Socio-economic and racial/ethnic disparities in the nutritional quality of packaged food purchases in the USA, 2008–2018

Abstract

Objective: To determine whether disparities exist in the nutritional quality of packaged foods and beverage purchases (PFPs) by household income, education, and race/ethnicity and if they changed over time. Design: We used Nielsen Homescan, a nationally representative household panel, from 2008-2018 (n=672,821 household-year observations). Multivariate, multilevel regressions were used to model the association between sociodemographic groups and a set of nutritional outcomes of public health interest, including nutrients of concern (sugar, saturated fat, sodium) and calories from specific food groups (fruits, non-starchy vegetables, processed meats, sugar-sweetened beverages and junk foods). Setting: Household panel survey Participants: Approximately 60,000 households each year from the United States. Results: Disparities were found by income and education for most outcomes, and widened for purchases of fruits, vegetables, and the percent of calories from sugar between 2008 and 2018. The magnitude of disparities was largest by education. Disparities between Black and White households include the consumption of processed meats and the percent calories from sugar, while no disparities between White and Hispanic households were found. Disparities have been largely persistent, as any significant changes over time have been substantively small. Conclusions: Policies to improve the healthfulness of packaged foods must be expanded beyond SSB taxes and future research should focus on what mediates the relationship between education and diet so as not to exacerbate disparities.

Dietary quality and cardiometabolic indicators in the USA: A comparison of the Planetary Health Diet Index, Healthy Eating Index-2015, and Dietary Approaches to Stop Hypertension

“…Income data were classified using the Poverty Income Ratio (PIR), a measure of family income relative to the Federal Poverty Level that accounts for household size. Income was categorized as PIR 0–185%, PIR 186–399%, PIR ≥ 400%, and Missing (due to high missingness in self-reported income, 8.1%) [ 27 ]. Education was reported in continuous years and classified as high school equivalent or lower, some college, and college degree or higher [ 28 ].…”

Special Supplemental Nutrition Program for Women, Infants, and Children Participant Grocery Store Purchases during the COVID-19 Pandemic in North Carolina

“…Our analysis focused on several food categories of public health interest [ [33] , [34] , [35] ]: 1 ) all fruits, vegetables, nuts, and legumes (FV) with and without added salt, fat, or sugar; 2 ) FV without added salt, fat, or sugar; 3 ) nonessential processed packaged foods (i.e., salty snacks, candy, and desserts), and 4 ) SSBs. We were interested in FV because they are high cost, nutrient-dense food categories of public health concern that were particularly influenced by rising costs due to inflation.…”

Developing health and environmental warning messages about red meat: An online experiment

“…In exploratory analyses, we used multivariate linear regression with OLS estimation to examine predictors of average PME for health and environmental messages (averaged across all warning messages shown in Table 2). Predictors were chosen based on characteristics previously found to be associated with food purchases and dietary intake overall and red meat intake in particular [61,62]. Separate regressions were conducted for health and environmental messages.…”