Socioeconomic inequalities in intakes of ultra-processed and minimally processed foods in nationally representative samples of adults in Canada: An analysis of trends between 2004 and 2015.

ABSTRACT

BACKGROUND: Individuals with a lower socioeconomic position (SEP) often have higher intakes of ultra-processed (UPF) and lower intakes of minimally processed foods (MPF); however, studies have not examined trends in absolute and relative gaps and gradients in UPF and MPF intake using multiple indicators of SEP. OBJECTIVE: We examined within-year absolute and relative gaps and gradients in UPF and MPF intake and trends between 2004 and 2015 according to six indicators of SEP among nationally representative samples of adults in Canada. METHODS: Adults (≥18 years) in the Canadian Community Health Survey-Nutrition 2004 (n=20,880) or 2015 (n=13,970) reported SEP (individual and household education, household income adequacy, household food insecurity, neighborhood material and social deprivation) and completed a 24-hour dietary recall. Multivariable linear regression assessed within-year absolute and relative gaps and gradients in the proportion of energy from UPF and MPF and trends between 2004 and 2015. RESULTS: The largest and most consistent within-year inequities in UPF and MPF intake were for individual and household educational attainment. Overall and among males, higher SEP groups had more favorable intakes over time based on trends in absolute and relative gaps and gradients in UPF and MPF intake by household food insecurity (e.g., the absolute gap in UPF intake declined from -1.2% [95%CI -5.3%, 2.9%] to -7.9% of energy [95%CI -11.2%, -4.5%] in the overall population). Overall and among males, lower SEP groups had more favorable intakes over time based on trends in absolute and relative gaps in UPF and MPF intake by neighborhood material deprivation. CONCLUSIONS: Socioeconomic inequalities in UPF and MPF intake were most pronounced for individual and household education. Between 2004 and 2015, several inequalities in UPF and MPF intake emerged according to household food insecurity (favoring higher SEP groups) and neighborhood material deprivation (favoring lower SEP groups).