For years, issues of taste, cost and convenience helped explain why the highest rates of poor nutrition are found among minorities and the working poor. Not only are fresh fruits, vegetables, and whole grains more expensive, they are also less likely to be available in low-income neighborhoods. The idea was: you improve access, you improve nutrition.
[Photo: Dr. Adam Drewnowski (left) and Dr. Anju Aggarwal]
However, a study from the University of Washington School of Public Health suggests that those who prioritize nutrition while food shopping have higher-quality diets regardless of gender, education, and income.
Using data from the National Health and Nutrition Examination Survey, researchers assessed the perceived importance of taste, nutrition, cost, and convenience as influencers of dietary choices. The Healthy Eating Index (HEI-2010), a measure of adherence to 2010 dietary guidelines, was used as the diet quality measure. Associations between attitude measures and HEI-2010 across socioeconomic strata (SES), gender, and race/ethnicity were also examined.
The study, published in the Journal of Preventive Medicine, found that people who attached more importance to nutrition while food shopping had markedly higher diet quality scores than those who did not. Interestingly, the same held true for people from lower income and education groups, and certain minorities. By contrast, those who attached more importance to taste had significantly reduced diet quality. Those who rated cost and convenience as most important had smaller, but still negative impacts on diet quality.
“In general, the rich in the U.S. eat better than do the poor,” says study co-author Dr. Adam Drewnowski, professor of epidemiology and director of the University of Washington’s Center for Public Health Nutrition. “However, some lower-income people and minorities manage to have healthy diets. We call this nutrition resilience.” The term resilience has been used to describe high-level performance in the face of adverse conditions. In this case, the ability to achieve higher quality diets despite economic or environmental constraints.
Consistent with the study findings, racial/ethnic groups that attached an importance to nutrition had higher quality diets. However, in contrast, Mexican-Americans and Hispanics consumed higher quality diets despite attaching importance to cost and convenience. This suggests that dietary choices among these ethnic groups may contain an important clue for achieving higher quality diets among populations with SES constraints.
“This study provides the first evidence of nutrition resilience among U.S. adults, which could be one strategy to address disparities in diets in the U.S.,” says Dr. Anju Aggarwal, lead author of the study and acting assistant professor of epidemiology. “The results suggest that making nutrition a priority is not class-dependent,” she says. “It is possible to eat healthy within your budget if you make it a priority.” Lower socioeconomic groups are able to achieve quality diets comparable to those in higher social classes. Understanding how vulnerable groups make diet choices is a crucial component for developing effective interventions.