Socio-economic patterning of dietary behaviour among Indian adolescents

Abstract:

Objectives: Examine the socio-economic pattern of dietary behaviour and the mediating role of diet quality in the association of socio-economic status (SES) with the prevalence  of cardiovascular disease (CVD) biomarkers, among Indian adolescents, aged 10-19 years.

Method: Analyses were conducted using the data for all the adolescents and the available sample for CVD biomarkers collected across all the 30 Indian states in the Comprehensive National Nutrition Survey (CNNS). Descriptive statistics were performed to understand the socio-economic patterning of dietary behaviour and prevalence of CVD biomarkers. To understand the mediating role of diet quality in the association between SES and CVD biomarkers, a cross-sectional mediation analysis was performed. Levels of maternal 
education attainment and household wealth indices were used as proxies for SES; calculated Dietary Diversity Score (DDS) as a measure of diet quality; and used overweight/obesity (measured by Body-Mass-Index for age z-score), lipid anomalies (measured by high ratio of total cholesterol to HDL-cholesterol and high serum triglycerides), hypertension, and pre-diabetes/diabetes (measured by HbA1c) as CVD biomarkers. Sensitivity analyses were conducted. STATA version 17.0 software was used for the data analysis.
 
Results: One in four adolescents exhibited abnormalities in at-least one of the CVD biomarkers. Those from the richer households were likely to have the highest burden whereas the burden was lowest amongst those with higher levels of maternal education attainment. 
Concerning dietary pattern, adolescents with daily consumption of fats & oils, sugar & jaggery, and those consuming unhealthy foods (junk food, fried food, sweets, and aerated drinks) frequently were more likely to have higher prevalence of anomalies in the CVD biomarkers. Results from the mediation analyses indicated that diet quality contributed to the impact of SES on overweight or obesity, although it did not fully explain this relation. Finally, the current study could not ascertain the role of diet quality in explaining the impact of SES on the remaining CVD biomarkers in this population.