Healthy eating: a privilege for the better-off?

Area of Science:

• Nutrition Science
• Public Health Policy
• Socioeconomic Determinants of Health

Background:

• Fiscal policies, such as food subsidies and taxes, are increasingly used to promote healthier diets.
• Concerns exist that taxes on unhealthy foods may disproportionately affect lower-income populations, raising equity issues.
• This study investigates the relationship between income and the consumption of key food groups in the Portuguese adult population.

Purpose of the Study:

• To estimate the association between household income and the consumption of Mediterranean diet-related foods (fish, vegetables, fruits, legumes).
• To examine the association between income and the consumption of non-Mediterranean diet foods (sweets, sugar-sweetened beverages, cakes, processed meats).
• To explore potential equity implications of fiscal policies on healthy and unhealthy food consumption across different income levels.

Main Methods:

• Utilized data from the Portuguese National Food, Nutrition and Physical Activity Survey (IAN-AF 2015-2016) with 3242 adult participants (18-79 years).
• Employed logistic regression models to assess the link between income categories and consumption of specific food groups.
• Conducted stratified analyses by education and age to provide nuanced insights into consumption patterns.

Main Results:

• Positive associations were observed between income and the consumption of fish, vegetables, and fruits, with a notable income gradient for vegetables and fruits.
• The positive income-consumption link for fish was primarily seen in low-educated individuals, while legumes showed this link in high-educated individuals and youth.
• Consumption of most unhealthy foods (sweets, cakes) was not positively associated with income, with some exceptions showing higher prevalence among higher-income groups.

Conclusions:

• Healthy food consumption is generally positively associated with income, unlike unhealthy food intake.
• Subsidies for healthy foods could improve access for lower-income populations.
• Taxing unhealthy foods may not impose a disproportionate financial burden on disadvantaged groups, supporting their potential use in public health strategies.