Introduction Dietary quality is an important predictor of health outcome and plays a prominent role in premature death from a number of chronic health conditions including cardiovascular disease and some cancers. Socio-economic gradients in food consumption are observed worldwide. Inadequate nutritional intake and poor dietary habits are also associated with food poverty, a well documented global public health problem, which is a complex and multi-faceted problem, with widespread consequences for dietary intake. Many definitions of food poverty have appeared in the literature, the majority of which include, to a more or lesser extent, the issues of food affordability, access to and availability of a healthy and nutritious diet to be consumed in a socially and acceptable way. Much of the published literature on the associations between access to and availability of healthy diets focuses on the food environments and individual dietary components for example, fruit and vegetables. However, due to the complex nature of the determinants of dietary habits, measuring dietary quality using an overall dietary index may provide additional insight. The physical availability of food has been shown to be a significant predictor of dietary quality.
Objectives This paper investigates the influence of the economic and physical availability of food on individual dietary quality.
Methods Data are drawn from a two-stage clustered sample of 10 364 individuals aged 18+ from the Republic of Ireland. Diet is assessed via a food frequency questionnaire and the results scored in terms of cardiovascular risk. Food availability is measured in terms of distance to and density of different types of food outlets. Dietary quality is decomposed using fixed effect multi-level regression models.
Results More socio-economically advantaged individuals are likely to live closer to a larger food store and to consume a better diet. Controlling for individual and household characteristics, individuals who live closer to a larger food outlet or who live in an area with a higher density of larger food outlets have a significantly better diet.
Conclusions There are significant and pronounced socio-economic gradients in diet and nutrition in the Republic of Ireland that may contribute to health inequalities. Food availability may also be a significant contributor to poorer dietary quality with the result that poorer households in poor areas are doubly disadvantaged.
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