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Education moderates the association between supermarket environment and diet

Education moderates the association between supermarket environment and diet
Education moderates the association between supermarket environment and diet
Introduction
Supermarkets are a major source of food for many families. Knowledge of how educational attainment affects the relationship between in-store environments of supermarkets and diet is needed. This study examined the relationship between maternal dietary quality and overall in-store supermarket environment, and assessed the effect modification of educational attainment.

Methods
Dietary quality z-scores were calculated for 829 mothers with young children using cross-sectional data collected in 2010–2011 from a 20-item food frequency questionnaire. Information about nine in-store factors (variety, price, quality, promotion, shelf placement, store placement, nutrition information, healthier alternatives, and single fruit sale) on 12 foods known to discriminate between better and poorer dietary quality were collected to create a standardized “healthfulness” z-score for each supermarket where mothers shopped.

Results
Multilevel unadjusted linear regression analysis completed in 2014–2015 showed that shopping at more-healthful supermarkets was associated with better dietary quality (β=0.39 SD/SD, p=0.01, 95% CI=0.10, 0.68). However, the relationship differed according to educational attainment (interaction, p=0.006). Among mothers who left school at age 16 years, those who shopped at less healthful supermarkets had poorer dietary quality (β=0.31 SD/SD, 95% CI=0.07, 0.55). Among mothers with degrees, those who shopped at less healthful supermarkets had better dietary quality (β=–0.59 SD/SD, 95% CI=–1.19, 0.00).

Conclusions
Mothers with low educational attainment show greater susceptibility to less healthful in-store environments than mothers with higher educational attainment who may be protected by greater psychological and financial resources. Policy initiatives to improve supermarket environments may be necessary to address dietary inequalities.
0749-3797
e27-e34
Vogel, C.
768f1dcd-2697-4aae-95cc-ee2f6d63dff5
Ntani, G.
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Inskip, H.
5fb4470a-9379-49b2-a533-9da8e61058b7
Barker, M.
374310ad-d308-44af-b6da-515bf5d2d6d2
Cummins, S.
d4b26eb6-881f-452f-983e-974548b4dd4e
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Moon, G.
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Baird, J.
f4bf2039-6118-436f-ab69-df8b4d17f824
Vogel, C.
768f1dcd-2697-4aae-95cc-ee2f6d63dff5
Ntani, G.
9b009e0a-5ab2-4c6e-a9fd-15a601e92be5
Inskip, H.
5fb4470a-9379-49b2-a533-9da8e61058b7
Barker, M.
374310ad-d308-44af-b6da-515bf5d2d6d2
Cummins, S.
d4b26eb6-881f-452f-983e-974548b4dd4e
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Moon, G.
68cffc4d-72c1-41e9-b1fa-1570c5f3a0b4
Baird, J.
f4bf2039-6118-436f-ab69-df8b4d17f824

Vogel, C., Ntani, G., Inskip, H., Barker, M., Cummins, S., Cooper, C., Moon, G. and Baird, J. (2016) Education moderates the association between supermarket environment and diet. American Journal of Preventive Medicine, 51 (2), e27-e34. (doi:10.1016/j.amepre.2016.02.030).

Record type: Article

Abstract

Introduction
Supermarkets are a major source of food for many families. Knowledge of how educational attainment affects the relationship between in-store environments of supermarkets and diet is needed. This study examined the relationship between maternal dietary quality and overall in-store supermarket environment, and assessed the effect modification of educational attainment.

Methods
Dietary quality z-scores were calculated for 829 mothers with young children using cross-sectional data collected in 2010–2011 from a 20-item food frequency questionnaire. Information about nine in-store factors (variety, price, quality, promotion, shelf placement, store placement, nutrition information, healthier alternatives, and single fruit sale) on 12 foods known to discriminate between better and poorer dietary quality were collected to create a standardized “healthfulness” z-score for each supermarket where mothers shopped.

Results
Multilevel unadjusted linear regression analysis completed in 2014–2015 showed that shopping at more-healthful supermarkets was associated with better dietary quality (β=0.39 SD/SD, p=0.01, 95% CI=0.10, 0.68). However, the relationship differed according to educational attainment (interaction, p=0.006). Among mothers who left school at age 16 years, those who shopped at less healthful supermarkets had poorer dietary quality (β=0.31 SD/SD, 95% CI=0.07, 0.55). Among mothers with degrees, those who shopped at less healthful supermarkets had better dietary quality (β=–0.59 SD/SD, 95% CI=–1.19, 0.00).

Conclusions
Mothers with low educational attainment show greater susceptibility to less healthful in-store environments than mothers with higher educational attainment who may be protected by greater psychological and financial resources. Policy initiatives to improve supermarket environments may be necessary to address dietary inequalities.

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More information

Accepted/In Press date: 28 January 2016
e-pub ahead of print date: 5 April 2016
Published date: August 2016
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 386776
URI: http://eprints.soton.ac.uk/id/eprint/386776
ISSN: 0749-3797
PURE UUID: f62416fb-6899-4b6b-b712-41f92ddcf3d1
ORCID for C. Vogel: ORCID iD orcid.org/0000-0002-3897-3786
ORCID for H. Inskip: ORCID iD orcid.org/0000-0001-8897-1749
ORCID for M. Barker: ORCID iD orcid.org/0000-0003-2976-0217
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for G. Moon: ORCID iD orcid.org/0000-0002-7256-8397
ORCID for J. Baird: ORCID iD orcid.org/0000-0002-4039-4361

Catalogue record

Date deposited: 04 Feb 2016 12:16
Last modified: 18 Feb 2021 17:14

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