Background Improving the diet of the Scottish population has been a government focus in recent years. Adolescent eating behaviour in Scotland has improved over time, while socioeconomic inequalities in eating behaviours have persisted with no significant change. Population health is known to vary between geographies, therefore alongside trends and socioeconomic inequalities in eating behaviour, urban-rural differences should also be monitored. The aim of this study is to describe urban-rural differences in eating behaviour among 15-year olds living in Scotland in 2010.
Methods Data from the 2010 Scotland Health Behaviour in School-Aged Children survey were modelled using multilevel linear modelling for fruit, vegetables, sweets, crisps and chips consumption frequency outcome variables, and multilevel logistic modelling for eating behaviour outcomes: dieting, family meals, food poverty and breakfast consumption. Geographic differences in a combined ‘healthy eating score’ were also analysed.
Results Adolescents living in remote rural Scotland have the highest consumption frequency of vegetables (on average consumed on 6.68 days a week) and the lowest consumption frequency of sweets and crisps (on 4.27 and 3.02 days a week respectively). However, it is not the 4 Cities, but the geography described by the classification ‘other urban areas’ (large towns of between 10,000 and 125,000 residents) that has the poorest diet. Categorical family affluence was significantly associated with vegetables and chips consumptions and the healthy eating score. Area-level deprivation (SIMD score) and rurality were independently associated with consumption frequencies for all but fruit consumption. Socioeconomic inequalities in fruit consumption were particularly great in accessible and remote rural areas, and significantly greater than those in urban areas. Thus, those living in the most deprived areas of remote rural Scotland (SIMD score = 48.87) consumed fruit on approximately 1 day less a week than those living in 4 Cities of equivalent deprivation. However, among the most affluent (SIMD = 3.03), Remote Rural residents ate fruit on average on 0.6 days more than their urban counterparts. Sharing a family meal, dieting behaviour, food poverty and breakfast consumption did not differ by rurality. Variance at the school level was significant for fruit and vegetable consumption frequencies and for irregular breakfast consumption.
Conclusion Young people from rural areas have a healthier diet than those living in urban areas. The eating behaviours examined did not explain these differences. Socioeconomic inequalities in fruit consumption were greater in rural areas. Future research should investigate why urban-rural differences in consumption frequencies exist.
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