Ricciuto Laurie E, Tarasuk Valerie S
Nutritional Sciences, University of Toronto, Fitzgerald Building, 150 College Street, Toronto, Ont., Canada M5S 3E2.
Soc Sci Med. 2007 Jan;64(1):186-98. doi: 10.1016/j.socscimed.2006.08.020. Epub 2006 Oct 6.
Socio-economic disparities in nutrition have been documented in numerous countries, and have been linked to health inequalities. Social and economic policy changes occurring over the last several years have resulted in growing levels of income inequality in many countries. However, the extent to which these temporal changes have affected nutrition disparities is largely unknown. Our research examined income-related disparities in the nutritional quality of food selections among Canadian households from 1986 to 2001. Data from the 1986, 1992, 1996 and 2001 Family Food Expenditure surveys were pooled together (n=35048). The relationships between household income and the nutritional quality of food purchases (considering nutrients both as absolute amounts and adjusted for energy, and total energy density) were estimated using general linear models, including tests of significance for differences across the survey years. Results revealed significant positive relationships between income and most nutrients, which persisted over time, and for some nutrients grew stronger. One exception was folate, where the positive relationship between income and folate (independent of energy) was no longer apparent in 2001; this could be attributed to the mandatory fortification of some cereal grain products with folic acid, which came into effect in 1998, resulting in greater availability of folate from grain products. There was also a significant negative relationship between income and total energy density (ratio of food energy to food weight), which persisted across the survey years. At a time of growing income inequality and worsening problems of poverty, food policy makers need to pay attention to the potential for policy interventions to exacerbate or improve nutrition disparities.
许多国家都记录了营养方面的社会经济差异，并且这些差异与健康不平等现象相关联。过去几年发生的社会和经济政策变化导致许多国家的收入不平等程度不断加剧。然而，这些时间上的变化在多大程度上影响了营养差异，目前尚不清楚。我们的研究调查了1986年至2001年加拿大家庭在食物选择营养质量方面与收入相关的差异。将1986年、1992年、1996年和2001年家庭食物支出调查的数据汇总在一起（n = 35048）。使用一般线性模型估计家庭收入与购买食物的营养质量之间的关系（将营养素既视为绝对量，又根据能量和总能量密度进行调整），包括对各调查年份差异的显著性检验。结果显示，收入与大多数营养素之间存在显著的正相关关系，这种关系随着时间的推移持续存在，并且对于某些营养素来说变得更强。一个例外是叶酸，2001年时收入与叶酸（与能量无关）之间的正相关关系不再明显；这可能归因于1998年生效的一些谷物产品强制添加叶酸，导致谷物产品中叶酸的可获得性增加。收入与总能量密度（食物能量与食物重量的比率）之间也存在显著的负相关关系，在整个调查年份中持续存在。在收入不平等加剧和贫困问题恶化的时期，食品政策制定者需要关注政策干预可能加剧或改善营养差异的可能性。
