Sociodemographic, health and lifestyle predictors of poor diets (original) (raw)

Objective: Poor-quality diet, regarded as an important contributor to health inequalities, is linked to adverse health outcomes. We investigated sociodemographic and lifestyle predictors of poor-quality diet in a population sample. Design: A cross-sectional analysis of the Survey of Lifestyle, Attitudes and Nutrition (SLÁ N). Diet was assessed using an FFQ (n 9223, response rate 5 89 %), from which a dietary score (the DASH (Dietary Approaches to Stop Hypertension) score) was constructed. Setting: General population of the Republic of Ireland. Subjects: The SLÁ N survey is a two-stage clustered sample of 10 364 individuals aged 18 years. Results: Adjusting for age and gender, a number of sociodemographic, lifestyle and health-related variables were associated with poor-quality diet: social class, education, marital status, social support, food poverty (FP), smoking status, alcohol consumption, underweight and self-perceived general health. These associations persisted when adjusted for age, gender and social class. They were not significantly altered in the multivariate analysis, although the association with social support was attenuated and that with FP was borderline significant (OR 5 1?2, 95 % CI 1?03, 1?45). A classical U-shaped relationship between alcohol consumption and dietary quality was observed. Dietary quality was associated with social class, educational attainment, FP and related core determinants of health. Conclusions: The extent to which social inequalities in health can be explained by socially determined differences in dietary intake is probably underestimated. The use of composite dietary quality scores such as the DASH score to address the issue of confounding by diet in the relationship between alcohol consumption and health merits further study. Keywords Dietary quality DASH score Dietary inequalities Diets are not consumed in isolation but are the product of a complex interplay between individuals' economic circumstances (1-3) , their social networks (4) and cultural beliefs (4,5) against the backdrop of both their individual (6,7) and global environments (8) and broader lifestyle behaviours (9-11). The impact of poor dietary habits on health outcomes is an important focus of contemporary health promotion strategies. It is recognised that the social determinants of dietary behaviour are multifaceted. Research that clarifies the determinants of dietary behaviour should help us target health promotion initiatives more effectively. Many indices have been developed over the past decades to assess dietary quality within specific populations on the basis of national dietary guidelines (12-14). Recently, the Dietary Approaches to Stop Hypertension (DASH) score was developed to assess adherence to the 'DASH eating plan', which has been successfully shown to substantially reduce blood pressure among hypertensive and normotensive adults (12) and reduce LDL cholesterol levels (15). Adherence to a DASH-style diet has also been associated with a lower risk of CHD and stroke, particularly among middle-aged women over a 24-year period (12) , highlighting the potential long-term benefits of the DASH diet in preventing CVD and other chronic diseases among healthy adults. Using a DASH score as an index of dietary quality, we examined the sociodemographic predictors of a poorquality diet with reference to social indicators (social support, food poverty (FP) and self-perceived area deprivation), lifestyle behaviours (smoking status and alcohol consumption) and health outcomes (BMI and pre-existing diabetes).