Time to address the double inequality of differences in dietary intake between Scotland and England.
Time to address the double inequality of differences in dietary intake between Scotland and England.
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DOI：
10.1017/s0007114518001435
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发表时间：
2018-07
期刊：
影响因子：
--
通讯作者：
Wrieden WL
中科院分区：
文献类型：
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作者：
Barton KL;Chambers S;Anderson AS;Wrieden WL
几十年来，英国各地健康状况的地域差异一直很明显。最近对苏格兰和英格兰饮食差异的分析可能在某种程度上解释了这些健康差异，但分析结果有限。这项研究旨在评估苏格兰人和英格兰人之间，特别是家庭收入相似的人群之间，饮食和营养方面是否存在差异，以及在多大程度上存在差异。12年的英国食品购买数据（2001-2012）被汇总并用于估计苏格兰和英格兰的家庭消费数据。对已知混杂因素（年份、家庭参考人的年龄、他们离开全日制教育的年龄和收入）进行调整后，估计了人口平均食物消费和营养摄入量。在同等收入五分位数内也进行了比较。分析显示，饮食中应该增加的食物和营养素（在苏格兰饮食目标中突出显示）在苏格兰比在英格兰低（例如水果和蔬菜267克/天；99% CI 259, 274和298克/天；99% CI 296, 301）， P< 0.001)。同样，在苏格兰，与不良健康结果相关的食物和饮料的比例更高。这些饮食的区域不平等在低收入群体中更为明显(例如，最低收入五分之一的红肉和加工肉消费量为65克/天；苏格兰的99%置信区间为61、69对58克/天；英格兰的99%置信区间为57、60，P< 0.001，但在最高收入五分之一的人群中类似（58克/天；99%置信区间为54、61对59克/天；99%置信区间分别为58、60）。与英格兰相比，苏格兰的饮食更差，尤其是在弱势群体中，这可能会导致各国之间的超额死亡率差异。
Geographical disparities in health outcomes have been evident across the UK for decades. Recent analysis on the dietary differences between Scotland and England that might go some way to explain these health differences is limited. This study aimed to assess whether, and to what degree, aspects of diet and nutrition differ between Scottish and English populations, specifically between those with similar household incomes. A period of 12 years of UK food purchase data (2001–2012) were pooled and used to estimate household-level consumption data for Scotland and England. Population mean food consumption and nutrient intakes were estimated, adjusting for known confounders (year, age of household reference person, age they left full-time education and income). Comparison was also made within equivalised income quintiles. Analysis showed that the foods and nutrients that should be increased in the diet (highlighted in the Scottish Dietary Goals) were lower in Scotland than in England (e.g. fruit and vegetables 267 g/d; 99 % CI 259, 274 v. 298 g/d; 99 % CI 296, 301), P<0·001). Similarly, foods and drinks linked with poor health outcomes were higher in Scotland. These regional inequalities in diet were even more pronounced in the lower-income groups (e.g. red and processed meat consumption in the lowest-income quintile was 65 g/d; 99 % CI 61, 69 in Scotland v. 58 g/day; 99 % CI 57, 60 in England, P<0·001, but similar in the highest-income quintile (58 g/d; 99 % CI 54, 61 v. 59 g/d; 99 % CI 58, 60, respectively). A poorer diet in Scotland compared with England, particularly among disadvantaged groups, may contribute to differences in excess mortality between countries.