Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
Int J Behav Nutr Phys Act. 2018 Apr 2;15(1):30. doi: 10.1186/s12966-018-0666-4.
Increasing inequalities in rates of obesity and chronic disease may be partly fuelled by increasing dietary inequalities, however very few nationally representative analyses of socioeconomic trends in dietary inequalities exist. The release of the 2011-13 Australian National Nutrition and Physical Activity Survey data allows investigation of change in dietary intake according to socioeconomic position (SEP) in Australia using a large, nationally representative sample, compared to the previous national survey in 1995. This study examined change in dietary intakes of energy, macronutrients, fiber, fruits and vegetables among Australian adults between 1995 and 2011-13, according to SEP.
Cross-sectional data were obtained from the 1995 National Nutrition Survey, and the 2011-13 National Nutrition and Physical Activity Survey. Dietary intake data were collected via a 24-h dietary recall (n = 17,484 adults) and a dietary questionnaire (n = 15,287 adults). SEP was assessed according to educational level, equivalized household income, and area-level disadvantage. Survey-weighted linear and logistic regression models, adjusted for age, sex/gender and smoking status, examined change in dietary intakes over time.
Dietary intakes remained poor across the SEP spectrum in both surveys, as evidenced by high consumption of saturated fat and total sugars, and low fiber, fruit and vegetable intakes. There was consistent evidence (i.e. according to ≥2 SEP measures) of more favorable changes in dietary intakes of carbohydrate, polyunsaturated and monounsaturated fat in higher, relative to lower SEP groups, particularly in women. Intakes of energy, total fat, saturated fat and fruit differed over time according to a single SEP measure (i.e. educational level, household income, or area-level disadvantage). There were no changes in intake of total sugars, protein, fiber or vegetables according to any SEP measures.
There were few changes in dietary intakes of energy, most macronutrients, fiber, fruits and vegetables in Australian adults between 1995 and 2011-13 according to SEP. For carbohydrate, polyunsaturated and monounsaturated fat, more favorable changes in intakes occurred in higher SEP groups. Despite the persistence of suboptimal dietary intakes, limited evidence of widening dietary inequalities is positive from a public health perspective.
Clinical trials registration: ACTRN12617001045303 .
肥胖率和慢性病的不平等现象日益加剧，这在一定程度上是由于饮食不平等现象日益加剧所致，然而，关于社会经济地位（SEP）与饮食不平等之间的关系，很少有全国性的代表性分析。2011-13 年澳大利亚国家营养与身体活动调查数据的发布，使得我们能够使用大量的全国代表性样本，来研究澳大利亚社会经济地位与饮食之间的变化，而这与 1995 年的上一次全国调查相比则更为先进。本研究根据 SEP，调查了澳大利亚成年人的能量、宏量营养素、纤维、水果和蔬菜的饮食摄入量随时间的变化。
本研究使用 1995 年全国营养调查和 2011-13 年全国营养与身体活动调查的横断面数据。通过 24 小时膳食回顾（17484 名成年人）和膳食问卷（15287 名成年人）收集膳食摄入数据。根据教育程度、家庭收入均等化和地区劣势来评估 SEP。调整年龄、性别/性别和吸烟状况后，使用调查加权线性和逻辑回归模型来检查随时间的饮食摄入量变化。
在两次调查中，整个 SEP 范围内的饮食摄入量仍然很差，这表现为饱和脂肪和总糖的摄入量很高，而纤维、水果和蔬菜的摄入量很低。有充分的证据表明（即根据≥2 个 SEP 措施），在较高的 SEP 组中，碳水化合物、多不饱和脂肪和单不饱和脂肪的饮食摄入有更有利的变化，而在较低的 SEP 组中则没有，这种情况尤其在女性中更为明显。能量、总脂肪、饱和脂肪和水果的摄入量随时间变化，根据单一 SEP 措施（即教育程度、家庭收入或地区劣势）而有所不同。根据任何 SEP 措施，总糖、蛋白质、纤维或蔬菜的摄入量均无变化。
根据 SEP，1995 年至 2011-13 年间，澳大利亚成年人的能量、大多数宏量营养素、纤维、水果和蔬菜的饮食摄入量几乎没有变化。对于碳水化合物、多不饱和脂肪和单不饱和脂肪，高 SEP 组的摄入量有更有利的变化。尽管饮食摄入仍然不理想，但从公共卫生的角度来看，饮食不平等现象日益加剧的证据有限，这是积极的。
临床试验注册：ACTRN12617001045303 。
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