Highlights
- •In our Dutch elderly cohort, a high level of education was the most pronounced socio-economic indicator of high diet quality at baseline and at 20-year follow-up.
- •Higher income was associated with lower diet quality at follow-up.
- •Occupational status was not associated with diet quality at baseline or at follow-up.
- •Different socio-economic factors influence diet quality in different ways.
Abstract
Purpose
To examine the strength and independence of associations between three major socio-economic
indicators (income, education and occupation) and diet quality (DQ) at baseline and
after 20-year follow-up.
Methods
Cross-sectional and longitudinal analyses using data collected in the Rotterdam Study,
a prospective population-based cohort. Participants were categorised according to
socio-economic indicators (education, occupation and household income) measured at
baseline (1989–1993). Participants aged 55 years or older were included (n = 5434). DQ was assessed at baseline (1989–1993) and after 20 years (2009–2011) and
quantified using the Dutch Healthy Diet Index, reflecting adherence to the Dutch guidelines
for a healthy diet; scores can range from 0 (no adherence) to 80 (optimal adherence).
Linear regression models were adjusted for sex, age, smoking status, BMI, physical
activity level, total energy intake and mutually adjusted for the other socio-economic
indicators.
Results
At baseline, scores on the Dutch Healthy Diet Index were 2.29 points higher for participants
with the highest level of education than for those with the lowest level (95%CI = 1.23–3.36); in addition, they were more likely to have a higher DQ at follow-up (β = 3.10, 95%CI = 0.71–5.50), after adjustment for baseline DQ. In contrast, higher income was associated
with lower DQ at follow-up (β = −1.92, 95%CI = −3.67, −0.17), whereas occupational status was not associated with DQ at baseline
or at follow-up.
Conclusion
In our cohort of Dutch participants, a high level of education was the most pronounced
socio-economic indicator of high DQ at baseline and at follow-up. Our results highlight
that different socio-economic indicators influence DQ in different ways.
Keywords
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Article info
Publication history
Published online: October 14, 2017
Accepted:
October 13,
2017
Received in revised form:
October 2,
2017
Received:
July 30,
2017
Identification
Copyright
© 2017 Published by Elsevier Ireland Ltd.
