Social inequalities shape diet composition among urban Colombians: the Colombian Nutritional Profiles cross-sectional study

Abstract

Abstract Objective: To explore the influence of socio-economic position (SEP) on habitual dietary intake in Colombian cities. Design: We conducted a cross-sectional, population-based study in five Colombian cities. Dietary intake was assessed with a 157-item semi-quantitative FFQ previously developed for the Colombian population. Nutrient analysis was performed using national and international food composition tables. SEP was assessed with two indicators: a government-defined, asset-based, household-level index called socio-economic stratum (SES) and, among adults, highest educational level attained. Setting: The five main urban centers of Colombia: Bogotá, Medellin, Barranquilla, Cali and Bucaramanga. Participants: Probabilistic, multi-stage sample of 1865 participants (n 1491 for analyses on education). Results: For both sexes, increasing SES was associated with a lower consumption of energy (P-trend <0·001 in both sexes), carbohydrates (P-trend <0·001 in both sexes), Na (P-trend = 0·005 in males, <0·001 in females), SFA (P-trend <0·001 in both sexes) and among females, cholesterol (P-trend = 0·002). More educated men consumed significantly less energy and carbohydrates (P-trend = 0·036 and <0·001, respectively). Among men, intake of trans fats increased monotonically with educational level, being 21 % higher among college graduates relative to those with only elementary education (P-trend = 0·023). Among women, higher educational level was associated with higher MUFA intake (P-trend = 0·027). Conclusions: SES and educational level are strong correlates of the usual diet of urban Colombians. Economically deprived and less educated segments of society display dietary habits that make them vulnerable to chronic diseases and should be the primary target of public health nutrition policies.