Socioeconomic disparities in diet quality in the French West Indies

Introduction and objective In the Caribbean context, high prevalence of obesity and chronic diseases coexist with high rate of poverty. Socioeconomic disparities in diet may be involved in social health inequalities. We therefore investigated the association between socioeconomic indicators and diet quality. Methods Dietary intakes were estimated from 24h dietary recalls in 1144 adults from the Kannari study, a cross-sectional survey based on a multistage stratified random sample of the Guadeloupean and Martican populations. Diet quality was assessed using the mPNNS-GS [maximum of 13.5 points], measuring adherence to French recommendations, and Diet Quality Index-International (DQI-I) [range 0 to 100 points], assessing several aspects of diet quality (variety, adequacy, moderation, overall balance). Associations between diet quality scores and socioeconomic indicators (education, employment status, social assistance benefits, single-parent household, presence of child in the household) were assessed using multivariate linear regression models, adjusted for area of residence (Martinique or Guadeloupe), age, sex and marital status. Results The mean mPNNS-GS was 8.3 points (range 4-11.5 points) and the mean DQI-I was 60.8 points (range 39-82 points). Compared with high educated subjects, no significant difference was found for mPNNS-GS in low educated individuals while middle educated participants had lower mPNNS-GS (8.0 (SEM:0.2) vs. 8.4 points (SEM:0.1); p=0.01). No association was found between DQI-I and education, however unemployed or never employed subjects had lower DQI-I compared with employed participants (60.7 (SEM:0.7) vs. 62.5 points (SEM:0.4); p=0.02). No association between employment status and mPNNS-GS was found. Conclusion Few socioeconomic differences in diet quality were found in the sample. However, our sample included low rates of disadvantaged participants and therefore new studies focusing on these subjects are necessary. Identifying sub-populations most at risk of having an unhealthy diet remains a main challenge in the Caribbean context, in order to help targeting nutrition and public health actions.