Dietary disparities among adolescents according to individual and school socioeconomic status: a multilevel analysis

Abstract

This study aimed to estimate disparities in dietary habits according to the individual and contextual socioeconomic status (SES), while taking into account school nutrition-related characteristics. Data came from the 2018 cross-sectional “Health Behaviour in School-aged Children” (HBSC) survey. Multilevel multiple logistic regressions were performed. Over two-thirds of the observed variance was explained by individual and school characteristics, with SES being the main contributors. For example, 76.9% of the variance in daily sugar-sweetened beverage (SSB) intake was explained by individual and school characteristics. Adolescents of a secondary or lower parental education level were more likely to consume SSB daily than those of a post-secondary level (aOR = 1.46 (1.29–1.66)). Compared to those in a high SES school, the odds to consume SSB daily was higher for adolescents in low SES schools (aOR = 2.37(1.90–2.96)). These findings support the need for schools to pursue a consistent nutrition policy, with an increased support in low socioeconomic populations.

Keywords:

• Dietary habits
• socioeconomic disparities
• contextual disparities
• multilevel analyses
• adolescents

Acknowledgements

The authors thank the students and the schools for their participation in the French-speaking HBSC survey. They are grateful to the HBSC International Coordination Center (University of St Andrews, United Kingdom) and the HBSC data Management Center (University of Bergen, Norway) for their scientific support, as well as Maud Dujeu, Estelle Méroc, Véronique Desnouck, Morgane Eggen, Omer Cimpaye and Nathalie Moreau (SIPES, Université libre de Bruxelles, Belgium) for their collaboration in data collection, cleaning and management.

Ethics approval and consent to participate

This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving research study participants were approved by the Ethical Committee of the Faculty of Psychology at the Université libre de Bruxelles in Belgium (opinion n°032/2017). The invited adolescents and their parents received an information letter prior the survey. Both were free to refuse participation, by letter for the parents and on the day of the survey for the adolescents.

Disclosure statement

The authors report no conflict of interest.

Data availability statement

The data analysed in this study is not available to the public, due to the law on the protection of privacy regarding the processing of personal data. Therefore, these data can only be made available to third parties under certain conditions.

Additional information

Funding

This work was funded by the Birth and Children Office (ONE), the Walloon Region, and the French Community Commission. The French Community of Belgium, as part of the “Actions de Recherche Concertée” funding programme provided financial support. Researchers performed the study (study design, data collection, analyses, interpretation and writing) independently of the funding bodies.