Economic Inequality in Healthy and Junk Foods Consumption and its determinants in Children and Adolescents: the CASPIAN- IV Study

Authors

1 Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.

2 Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran AND Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

3 Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

4 Food and Nutrition Policy and Planning Research Department, National Nutrition & Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

5 Development of Research & Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran.

6 Department of Epidemiology and Biostatistics, Shahid Beheshti University of Medical Science, Tehran, Iran.

7 Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

8 Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.

9 Child Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Diseases, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Background: Nutritional habits and its determinants, especially in children and adolescents have recently turned into the one of the major concerns of health researches. We examine the diet contribution inequality in according to socio-demographic factors, age, gender, physical activity and body image to alleviate this gap in Iranian children and adolescents.
Materials and Methods: Study sample was comprised of 14,880 students aged 6-18 years who selected from urban and rural districts of 30 provinces of Iran via stratified multi-stage sampling method. A short food frequency questionnaire was used for estimating the food group consumption. The Blinder-Oaxaca method was applied to investigate the inequality in the prevalence of healthy and junk foods consumption between the first and fifth socio-economic status (SES) quintiles.
Results: The frequency of healthy and junk foods consumption showed considerable differences between the SES quintiles. The highest differences were found in the frequency of fresh fruit (25.38%), vegetable (12.92%), and milk (10.74%) consumption, respectively. The daily consumption of vegetables, and fresh and dried fruits increased linearly by increasing the SES quintiles. The highest absolute difference was seen in the frequency of fresh fruit consumption between the bottom and top of the socioeconomic groups (SII value=-32%).  The estimated SII was statistically significant for the consumption of all healthy and junk foods except for fast foods and milk consumption. The estimated C index for consumption of healthy and junk foods was positive and negative, respectively.
Conclusion: This study provides the considerable information on the consumption of healthy and junk foods and its determinants among Iranian children and adolescents for better programming, developing health policies, and future complementary analyses.

Keywords