Socioeconomic Inequalities, Dietary Patterns And Adherence To Dietary Guidelines: Evidence From The E3N-EPIC Cohort Study

Aurélie AFFRET, Center for Research in Epidemiology and Population Health (CESP), France
BOUTRON-RUAULT M. 1,2,3 , CLAVEL-CHAPELON F. 1,2,3 , FAGHERAZZI G. 1,2,3

1 Inserm U1018, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
2 Paris-South University, Villejuif, France
3 Gustave Roussy Institute, Villejuif, France

Purpose
It is crucial to understand the socioeconomic brakes and leverages of adopting a healthy diet, diet being of the main modifiable factors that public health can act on to reduce the burden of non-communicable diseases such as cancer.

Methods
We used data from 58,193 participants of the large French E3N-EPIC cohort study. As the socioeconomic factors are highly correlated, we derived socioeconomic patterns thanks to a latent class analysis and we studied the relationships between these profiles, French dietary guidelines and dietary patterns.

Results
Respect to dietary guidelines, we found the alcohol intake was inversely associated with a deprivation index (p<0.001) and the number of siblings was positively associated with the consumption of vegetables (p<0.001). Regarding our analysis on patterns, women in the “Highly Educated” pattern who had a high education level and highly educated partners, were found to be more frequently in the “Western” dietary pattern (p<0.01). Women in the “Rural” pattern, who had a high deprivation index and a lower education level, were more frequently in the “Processed Food” pattern (p<0.001).

Conclusions
Thanks to an innovative modeling, we disentangled the relationships between the socioeconomic environment and dietary habits. We have also shown that it is compulsory to study the influence of the socioeconomic environment thanks to the conjunction of several factors, when available, rather than a single factor such as the level of education. Public health and nutritional prevention strategies for cancer should be universal, but modulated according to the socioeconomic position.
 
Funding source:
This work was supported by the INCa (French National Institute on Cancer) and the WCRF (World Cancer Research Fund). Aurélie Affret was supported by a PhD fellowship from the INCa, the EHESS (French School of Social Sciences) and the EHESP (French School of Public Health).