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Cambridge University Press, British Journal of Nutrition, 9(114), p. 1464-1470, 2015

DOI: 10.1017/s0007114515003025

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Does the importance of dietary costs for fruit and vegetable intake vary by socioeconomic position?

This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

This is the accepted manuscript of a paper that will be published in the British Journal of Nutrition. It is currently under an indefinite embargo. ; Evidence suggests that diets meeting recommendations for fruit and vegetable (F&V) intake are more costly. Dietary costs may be a greater constraint on the diet quality of people of lower socioeconomic position (SEP). The aim of this study was to examine whether dietary costs are more strongly associated with F&V intake in lower-SEP groups than in higher-SEP groups. Data on individual participants? education and income was available from a population based, cross-sectional study of 10,020 British adults. F&V intake and dietary costs (GBP/day) were derived from a semi-quantitative Food Frequency Questionnaire. Dietary cost estimates were based on UK food prices. General linear models were used to assess associations between SEP, quartiles of dietary costs, and F&V intake. Effect modification of SEP gradients by dietary costs was examined with interaction terms. Analysis demonstrated that individuals with lowest quartile dietary costs, low income and low education consumed less F&V than individuals with higher dietary costs, high income or education. Significant interaction between SEP and dietary costs indicated that the association between dietary costs and F&V intake was stronger for less-educated and lower income groups. That is, socioeconomic differences in F&V intake were magnified among individuals who consumed lowest-cost diets. Such amplification of socioeconomic inequalities in diet among those consuming low-cost diets indicates the need to address food costs in strategies to promote healthy diets. Additionally, the absence of socioeconomic inequalities for individuals with high dietary costs suggests that high dietary costs can compensate for lack of other material, or psychosocial resources. ; This work was undertaken by the Centre for Diet and Activity Research, a UK Clinical Research Collaboration Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, National Institute for Health Research, and Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. Core MRC Epidemiology Unit support through programmes MC_UU_12015/1 and MC_UU_12015/5 is acknowledged. Funders had no role in the design, conduct, analysis, interpretation or publication of the manuscript.