Better Dietary Knowledge and Socioeconomic Status (SES), Better Body Mass Index? Evidence from China-An Unconditional Quantile Regression Approach

Nutrients. 2020 Apr 24;12(4):1197. doi: 10.3390/nu12041197.

Abstract

Obesity is a rapidly growing public health threat in China. Improvement of dietary knowledge may potentially reduce the risk of obesity and being overweight. However, existing studies focus on measuring the mean effects of nutrition knowledge on body mass index (BMI). There is a lack of literature on the effect of dietary knowledge on BMI, and the potential heterogeneity of the effect across the whole BMI distribution and across socioeconomic status (SES) groups. This study aims to investigate the heterogeneous nature of the relationship between dietary knowledge, SES, and BMI, using data from the China Health and Nutrition Survey (CHNS) in 2015. We employed unconditional quantile regression (UQR) to assess how the relationship between dietary knowledge, SES, and BMI varies across the whole BMI distribution, and conducted subgroup analyses using different socio-economic subsamples. Results indicate that dietary knowledge had no statistically significant impact on BMI across the BMI distribution. There was a large degree of heterogeneity in the SES effect across the BMI distribution as well as a major gender difference in the SES effect on BMI. Education had a significant and inverse association with BMI across the BMI distribution, greater at higher BMI quantiles. Income growth had a larger effect on the 50th quantile of BMI for males in the middle-income group, but was not significant for females. As income increased, males without college educations had higher BMI while females with college or higher education generally had lower BMI. The findings of this study reveal the heterogeneous nature of the relationship between SES, gender, and obesity across the entire BMI distribution, suggesting that quantile regressions might offer a valuable framework for exploring the complex relationship of dietary knowledge, demographic, and socio-economic factors on obesity.

Keywords: body mass index; dietary knowledge; socioeconomic status; unconditional quantile regressions.

MeSH terms

  • Algorithms
  • Body Mass Index*
  • China / epidemiology
  • Diet*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Health Surveys
  • Humans
  • Male
  • Models, Theoretical
  • Nutrition Surveys
  • Social Class*
  • Socioeconomic Factors