Socioeconomic disparities in diet quality in the French West Indies
2018
Colombet, Zoé | Perignon, Marlène | Salanave, Benoît | Landais, Edwige | Martin-Prével, Yves | Allès, Benjamin | Drogue, Sophie | Amiot-Carlin, Marie Josephe | Méjean, Caroline | Marchés, Organisations, Institutions et Stratégies d'Acteurs (UMR MOISA) ; Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut National de la Recherche Agronomique (INRA)-Centre international d'études supérieures en sciences agronomiques (Montpellier SupAgro)-Centre International de Hautes Etudes Agronomiques Méditerranéennes - Institut Agronomique Méditerranéen de Montpellier (CIHEAM-IAMM) ; Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro) | Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro) | Santé publique France - French National Public Health Agency [Saint-Maurice, France] | Institut de Recherche pour le Développement (IRD) | Nutrition et Alimentation des Populations aux Suds (NutriPass) ; Université Montpellier 1 (UM1)-Institut de Recherche pour le Développement (IRD)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université de Montpellier (UM)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro) | Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)) ; Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM) | Equipe 3: EREN- Equipe de Recherche en Epidémiologie Nutritionnelle (CRESS - U1153) ; Université Paris 13 (UP13)-Institut National de la Recherche Agronomique (INRA)-Conservatoire National des Arts et Métiers [Cnam] (Cnam)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)) ; Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM) | Agence Pour la Recherche et l'Information en Fruits et Légumes (APRIFEL). FRA.
Introduction and objectiveIn the Caribbean context, high prevalence of obesity and chronic diseases coexist with high rate of poverty. Socioeconomic disparities in diet may be involved in social health inequalities. We therefore investigated the association between socioeconomic indicators and diet quality.MethodsDietary intakes were estimated from 24h dietary recalls in 1144 adults from the Kannari study, a cross-sectional survey based on a multistage stratified random sample of the Guadeloupean and Martican populations. Diet quality was assessed using the mPNNS-GS [maximum of 13.5 points], measuring adherence to French recommendations, and Diet Quality Index-International (DQI-I) [range 0 to 100 points], assessing several aspects of diet quality (variety, adequacy, moderation, overall balance). Associations between diet quality scores and socioeconomic indicators (education, employment status, social assistance benefits, single-parent household, presence of child in the household) were assessed using multivariate linear regression models, adjusted for area of residence (Martinique or Guadeloupe), age, sex and marital status.ResultsThe mean mPNNS-GS was 8.3 points (range 4-11.5 points) and the mean DQI-I was 60.8 points (range 39-82 points). Compared with high educated subjects, no significant difference was found for mPNNS-GS in low educated individuals while middle educated participants had lower mPNNS-GS (8.0 (SEM:0.2) vs. 8.4 points (SEM:0.1); p=0.01). No association was found between DQI-I and education, however unemployed or never employed subjects had lower DQI-I compared with employed participants (60.7 (SEM:0.7) vs. 62.5 points (SEM:0.4); p=0.02). No association between employment status and mPNNS-GS was found.ConclusionFew socioeconomic differences in diet quality were found in the sample. However, our sample included low rates of disadvantaged participants and therefore new studies focusing on these subjects are necessary. Identifying sub-populations most at risk of having an unhealthy diet remains a main challenge in the Caribbean context, in order to help targeting nutrition and public health actions.
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