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Review
. 2008 May;87(5):1107-17.
doi: 10.1093/ajcn/87.5.1107.

Does social class predict diet quality?

Nicole Darmon  1 , Adam Drewnowski
Affiliations
Free article
Review

Does social class predict diet quality?

Nicole Darmon et al. Am J Clin Nutr. 2008 May.
Free article

Abstract

A large body of epidemiologic data show that diet quality follows a socioeconomic gradient. Whereas higher-quality diets are associated with greater affluence, energy-dense diets that are nutrient-poor are preferentially consumed by persons of lower socioeconomic status (SES) and of more limited economic means. As this review demonstrates, whole grains, lean meats, fish, low-fat dairy products, and fresh vegetables and fruit are more likely to be consumed by groups of higher SES. In contrast, the consumption of refined grains and added fats has been associated with lower SES. Although micronutrient intake and, hence, diet quality are affected by SES, little evidence indicates that SES affects either total energy intakes or the macronutrient composition of the diet. The observed associations between SES variables and diet-quality measures can be explained by a variety of potentially causal mechanisms. The disparity in energy costs ($/MJ) between energy-dense and nutrient-dense foods is one such mechanism; easy physical access to low-cost energy-dense foods is another. If higher SES is a causal determinant of diet quality, then the reported associations between diet quality and better health, found in so many epidemiologic studies, may have been confounded by unobserved indexes of social class. Conversely, if limited economic resources are causally linked to low-quality diets, some current strategies for health promotion, based on recommending high-cost foods to low-income people, may prove to be wholly ineffective. Exploring the possible causal relations between SES and diet quality is the purpose of this review.

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Comment in

  • Social class and diet quality.
    Karp RJ. Karp RJ. Am J Clin Nutr. 2008 Oct;88(4):1177-8; author reply 1178-9. doi: 10.1093/ajcn/88.4.1177. Am J Clin Nutr. 2008. PMID: 18842810 No abstract available.

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