Socioeconomic Indicators Are Independently Associated with Nutrient Intake in French Adults: A DEDIPAC Study

Studies have suggested differential associations of specific indicators of socioeconomic position (SEP) with nutrient intake and a cumulative effect of these indicators on diet. We investigated the independent association of SEP indicators (education, income, occupation) with nutrient intake and their effect modification. This cross-sectional analysis included 91,900 French adults from the NutriNet-Santé cohort. Nutrient intake was estimated using three 24-h records. We investigated associations between the three SEP factors and nutrient intake using sex-stratified analysis of covariance, adjusted for age and energy intake, and associations between income and nutrient intake stratified by education and occupation. Low educated participants had higher protein and cholesterol intakes and lower fibre, vitamin C and beta-carotene intakes. Low income individuals had higher complex carbohydrate intakes, and lower magnesium, potassium, folate and vitamin C intakes. Intakes of vitamin D and alcohol were lower in low occupation individuals. Higher income was associated with higher intakes of fibre, protein, magnesium, potassium, beta-carotene, and folate among low educated persons only, highlighting effect modification. Lower SEP, particularly low education, was associated with lower intakes of nutrients required for a healthy diet. Each SEP indicator was associated with specific differences in nutrient intake suggesting that they underpin different social processes

Social disparities in food preparation behaviours: a DEDIPAC study

BACKGROUND: The specific role of major socio-economic indicators in influencing food preparation behaviours could reveal distinct socio-economic patterns, thus enabling mechanisms to be understood that contribute to social inequalities in health. This study investigated whether there was an independent association of each socio-economic indicator (education, occupation, income) with food preparation behaviours. METHODS: A total of 62,373 adults participating in the web-based NutriNet-Santé cohort study were included in our cross-sectional analyses. Cooking skills, preparation from scratch and kitchen equipment were assessed using a 0-10-point score; frequency of meal preparation, enjoyment of cooking and willingness to cook better/more frequently were categorical variables. Independent associations between socio-economic factors (education, income and occupation) and food preparation behaviours were assessed using analysis of covariance and logistic regression models stratified by sex. The models simultaneously included the three socio-economic indicators, adjusting for age, household composition and whether or not they were the main cook in the household. RESULTS: Participants with the lowest education, the lowest income group and female manual and office workers spent more time preparing food daily than participants with the highest education, those with the highest income and managerial staff (P < 0.0001). The lowest educated individuals were more likely to be non-cooks than those with the highest education level (Women: OR = 3.36 (1.69;6.69); Men: OR = 1.83 (1.07;3.16)) while female manual and office workers and the never-employed were less likely to be non-cooks (OR = 0.52 (0.28;0.97); OR = 0.30 (0.11;0.77)). Female manual and office workers had lower scores of preparation from scratch and were less likely to want to cook more frequently than managerial staff (P < 0.001 and P < 0.001). Women belonging to the lowest income group had a lower score of kitchen equipment (P < 0.0001) and were less likely to enjoy cooking meal daily (OR = 0.68 (0.45;0.86)) than those with the highest income. CONCLUSION: Lowest socio-economic groups, particularly women, spend more time preparing food than high socioeconomic groups. However, female manual and office workers used less raw or fresh ingredients to prepare meals than managerial staff. In the unfavourable context in France with reduced time spent preparing meals over last decades, our findings showed socioeconomic disparities in food preparation behaviours in women, whereas few differences were observed in men

Associations Between Socioeconomic Indicators, Life Events and Dietary Behaviours in French Adults

