Social determinants, lifestyle and diet quality: a population-based study from the 2015 Health Survey of São Paulo, Brazil

• Published in: Public health nutrition Vol. 23; no. 10; pp. 1766 - 1777
• Main Authors: Mello, Aline Veroneze de, Pereira, Jaqueline Lopes, Leme, Ana Carolina Barco, Goldbaum, Moises, Cesar, Chester Luiz Galvao, Fisberg, Regina Mara
• Format: Journal Article
• Language: English
• Published: England Cambridge University Press 01.07.2020
• Subjects: Adult; Adults; Brazil; Censuses; Cross-Sectional Studies; Data collection; Diabetes; Diabetes mellitus; Diet; Diet Surveys; Diet, Healthy - statistics & numerical data; Eating; Education; Female; Health care; Health Surveys; Households; Humans; Hypertension; Income; Life Style; Lifestyles; Male; Mental health; Middle Aged; Nutrition; Nutrition research; Nutritional Epidemiology; Obesity; Occupations; Older people; Polls & surveys; Population; Population studies; Population-based studies; Public health; Quality; Questionnaires; Research Paper; Social Determinants of Health - statistics & numerical data; Social factors; Socioeconomic Factors; Studies; Sugar; Variables; Womens health; Young Adult; Brazil; United States > US; Dietary intake; Diet quality; Food consumption; Social determinants; Inequalities
• ISSN: 1368-9800; 1475-2727
• DOI: 10.1017/S1368980019003483

To investigate the association among social determinants, lifestyle variables and diet quality in São Paulo, Brazil. Cross-sectional study, 2015 Health Survey of São Paulo (Inquérito de Saúde de São Paulo (2015 ISA-Capital)) with Focus on Nutrition Study (2015 ISA-Nutrition). Population-based study, with a representative sample of adults living in São Paulo, Brazil. Adults (aged 20-59 years, n 643) and older adults (aged ≥60 years, n 545). We observed differences in the Brazilian Healthy Eating Index-Revised (BHEI-R) by education, income, occupation, sex and race. Whole grains (0·63 points, 12·6 % of the maximum score), sodium (2·50 points, 25·0 %) and solid fat, alcohol and added sugars (9·28 points, 46·4 %) components had the lowest BHEI-R scores. Factors positively associated with diet quality included the presence of one disease or more (e.g. diabetes mellitus, hypertension, cancer, hypercholesterolaemia: β = 0·636, P < 0·001), income (middle income: β = 0·478, P < 0·001; high income: β = 0·966, P < 0·001) and occupation (other: β = 1·418, P < 0·001). Energy (β = -0·001, P < 0·001), alcohol consumption (β = -0·207, P = 0·027), education level (middle education: β = -0·975, P < 0·001; high education: β = -1·376, P < 0·001), races other than white (β = -0·366, P < 0·001) and being unemployed (β = -0·369, P < 0·046) were negatively associated with diet quality. Groups affected by socio-economic inequalities need better diet quality. Governmental actions should be implemented to reduce the consumption of energy-dense and sodium-rich foods, facilitate access and information on healthy eating, and conduct nutritional education.