Ball Kylie, Lamb Karen E, Costa Claudia, Cutumisu Nicoleta, Ellaway Anne, Kamphuis Carlijn B M, Mentz Graciela, Pearce Jamie, Santana Paula, Santos Rita, Schulz Amy J, Spence John C, Thornton Lukar E, van Lenthe Frank J, Zenk Shannon N
Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Melbourne, VIC, 3125, Australia.
Centre of Studies on Geography and Spatial Planning (CEGOT), University of Coimbra, Coimbra, Portugal.
Int J Behav Nutr Phys Act. 2015 May 22;12:68. doi: 10.1186/s12966-015-0229-x.
Low fruit and vegetable consumption is a risk factor for poor health. Studies have shown consumption varies across neighbourhoods, with lower intakes in disadvantaged neighbourhoods. However, findings are inconsistent, suggesting that socio-spatial inequities in diet could be context-specific, highlighting a need for international comparisons across contexts. This study examined variations in fruit and vegetable consumption among adults from neighbourhoods of varying socioeconomic status (SES) across seven countries (Australia, Canada, Netherlands, New Zealand, Portugal, Scotland, US).
Data from seven existing studies, identified through literature searches and knowledge of co-authors, which collected measures of both neighbourhood-level SES and fruit and vegetable consumption were used. Logistic regression was used to examine associations between neighbourhood-level SES and binary fruit and vegetable consumption separately, adjusting for neighbourhood clustering and age, gender and education. As much as possible, variables were treated in a consistent manner in the analysis for each study to allow the identification of patterns of association within study and to examine differences in the associations across studies.
Adjusted analyses showed evidence of an association between neighbourhood-level SES and fruit consumption in Canada, New Zealand and Scotland, with increased odds of greater fruit intake in higher SES neighbourhoods. In Australia, Canada, New Zealand and Portugal, those residing in higher SES neighbourhoods had increased odds of greater vegetable intake. The other studies showed no evidence of a difference by neighbourhood-level SES.
Acknowledging discrepancies across studies in terms of sampling, measures, and definitions of neighbourhoods, this opportunistic study, which treated data in a consistent manner, suggests that associations between diet and neighbourhood-level socioeconomic status vary across countries. Neighbourhood socioeconomic disadvantage may differentially impact on access to resources in which produce is available in different countries. Neighbourhood environments have the potential to influence behaviour and further research is required to examine the context in which these associations arise.
水果和蔬菜摄入量低是健康状况不佳的一个风险因素。研究表明，不同社区的摄入量存在差异，贫困社区的摄入量较低。然而，研究结果并不一致，这表明饮食方面的社会空间不平等可能因具体情况而异，凸显了进行跨背景国际比较的必要性。本研究调查了七个国家（澳大利亚、加拿大、荷兰、新西兰、葡萄牙、苏格兰、美国）不同社会经济地位（SES）社区的成年人在水果和蔬菜消费方面的差异。
使用通过文献检索和共同作者的知识确定的七项现有研究的数据，这些研究收集了社区层面的SES以及水果和蔬菜消费的测量数据。使用逻辑回归分别检验社区层面的SES与二元水果和蔬菜消费之间的关联，并对社区聚类以及年龄、性别和教育进行调整。在每项研究的分析中，尽可能以一致的方式处理变量，以便识别研究中的关联模式并检查不同研究之间关联的差异。
调整后的分析表明，在加拿大、新西兰和苏格兰，社区层面的SES与水果消费之间存在关联，SES较高的社区水果摄入量增加的几率更高。在澳大利亚、加拿大、新西兰和葡萄牙，居住在SES较高社区的人蔬菜摄入量增加的几率更高。其他研究没有显示出社区层面的SES存在差异的证据。
鉴于各项研究在抽样、测量和社区定义方面存在差异，这项以一致方式处理数据的机会性研究表明，饮食与社区层面社会经济地位之间的关联在不同国家有所不同。社区社会经济劣势可能对不同国家获取有农产品的资源产生不同影响。社区环境有可能影响行为，需要进一步研究以考察这些关联产生的背景。
