Browsing by Author "Victorino, Charlie"

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    Socioeconomic inequities in diet quality among a nationally representative sample of adults living in Canada: an analysis of trends between 2004 and 2015
    (Oxford University Press, 2021-09-03) Olstad, Dana Lee; Nejatinamini, Sara; Victorino, Charlie; Kirkpatrick, Sharon I; Minaker, Leia M; McLaren, Lindsay
    Background: Socioeconomic inequities in diet quality are stable or widening in the US, however these trends have not been well characterized in other nations. Moreover, purpose-developed indices of inequities that can provide a more comprehensive and precise perspective of trends in absolute and relative dietary gaps and gradients using multiple indicators of socioeconomic position have not yet been used, and can inform strategies to narrow dietary inequities. Objective: We quantified nationally representative trends in absolute and relative gaps and gradients in diet quality between 2004 and 2015 according to three indicators of socioeconomic position among adults in Canada. Design: Adults (≥18 years) who participated in the nationally representative, cross-sectional Canadian Community Health Survey-Nutrition in 2004 (n=20,880) or 2015 (n=13,970) were included. Socioeconomic position was classified using household income (quintiles), education (five categories) and neighborhood deprivation (quintiles). Dietary intake data from 24-hour recalls were used to derive Healthy Eating Index-2015 (HEI-2015) scores. Dietary inequities were quantified using absolute and relative gaps (between most and least disadvantaged), and absolute (Slope Index of Inequality) and relative gradients (Relative Index of Inequality). Overall and sex-stratified multivariable linear regression and generalized linear models examined trends in HEI-2015 scores between 2004 and 2015. Results: Mean HEI-2015 scores improved from 55.3 to 59.0 (maximum 100); however, these trends were not consistently equitable. While inequities in HEI-2015 scores were stable in the total population and in females, the absolute gap [1.60 (95% CI 0.09, 3.10) to 4.27 (2.20, 6.34)] and gradient [SII=2.09 (0.45, 3.73) to SII=4.84 (2.49, 7.20)] in HEI-2015 scores for household income, and the absolute gradient for education [SII=8.06 (6.41, 9.71) to SII=10.52 (8.73, 12.31)], increased in males. Conclusions: Absolute and relative gaps and gradients in overall diet quality remained stable or widened between 2004 and 2015 among adults in Canada.
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    Trends in Socioeconomic Inequities in Diet Quality between 2004 and 2015 among a Nationally Representative Sample of Children in Canada
    (Oxford University Press, 2021-09-13) Olstad, Dana Lee; Nejatinamini, Sara; Victorino, Charlie; Kirkpatrick, Sharon; Minaker, Leia M; McLaren, Lindsay
    Background: Dietary inequities in childhood may shape dietary and health inequities across the life course. Quantifying the magnitude and direction of trends in absolute and relative gaps and gradients in diet quality according to multiple indicators of socioeconomic position (SEP) can inform strategies to narrow these inequities. Objectives: We examined trends in absolute and relative gaps and gradients in diet quality between 2004 and 2015 according to 3 indicators of SEP among a nationally representative sample of children in Canada. Methods: Data from children (aged 2-17 y; n = 18,670) who participated in the cross-sectional Canadian Community Health Survey-Nutrition in 2004 or 2015 were analyzed. SEP was based on total household income, household educational attainment, and neighborhood deprivation. Dietary intake data from 1 interviewer-administered 24-h dietary recall were used to derive a Healthy Eating Index-2015 (HEI-2015) score for each participant as a measure of diet quality. Inequities in diet quality were quantified using 4 indices: absolute and relative gaps (between highest and lowest SEP) and absolute (Slope Index of Inequality) and relative gradients (Relative Index of Inequality). Overall and age-stratified multivariable linear regression and generalized linear models examined trends in HEI-2015 scores between 2004 and 2015. Results: Although mean HEI-2015 total scores improved from 52.3 to 57.3 (maximum 100 points; P < 0.001), absolute and relative gaps and gradients in diet quality remained mostly stable for all 3 SEP indicators. However, among children aged 6-11 y, absolute and relative gradients in diet quality according to household educational attainment and neighborhood deprivation widened. Conclusions: The diet quality of children in Canada was poor and inequitably patterned in 2004 and 2015. Although mean diet quality improved between 2004 and 2015, absolute and relative gaps and gradients in diet quality persisted, with some evidence of widening absolute and relative gradients among 6- to 11-y-olds.