Nutrition quality of food purchases varies by household income: the SHoPPER study

Simone A French, Christy C Tangney, Melissa M Crane, Yamin Wang, Bradley M Appelhans, Simone A French, Christy C Tangney, Melissa M Crane, Yamin Wang, Bradley M Appelhans

Abstract

Background: Lower household income has been consistently associated with poorer diet quality. Household food purchases may be an important intervention target to improve diet quality among low income populations. Associations between household income and the diet quality of household food purchases were examined.

Methods: Food purchase receipt data were collected for 14 days from 202 urban households participating in a study about food shopping. Purchase data were analyzed using NDS-R software and scored using the Healthy Eating Index 2010 (HEI 2010). HEI total and subscores, and proportion of grocery dollars spent on food categories (e.g. fruits, vegetables, sugar sweetened beverages) were examined by household income-to-poverty ratio.

Results: Compared to lower income households, after adjusting for education, marital status and race, higher income households had significantly higher HEI total scores (mean [sd] = 68.2 [13.3] versus 51.6 [13.9], respectively, adjusted p = 0.05), higher total vegetable scores (mean [sd] = 3.6 [1.4] versus 2.3 [1.6], respectively, adjusted p < .01), higher dairy scores (mean [sd] = 5.6 [3.0] versus 5.0 [3.3], p = .05) and lower proportion of grocery dollars spent on frozen desserts (1% [.02] versus 3% [.07], respectively, p = .02).

Conclusions: Lower income households purchase less healthful foods compared with higher income households. Food purchasing patterns may mediate income differences in dietary intake quality.

Trial registration: ClinicalTrials.gov identifier: NCT02073643.

Keywords: Dietary intake; Food purchases; Household income; Nutritional quality.

Conflict of interest statement

Ethics approval and consent to participate

The Rush University IRB approved the study. All participants consented in writing to participate at the time of study enrollment.

