Associations Between Socioeconomic Status, Dietary Quality, and Food Intakes From a Biracial Population-Based Community Study

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Objectives: Socioeconomic status (SES) is an indicator of dietary quality. However, few studies have evaluated intakes of specific food groups across different racial/ethnic groups. We aim to examine the association of SES with dietary patterns and food intake by race/ethnicity. Methods: We included 6,695 participants (62.7% African American [AA], 60.9% females) from the Chicago Health and Aging Project. SES was a composite Z-score derived from childhood SES, education, occupation prestige score, and income collected at the baseline interview. Diet intakes were assessed by a 144-item Food Frequency Questionnaire (FFQ) collected every three years. Linear regression models were used to estimate the association of SES, dietary patterns, and food intake accounted for age, sex, race, SES, and race x SES interaction. Results: Participants' mean age was 75 at baseline, with a mean follow-up of 6.1 years. There was a positive correlation between SES and scores for the MIND diet, MedDiet, and DASH (P< 0.001). Each unit increase in SES was associated with an increase in the MIND score of 0.46 (SE 0.05), MedDiet score of 1.62 (SE 0.13), and DASH score of 0.15 (SE 0.04). Racial differences were observed, with Blacks having higher scores for MIND but lower scores for MedDiet, DASH, and Western dietary patterns than Whites (P< 0.01 for all). For individual food, AAs showed significantly higher consumption of whole grains (1.31 vs. 0.87 serving/d), sugar-sweetened beverage (SSB) (2.00 vs. 1.10 serving/d), and seafood (0.24 vs. 0.20, serving/d), independent from SES (p< 0.001 for all vs. Whites). Compared to Whites, AAs had lower intakes in fruits, vegetables, refined grains, and sweets and desserts by -0.05±0.01, -0.09±0.01, -0.21±0.01, and -0.2±0.02 serving/d, respectively (p< 0.0001 for all). We observed variations in SES and food intakes among AAs, where higher SES was associated with increased consumption of fruits (P=0.008) and vegetables (P=0.001) and decreased consumption of SSB (P=0.034). Conclusions: Higher SES was associated with improved dietary quality in Blacks and Whites. There were differences between ethnic groups and within each ethnic group regarding intakes of individual food groups, with Blacks being more susceptible to SES.