Socioeconomic differences in food habits among 6- to 9-year-old children from 23 countries-WHO European Childhood Obesity Surveillance Initiative (COSI 2015/2017)
Background: Socioeconomic differences in children's food habits are a key public health concern. In order to inform policy makers, cross-country surveillance studies of dietary patterns across socioeconomic groups are required. The purpose of this study was to examine associations between socioeconomic status (SES) and children's food habits.
Methods: The study was based on nationally representative data from children aged 6-9 years (n = 129,164) in 23 countries in the World Health Organization (WHO) European Region. Multivariate multilevel analyses were used to explore associations between children's food habits (consumption of fruit, vegetables, and sugar-containing soft drinks) and parental education, perceived family wealth and parental employment status.
Results: Overall, the present study suggests that unhealthy food habits are associated with lower SES, particularly as assessed by parental education and family perceived wealth, but not parental employment status. We found cross-national and regional variation in associations between SES and food habits and differences in the extent to which the respective indicators of SES were related to children's diet.
Conclusion: Socioeconomic differences in children's food habits exist in the majority of European and Asian countries examined in this study. The results are of relevance when addressing strategies, policy actions, and interventions targeting social inequalities in children's diets.The authors gratefully acknowledge support from a grant from the
Russian Government in the context of the WHO European Office for
the Prevention and Control of NCDs.
Data collection in the countries was made possible through
funding from Albania: WHO through the Joint Programme on
Children, Food Security and Nutrition “Reducing Malnutrition in
Children,” funded by the Millennium Development Goals Achievement Fund, and the Institute of Public Health; Bulgaria: Ministry of
Health, National Center of Public Health and Analyses, WHO
Regional Office for Europe; Croatia: Ministry of Health, Croatian
Institute of Public Health and WHO Regional Office for Europe;
Czechia: Ministry of Health of the Czech Republic, grant nr. AZV
MZČR 17-31670 A and MZČ–VO EÚ 00023761; Denmark: Danish
Ministry of Health; Georgia: WHO; Ireland: Health Service Executive; Italy: Ministry of Health and Italian National Institute of Health;
Kazakhstan: Ministry of Health of the Republic of Kazakhstan and
WHO Country Office; Kyrgyzstan: World Health Organization;
Latvia: Ministry of Health, Centre for Disease Prevention and
Control; Lithuania: Science Foundation of Lithuanian University of
Health Sciences and Lithuanian Science Council and WHO; Malta:
Ministry of Health; Montenegro: WHO and Institute of Public
Health of Montenegro; Norway: Ministry of Health and Norwegian
Institute of Public Health; Poland: National Health Programme, Ministry of Health; Portugal: Ministry of Health Institutions, the
National Institute of Health, Directorate General of Health, Regional
Health Directorates and the kind technical support from the
Center for Studies and Research on Social Dynamics and Health
(CEIDSS); Romania: Ministry of Health; Russian Federation: WHO;
San Marino: Health Ministry, Educational Ministry; Serbia: This
study was supported by the World Health Organization (Ref. File
2015-540940); Spain: Spanish Agency for Food Safety and Nutrition
(AESAN); Tajikistan: WHO Country Office in Tajikistan and Ministry of Health and Social Protection; Turkmenistan: WHO Country
Office in Turkmenistan and Ministry of Health; Turkey: Turkish Ministry of Health and World Bank.
The CO-CREATE project has received funding from the European
Union's Horizon 2020 research and innovation program under grant
agreement No. 774210.info:eu-repo/semantics/publishedVersio
