Yu Yan, Cao Na, He Anqi, Jiang Junfeng
Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Hubei Clinical Research Center for Infectious Diseases, Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan, China.
School of Public Health, Wuhan University, Wuhan, China.
Front Nutr. 2022 Oct 20;9:1020364. doi: 10.3389/fnut.2022.1020364. eCollection 2022.
The association between socioeconomic status (SES) and dietary diversity score (DDS) has been widely discussed, but little is known about the age and cohort effects on DDS and how the SES effect on DDS varies with age and across successive cohorts among urban and rural older adults in China. Thus, this study aimed to examine the temporal change in DDS among Chinese older adults and SES heterogeneities in such change from the perspective of urban-rural differentiation. Data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) between 2002 and 2018 were used, and a total of 13,728 participants aged between 65 and 105 years were included in this study. A total of eight food groups were used to assess DDS, while education, family income, and perceived income status were used to assess SES. A linear mixed model was used to estimate the age and cohort effects on DDS and their urban-rural and SES disparities. The results show that higher SES, including more education, family income, and perceived income status, was associated with higher DDS (for urban older adults, β = 0.1645, = 0.0003, β = 0.2638, < 0.0001, β = 0.2917, < 0.0001, respectively; for rural older adults, β = 0.0932, = 0.0080, β = 0.4063, < 0.0001, β = 0.2921, < 0.0001, respectively). The DDS of older adults increased with age and across successive cohorts in both urban and rural China. Moreover, we found the three-way interaction effect of SES, age, and cohort was statistically significant in both urban and rural China. Thus, living in an urban area and having higher SES are associated with higher DDS, but these associations change with age and across successive cohorts. The dietary health of earlier cohorts and rural oldest-old in China deserves more attention.
社会经济地位（SES）与饮食多样性得分（DDS）之间的关联已被广泛讨论，但对于年龄和队列对DDS的影响，以及在中国城乡老年人中SES对DDS的影响如何随年龄和不同连续队列而变化，人们知之甚少。因此，本研究旨在从城乡差异的角度，考察中国老年人DDS的时间变化以及这种变化中的SES异质性。使用了2002年至2018年中国老年健康长寿纵向调查（CLHLS）的数据，本研究共纳入了13728名年龄在65岁至105岁之间的参与者。总共使用八个食物组来评估DDS，同时使用教育程度、家庭收入和感知收入状况来评估SES。采用线性混合模型来估计年龄和队列对DDS的影响及其城乡和SES差异。结果表明，较高的SES，包括更多的教育程度、家庭收入和感知收入状况，与较高的DDS相关（对于城市老年人，β分别为0.1645，P = 0.0003；β为0.2638，P < 0.0001；β为0.2917，P < 0.0001；对于农村老年人，β分别为0.0932，P = 0.0080；β为0.4063，P < 0.0001；β为0.2921，P < 0.0001）。在中国城乡，老年人的DDS均随年龄增长和不同连续队列而增加。此外，我们发现SES、年龄和队列的三向交互作用在中国城乡均具有统计学意义。因此，居住在城市地区且具有较高的SES与较高的DDS相关，但这些关联会随年龄和不同连续队列而变化。中国早期队列和农村高龄老人的饮食健康值得更多关注。
