet. In earlier studies, particularly in other western European countries and also in Finland, socioeconomic status has been an important predictor of food choices and nutrient intake (Roos et al, 1998;Johansson et al, Longitudinal changes in diet V Mikkilä et al 1999;De Irala-Estévez et al, 2000;Groth et al, 2001). The participants of our study were 24-39 y of age at follow-up, thus, most had completed their studies.…”

A systematic review of socioeconomic differences in food habits in Europe: consumption of cheese and milk

“…Some of the methods for this meta-analysis have been reported elsewhere (Irala-Estévez et al, 2000).…”

“…A healthier dietary pattern is believed to include a higher consumption of fruits and vegetables and a lower intake of fat and meat. Thus, people with a higher socioeconomic level tend to show a higher consumption of vegetables, fruits and fiber products and a lower consumption of meat, meat products, and fats than people from a lower socioeconomic level (Erkkilä et al, 1999;Fraser et al, 2000;Irala-Estévez et al, 2000). In fact, there is available evidence supporting the assumption that a lower intake of meat and fat is associated with a higher socioeconomic level in Europe (Johansson et al, 1999;Roos et al, 1999;Groth et al, 2001).…”

“…Roos et al reviewed published data dealing with differences in fruit and vegetable consumption across Europe (Roos et al, 2001) while Irala-Estévez et al carried out an analysis based on the differences in the consumption of fruits and vegetables across educational and occupational levels (Irala-Estévez et al, 2000). This new analysis is also a systematic review aimed to assess differences in consumption based on socioeconomic differences across European countries.…”

The contribution of three components of nutrition knowledge to socio-economic differences in food purchasing choices

“…It is well established that those with lower levels of income and education make food choices less consistent with dietary guideline recommendations compared with their more affluent or educated counterparts (1)(2)(3) . The resulting poorer dietary profile of those of low socioeconomic position (SEP) may contribute to their higher rates of morbidity and mortality for many health conditions, including type 2 diabetes (4,5) , heart disease (6)(7)(8) , obesity (9)(10)(11) and stroke (6,12) .…”