Country-level sociocultural context and socioeconomic inequalities in adolescent dietary behaviours: A multilevel analysis in 21 European countries

Maxim Dierckens; Benedicte Deforche; Bart De Clercq; Dominic Weinberg; Gonneke W J M Stevens; Angeline Chatelan; Manon Rouche; Els Clays; Katrijn Delaruelle

doi:10.1016/j.appet.2024.107339

Country-level sociocultural context and socioeconomic inequalities in adolescent dietary behaviours: A multilevel analysis in 21 European countries

Appetite. 2024 Apr 10:198:107339. doi: 10.1016/j.appet.2024.107339. Online ahead of print.

Authors

Maxim Dierckens¹, Benedicte Deforche², Bart De Clercq³, Dominic Weinberg⁴, Gonneke W J M Stevens⁴, Angeline Chatelan⁵, Manon Rouche⁵, Els Clays⁶, Katrijn Delaruelle⁷

Affiliations

¹ Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium. Electronic address: Maxim.Dierckens@UGent.be.
² Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium; Movement and Nutrition for Health and Performance Research Group, Department of Movement and Sports Sciences, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium.
³ Mensura R&D Department, Mensura EDPB, Italiëlei 2, 2000, Antwerpen, Belgium.
⁴ Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Padualaan 14, 3584 CH, Utrecht, the Netherlands.
⁵ Research Centre in Epidemiology, Biostatistics and Clinical Trials, School of Public Health, Université libre de Bruxelles, Route de Lennik 808, 1070, Brussels, Belgium.
⁶ Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
⁷ Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium; Department of Sociology, Ghent University, Sint-Pietersnieuwstraat 41, 9000, Ghent, Belgium.

PMID: 38604381
DOI: 10.1016/j.appet.2024.107339

Abstract

Studies to date have predominantly focused on countries' socioeconomic conditions (e.g., income inequality) to explain cross-national differences in socioeconomic inequalities in adolescent health (behaviours). However, the potential explanatory role of sociocultural contexts at country-level remains underexamined. This study examined whether the country-level sociocultural context and changes thereof were associated with adolescent socioeconomic inequalities in dietary behaviours. International comparative data of 344,352 adolescents living in 21 countries participating in 2002, 2006, 2010 and 2014 waves of the Health Behaviour in School-aged Children (HBSC) survey were combined with aggregated levels of openness-to-change from the European Social Survey (ESS). Four dietary behaviours (i.e., fruit, vegetable, sweets and soft drink consumption) and two measures of socioeconomic status (SES) on the individual level (i.e., family affluence scale [FAS] and occupational social class [OSC]) were studied. Multilevel logistic regression analyses returned contrasting results for the two SES measures used. In countries with higher levels of openness-to-change, smaller FAS inequalities in daily fruit, sweets and soft drink consumption were observed, but no such inequalities were found for vegetable consumption. Conversely, in these countries, larger OSC inequalities in soft drink consumption were found. Country-specific changes in openness-to-change over time were not associated with the magnitude of adolescent dietary inequalities. Findings underscore the importance of including country-level sociocultural contexts to improve the understanding of cross-national differences in socioeconomic inequalities in adolescents' diets. Future studies, spanning a longer timeframe, are required to examine whether such associations exist within countries over time since our timeframe might have been too small to capture these long-term trends.

Keywords: Eating behaviour; Health inequalities; Multilevel regression analysis; Socioeconomic status; Youth.