Inequalities in education and national income are associated with poorer diet: Pooled analysis of individual participant data across 12 European countries

Rippin, Holly; Hutchinson, Jayne; Greenwood, DC; Jewell, Jo; Breda, João; Martin, Adam; Rippin, David M.; Schindler, Karin; Rust, Petra; Fagt, Sisse; Matthiessen, Jeppe; Nurk, Eha; Nelis, Keiu; Kukk, M.; Tapanainen, Heli; Valsta, Liisa; Heuer, Thorsten; Sarkadi-Nagy, Eszter; Bakacs, Márta; Tazhibayev, Shamil; Sharmanov, T Sh; Spiroski, Igor; Beukers, M.; Rossum, Caroline van; Ocké, Marga C.; Lindroos, Anna Karin; Lemming, Eva Warensjö; Cade, Janet

doi:10.1371/journal.pone.0232447

Cited by 52 publications

(26 citation statements)

References 21 publications

(25 reference statements)

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“…Besides regional differences, education is a social determinant with high impact on dietary habits. 19 More educated people tend to live in urban areas with less educated people living in rural areas. 33 Comparing the diabetes study population with the general population in DANSDA, limitations are the same (educational and regional differences) together with differences in age range.…”

Section: Discussionmentioning

confidence: 99%

Intention and Perceptions of Healthy Eating versus Actual Intake Among Patients with Type 1 and Type 2 Diabetes and the General Population

Ewers¹,

Sørensen²,

Fagt³

et al. 2021

PPA

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Purpose Intention and perceptions of healthy eating may affect diet-related behavior. We assessed the intention and perceptions of eating healthily in patients with type 1 (T1D) and type 2 diabetes (T2D) compared with the general population. Secondly, differences in diet quality were assessed in patients with diabetes perceiving their dietary habits as more or less healthy. Materials and Methods This cross-sectional study included data on socioeconomic status, dietary intake, and questions on healthy eating from adults with T1D (n=426), T2D (n=348) and from the general population (n=2899). Results Patients with T2D were less likely to perceive their dietary habits as healthy compared with T1D and the general population. Patients with T1D or T2D perceiving their dietary habits as healthy reported higher intake of vegetables, fruit, fish, fibre and protein. In addition, patients with T1D with perceived healthy versus less healthy dietary habits had lower sugar intake and higher alcohol intake. Overall, adherence to dietary guidelines in patients with T1D and T2D was too low both in self-perceived healthy and less healthy eaters. In comparison with T1D patients, patients with T2D were less likely and the general population was more likely to strive to eat a healthy diet. Conclusion Patients with T2D had poorer self-perception of their dietary healthiness and less intention of eating healthily, compared with patients with T1D and the general population. Actual diet quality was higher amongst patients with T1D and T2D perceiving their dietary habits as healthy than those perceiving their dietary habits as less healthy. But inadequate intakes were found in all groups. Health care providers should address and explore the patient’s intention and perceptions of healthy eating when discussing dietary changes in diabetes to improve nutritional support.

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Section: Discussionmentioning

confidence: 99%

Intention and Perceptions of Healthy Eating versus Actual Intake Among Patients with Type 1 and Type 2 Diabetes and the General Population

Ewers¹,

Sørensen²,

Fagt³

et al. 2021

PPA

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“…Many countries recommend vitamin D supplementation and fortify some food products [ 28 , 29 ]. However, there is insufficient scientific evidence that a change to the typical EE model of nutrition can improve vitamin D status, excluding the population where there is a high consumption of fish and fish products [ 33 , 34 , 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

