Inequalities in education and national income are associated with poorer diet: Pooled analysis of individual participant data across 12 European countries.

BACKGROUND: Malnutrition linked to noncommunicable diseases presents major health problems across Europe. The World Health Organisation encourages countries to conduct national dietary surveys to obtain data to inform public health policies designed to prevent noncommunicable diseases. METHODS: Data on 27334 participants aged 19-64y were harmonised and pooled across national dietary survey datasets from 12 countries across the WHO European Region. Weighted mean nutrient intakes were age-standardised using the Eurostat 2013 European Standard Population. Associations between country-level Gross Domestic Product (GDP) and key nutrients and nutrient densities were investigated using linear regression. The potential mitigating influence of participant-level educational status was explored. FINDINGS: Higher GDP was positively associated with total sugar intake (5·0% energy for each 10% increase in GDP, 95% CI 0·6, 9·3). Scandinavian countries had the highest vitamin D intakes. Participants with higher educational status had better nutritional intakes, particularly within lower GDP countries. A 10% higher GDP was associated with lower total fat intakes (-0·2% energy, 95% CI -0·3, -0·1) and higher daily total folate intakes (14µg, 95% CI 12, 16) in higher educated individuals. INTERPRETATION: Lower income countries and lower education groups had poorer diet, particularly for micronutrients. We demonstrate for the first time that higher educational status appeared to have a mitigating effect on poorer diet in lower income countries. It illustrates the feasibility and value of harmonising national dietary survey data to inform European policy regarding access to healthy diets, particularly in disadvantaged groups. It specifically highlights the need for strong policies supporting nutritional intakes, prioritising lower education groups and lower income countries.

Dimensions of socioeconomic position related to body mass index and obesity among Danish women and men.

AIMS: The aim of this study was to examine the association between different dimensions of socioeconomic position, body mass index (BMI) and obesity in the Danish population. Possible interactions between the different dimensions and gender differences were also investigated. METHODS: This was a cross-sectional survey conducted in 2000-2002 including a simple random sample from the civil registration system, comprising 1953 males and 2167 females aged 4-75 years. Information about different dimensions of socioeconomic position, height and weight was obtained by face-to-face interview. Associations between dimensions of socioeconomic position and weight status were examined by use of linear multiple regression analysis and logistic regression analysis. RESULTS: BMI and prevalence of obesity were significantly associated with education for both men and women. Odds ratios (ORs) for obesity were 2.9 (95% confidence interval (CI) 1.4-5.9) and 6.5 (95% CI 2.3-18.7) for those with basic school as compared with those with long higher education for men and women, respectively. Women outside the labour market had higher BMIs and a greater prevalence of obesity (OR 2.5 (95% CI 1.6-3.9)) after adjustment for educational level. CONCLUSIONS: Education was the dimension most consistently associated with BMI and obesity, indicating the importance of cultural capital for weight status. The gender-specific pattern showed a stronger social gradient for women, and indicated that a high relative body weight was associated with less favourable social and material conditions for women, but not for men. A public health strategy to prevent and reduce obesity should be gender-specific, focus on groups with short education, and incorporate cultural norms.

[Trends in dietary habits in Denmark and Sweden since the 1960s]. / Udviklingen i kostvaner i Danmark og Sverige siden 1960'erne.

Dietary habits in Denmark and Sweden are compared during the period 1965-1998 based on data from Food Balance Sheets. Common trends are an increase in consumption of vegetables, fruits, berries and meat and a decrease in consumption of fats. In the latest ten years percentage of energy from fat has also decreased. Denmark has a higher consumption of fats and meat and a lower consumption of fruits, berries and fish. These differences contribute to a higher percentage of energy from fat in the Danish diet compared to the Swedish. Data consequently indicate that dietary habits in Sweden are healthier than in Denmark. Differences in dietary habits may have contributed to differences in life expectancy between the countries. Disparities in dietary habits are seen in both countries. The tendency is greater social differences in Denmark.

Para-aminobenzoic acid used as a marker for completeness of 24 hour urine: assessment of control limits for a specific HPLC method.

OBJECTIVE AND DESIGN: The study comprised three protocols. Protocol 1 compared a HPLC method with the commonly employed colorimetric diazocoupling method. Protocol 2 examined, if the last dosage of p-aminobenzoic acid (PABA) could be advanced in the old to allow for a delayed age-dependent urinary excretion of PABA. Protocol 3 established limits for recovery of PABA in 24 h urine applying the HPLC method. SUBJECTS AND SETTING: A total of 151 healthy volunteers participated in the study of which 140 were accepted. In protocol 1: 37 subjects aged 20-78 y were included. All subjects took PABA as recommended (80 mg orally at 08.00, 12.00 and 18.00 h). Protocol 2: compared urinary PABA excretion in two groups of 80 y old subjects who had their last PABA dosage administered at 15.00 h (n = 16) and at 18.00 h (n = 31), respectively. Protocol 3: comprised 56 subjects aged 20-80 y. In the younger age group (20-59 y; n = 34) PABA was taken as recommended, whereas in the older age group (60-80 y; n = 22) the last PABA dosage was advanced three hours. RESULTS: Protocol 1: HPLC gave significantly lower PABA recovery results compared to colorimetry, the difference between methods being 23.9 +/- 8.5 mg/24 h (P < 0.001). Protocol 2: higher PABA recoveries were demonstrated with the advanced dosage schedule compared to the recommended schedule (208 +/- 14 mg/24 h vs 181 +/- 22 mg/24 h; P < 0.001). Protocol 3: PABA recovery with HPLC was 211 +/- 12 mg/24 h, and the lower limit comprising 95% of subjects was 187 mg/24 h. Similar PABA recoveries were demonstrated in the younger subjects and the older subjects (211 +/- 11 mg/24 h vs 211 +/- 13 mg/24 h; NS). CONCLUSION: An advanced dosage schedule for PABA in the aged is recommended. Because of lower recoveries with HPLC, the low limit for recovered PABA in a complete 24 h urine differs from the limit based on colorimetry. This study found a limit of 187 mg/24 h corresponding to the lower 95% confidence limit for a single subject.