Consent for publication

Not Applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

    1. U.S. Department of Health and Human Services. Healthy people 2020, 2nd ed. Washington, DC: U.S. Government Printing Office. Accessed 19 Feb 2019.
    1. U.S. Department of Agriculture, Food and Nutrition Service, Office of Research, Nutrition and Analysis. Diet Quality of Americans by Food Stamp Participation Status: Data from the National Health and Nutrition Examination Survey, 1999–2004, by Nancy Cole and Mary Kay Fox. Project Officer: Jenny Laster Genser, Alexandria, VA: 2008. Accessed 5 Feb 2018.
    1. Frazão E, Andrews MS, Smallwood D, Prell MA. 2007. Food spending patterns of low-income households: will increasing purchasing power result in healthier food choices? (economic information bulletin number 29-4). Washington, DC: U.S. Department of Agriculture, economic research service. Accessed 5 Feb 2018.
    1. Mancino L, Guthrie J, Ver Ploeg M, Lin, B-H. 2018 Nutritional quality of foods acquired by Americans: Findings from USDA’s National Household Food Acquisition and purchase survey. Washington DC: United States Department of Agriculture, Economic Research Service, bulletin number 188. Accessed 25 Sept 2018.
    1. French SA, Wall M, Mitchell NR, Shimotsu ST, Welsh E. Annotated receipts capture household food purchases from a broad range of sources. Int J Behav Nutr Phys Act 2009;6:37. PMCID: PMC2714491.
    1. Blisard WN, Stewart H. 2006. How low-income households allocate their food budget relative to the cost of the thrifty food plan. Washington, DC: U.S. Department of Agriculture, economic research service. Accessed 5 Feb 2018.
    1. French SA, Wall M, Mitchell NR. Household income differences in food sources and food items purchased. Int J Behav Nutr Phys Act 2010;7:77. PMCID: PMC2988056.
    1. Pechey R, Monsivais P. Socioeconomic inequalities in the healthfulness of food choices: exploring the contributions of food expenditures. Prev Med 2016;88:203–209. PMCID: PMC4910945.
    1. Appelhans BM, Milliron BJ, Woolf K, Johnson TJ, Pagoto SL, Schneider KL, Whited MC, Ventrelle JC. Socioeconomic status, energy cost, and nutrient content of supermarket food purchases. Am J Prev Med 2012;42:398–402. PMCID: PMC3858078.
    1. Turrell G, Hewitt B, Patterson C, Oldenburg B, Gould T. Socioeconomic differences in food purchasing behavior and suggested implications for diet-related health promotion. J Hum Nutr Diet. 2002;15(5):355–364. doi: 10.1046/j.1365-277X.2002.00384.x.
    1. Turrell G, Kavanagh AM. Socio-economic pathways to diet: modelling the association between socio-economic position and food purchasing behaviour. Public Health Nutr. 2006;9(3):375–383. doi: 10.1079/PHN2006850.
    1. Pechey R, Monsivais P. Supermarket choice, shopping behavior, socioeconomic status, and food purchases Am J Prev Med 2015;49(6):868–877. PMCID: PMC4651322.
    1. Pechey R, Jebb SA, Kelly MP, Almiron-Roig E, Conde S, Nakamura R, Shemilt I, Suhrcke M, Marteau TM. Socioeconomic differences in purchases of more vs. less healthy foods and beverages: analysis of over 25,000 British households in 2010. Soc Sci Med 2013;92:22–26. PMCID: PMC3726935.
    1. Andreyeva T, Luedicke J, Henderson KE, Tripp AS. Grocery store beverage choices by participants in federal food assistance and nutrition programs. Am J Prev Med. 2012;43(4):411–418. doi: 10.1016/j.amepre.2012.06.015.
    1. Appelhans BM, French SA, Tangney CC, Powell LM, Wang Y. To what extent to purchases reflect shoppers' diet quality and nutrient intake? IJBNPA. 2017;14:46.
    1. Guenther PM, Kirkpatrick SI, Reedy J, Krebs-Smith SM, Buckman DW, Dodd KW, Casavale KO, Carroll RJ. The healthy eating Index-2010 is a valid and reliable measure of diet quality according to the 2010 dietary guidelines for Americans. J Nutr. 2014;144:399–407. doi: 10.3945/jn.113.183079.
    1. French SA, Gerlach AF, Mitchell NR, Hannan PJ, Welsh EM. Household obesity prevention: take action-a group randomized trial. Obesity. 2011;19(10):2082–2088. doi: 10.1038/oby.2010.328.
    1. French SA, Harnack L, Rydell S, Mitchell NR, Oakes MJ. Financial incentives and purchase restrictions in a food benefit program affect the types of foods and beverages purchased: Results from a randomized trial. IJBNPA. 2017;14:127. doi: 10.1186/S12966-017-0585-9.
    1. Harnack L, Oakes JM, Elbel B, Beatty T, Rydell S, French SA. Do SNAP prohibitions and subsidies improve nutrition? A randomized trial. JAMA Intern Med. 2016;176(11):1610–18. 10.1001/jamainternmed.2016.5633.
    1. Nutrition Data System for Research. University of Minnesota Nutrition Coordinating Center. . Accessed 5 Feb 2018.
    1. Wang DD, Leung CW, Li Y, Chiuve SE, Hu FB, Willett WC. Trends in dietary quality among adults in the United States 1999 through 2010. JAMA Intern Med. 2014;174(10):1587–1595. doi: 10.1001/jamainternmed.2014.3422.
    1. Bartlett S, Klerman J, Olsho L, et al. Evaluation of the Healthy Incentive Pilot (HIP): Final Report. USDA. Washington: 2014. Accessed 19 Feb 2019.
    1. French SA, Shimotsu ST, Wall M, Gerlach A. Capturing the spectrum of household food and beverage purchasing behavior: a review. J Am Diet Assoc. 2008;108(2):2051–2058. doi: 10.1016/j.jada.2008.09.001.
    1. Marty L, Dubois C, Gaubard MS, Maidon A, Lesturgeon A, Gaigi H, Darmon N. Higher nutritional quality at no additional cost among low-income households: insights from food purchases of “positive deviants”. Am J Clin Nutr. 2015;102(1):190–198. doi: 10.3945/ajcn.114.104380.
    1. Drewnowski A, Specter SE. Poverty and obesity: the role of energy density and costs. Am J Clin Nutr. 2004;79(1):6–16. doi: 10.1093/ajcn/79.1.6.

Source: PubMed

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