Differences in the Concentration of Vitamin D Metabolites in Plasma Due to the Low-Carbohydrate-High-Fat Diet and the Eastern European Diet—A Pilot Study

et al. 2021

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Vitamin D deficiency is a global problem with many health consequences, and it is currently recommended to supplement vitamin D. Change of diet should also be considered to ensure adequate vitamin D in the human body. The aim of this study was to assess the concentration of vitamin D metabolites in two different groups: one group on the low-carbohydrate-high-fat (LCHF) diet and the other group on the Eastern European (EE) diet. In the first stage, 817 participants declaring traditional EE diet or LCHF diet were investigated. Nutrition (self-reported 3-day estimated food record) and basic anthropometric parameters were assessed. After extra screening, 67 participants on the EE diet and 41 on the LCHF diet were qualified for the second stage. Plasma 25-hydroxycholecalciferol (25(OH)D3) and (25(OH)D2) concentration was measured by the validated HPLC—MS/MS method. Plasma 25(OH)D3 concentration was significantly higher in the group on the LCHF diet (34.9 ± 15.9 ng/mL) than in the group on the EE diet (22.6 ± 12.1 ng/mL). No statistical differences were observed in plasma 25(OH)D2 concentration between the study groups (p > 0.05). Women had a higher plasma 25(OH)D2 concentration than men regardless of diet type. The LCHF diet had a positive influence on plasma vitamin D concentration. However, long-term use of the LCHF diet remains contentious due to the high risk of cardiovascular disease. This study confirmed that the type of diet influences the concentration of vitamin D metabolites in the plasma.

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“…A higher educational attainment polygenic score was positively associated with nutrient intake, providing a genetic basis for the phenotypic association between EA and dietary intake (Rippin et al 2020). Adjusted for phenotypic EA attenuated associations, as expected.…”

Section: Discussionmentioning

confidence: 99%

Association between polygenic propensity for a psychiatric disorder and nutrient intake

Hunjan

Huebel

et al. 2021

Preprint

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BackgroundDespite the observed associations between psychiatric disorders and nutrient intake, genetic studies are limited.AimsWe examined whether polygenic scores for psychiatric disorders, including anorexia nervosa, major depressive disorder and schizophrenia, are associated with self-reported nutrient intake.MethodsWe used data obtained by the UK Biobank ‘Diet by 24-hour recall’ questionnaire (N=163,619). Association was assessed using linear mixed models for the analysis of data with repeated measures.ResultsWe find polygenic scores for psychiatric disorders are differentially associated with nutrient intake, with attention-deficit/hyperactivity disorder, bipolar disorder and schizophrenia showing the strongest associations, whilst autism spectrum disorder showed no association. Expressed as the effect of a one standard deviation higher polygenic score, anorexia nervosa polygenic score was associated with higher intake of fibre (0.06 g), folate (0.93 μg), iron (0.03 mg) and vitamin C (0.92 μg). Similarly, a higher major depressive disorder polygenic score was associated with 0.04 mg lower iron and 1.13 μg lower vitamin C intake per day, and a greater obsessive-compulsive disorder polygenic score with 0.06 g higher fibre intake. These associations were predominantly driven by socioeconomic status and educational attainment. However, a higher alcohol dependence polygenic score was associated with higher alcohol intake and individuals with higher persistent thinness polygenic scores reported their food to weigh 8.61 g less, both independent of socioeconomic status.ConclusionsOur findings suggest that polygenic propensity for a psychiatric disorder is associated with dietary behaviour. The nutrient intake is based on self-reported data and findings must therefore be interpreted mindfully.Declaration of interestNone.

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Inequalities in education and national income are associated with poorer diet: Pooled analysis of individual participant data across 12 European countries

Cited by 52 publications

References 21 publications

Intention and Perceptions of Healthy Eating versus Actual Intake Among Patients with Type 1 and Type 2 Diabetes and the General Population

Intention and Perceptions of Healthy Eating versus Actual Intake Among Patients with Type 1 and Type 2 Diabetes and the General Population

Differences in the Concentration of Vitamin D Metabolites in Plasma Due to the Low-Carbohydrate-High-Fat Diet and the Eastern European Diet—A Pilot Study

Association between polygenic propensity for a psychiatric disorder and nutrient intake

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