Aujourd’hui, de fortes inégalités sociales de santé persistent entre les individus les plus favorisés socio-économiquement et ceux vivants dans des situations moins favorables, et l’alimentation y contribue fortement. Bien que les disparités sociales de nutrition soient bien documentées, notamment en ce qui concerne le niveau d’études, les connaissances relatives à l’influence indépendante des différents indicateurs socio-économiques sur l’alimentation et notamment ses dimensions comportementales sont insuffisantes. Par ailleurs, les mécanismes sous-jacents des disparités en nutrition sont encore mal compris. Parmi les déterminants individuels, nous manquons de connaissances sur l’influence du parcours de vie des individus sur leurs comportements alimentaires. Dans ce contexte, les objectifs de cette thèse étaient d’analyser les associations entre les facteurs socio-économiques et les comportements alimentaires, abordés sous différentes dimensions : apports en nutriments, prise des repas principaux, et pratiques de snacking (i.e. prises alimentaires différentes des repas principaux). Il s’agissait également d’évaluer l’influence d’événements de vie professionnels sur les comportements alimentaires. Les résultats montrent que les individus ayant la position socio-économique (PSE) la plus favorisée ont des apports plus élevés en nutriments recommandés (fibre, vitamine C, B9, magnésium, etc.). Le niveau d’éducation semble être un déterminant majeur des apports nutritionnels et modifie les associations entre revenus et apports en nutriments. Bien que les individus de PSE moins favorisée soient moins susceptibles d’avoir des prises de snacking, la qualité nutritionnelle de ces prises est moindre. Par ailleurs, le passage à la retraite est associé à des apports alimentaires moins favorables à la santé (qualité globale, lipides, sodium, acides gras saturés…), en particulier chez les hommes ayant les plus bas revenus avant la retraite (diminution de l’apport en produits laitiers et augmentation de l’apport en lipides). L’ensemble de ces résultats soulignent l’importance des déterminants socio-économiques ainsi que des événements de vie professionnels sur les comportements alimentaires et la nécessité de mieux adapter les politiques nutritionnelles de santé en fonction des sous-groupes de la population et des périodes et événements de la vie.Strong health inequalities remain between socio-economically advantaged individuals and those of lower socioeconomic position. Diet appears to be an important modifiable factor, which contributes to health inequalities. Although social disparities in nutrition have been well documented, the independent influences of the different socioeconomic indicators on diet – in particular its behavioural dimensions – have not been deeply investigated. In addition, the pathways underlying these disparities are still poorly understood. Among individual determinants, there is a lack of knowledge regarding effects of life course on dietary behaviours.The objective of this Ph.D. thesis was to investigate the associations between socioeconomic factors and dietary behaviours, expressed in terms of nutrient intakes and snacking practices. The influence of occupational life events on dietary behaviours was also assessed.The results showed that individuals with high socioeconomic position (PSE) had higher intakes of recommended nutrients (fibre, vitamin C, folate, magnesium, etc.). Education appears to be a major determinant of dietary intakes and modifies the associations between income and dietary intakes. Although individuals with low socioeconomic position are less likely to snack, the nutritional quality of their snacks is lower. Moreover, retirement was associated with unhealthier dietary intakes (overall diet quality, lipids, sodium, saturated fatty acids,...), particularly in men with the lowest income before retirement (decrease in intake of dairy products and increase in intake of lipids).The results underline the importance of socioeconomic determinants and life events on dietary behaviours. The identification of life periods and events leading to changes in dietary behaviours enables on one hand to improve knowledge regarding pathways underlying socioeconomic inequalities in health related to nutrient and food intake, and on the other hand to determine target populations for interventions. Adapting nutritional public interventions among social subgroups of the population and throughout the entire life is key to improve dietary behaviours

Impact du passage à la retraite sur les consommations alimentaires des adultes français (Etude Nutrinet-Santé)

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Associations between transition to retirement and changes in dietary intakes in French adults (NutriNet-Santé cohort study)

Background:Few studies have focused on the influence of retirement on dietary behaviors. Our study aimed at assessing the associations between transition to retirement and changes in dietary intake in French adults, particularly according to spousal retirement and baseline income.Methods:This prospective study included 577 French participants from the NutriNet-Santé cohort who retired over a 5-year follow-up (2009-2014 or 2010-2015). At baseline and every year, dietary intakes were assessed using 24 h records. Repeated measures of dietary intake were analysed using mixed models adjusted for energy with random effects of time and period (before and after retirement) to assess changes following retirement for each gender.Results:After retirement, intakes of saturated fatty acids and sodium increased in both genders. Women showed specific changes after retirement: decrease in the score of adherence to recommendations and in intakes of fruits, proteins, vitamins; increase in intakes of fatty sweet products. In men with the lowest income at baseline, specific changes in intake were associated with retirement such as decrease in intake of dairy products and increase in intake of lipids.Conclusions:Transition to retirement was associated with unhealthier dietary intakes. These results may help defining interventions during this vulnerable life-period.Trial registration:This study was conducted according to guidelines laid down in the Declaration of Helsinki and all procedures were approved by the Institutional Review Board of the French Institute for Health and Medical Research (IRB Inserm No. 0000388FWA00005831) and the French Data Protection Authority (Commission Nationale Informatique et Libertés No. 908450 and No. 909216). Electronic informed consents were obtained from all participants

Impact du passage à la retraite sur les consommations alimentaires des adultes français (Etude Nutrinet-Santé)

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Fréquence et contenu nutritionnel des prises alimentaires hors repas chez les adultes français (Etude Nutrinet-Santé)

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Contribution des parcours de vie aux inégalités sociales des comportements alimentaires des adultes vivant en France

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