Factors associated with the quality of the diet of residents of a rural area in Southern Brazil

Fernandes, Mayra Pacheco; Bielemann, Renata Moraes; Fassa, Anaclaudia Gastal

doi:10.11606/S1518-8787.2018052000267

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Rural Health Supplement, Original Articles • Rev. Saúde Pública 52 (suppl 1) • 2018 • https://doi.org/10.11606/S1518-8787.2018052000267 copy

Factors associated with the quality of the diet of residents of a rural area in Southern Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

To identify factors associated with a better quality of the diet of residents of a rural area in Southern Brazil.

METHODS

This is a population-based, cross-sectional study with individuals aged 18 years or over living in the rural area of Pelotas, State of Rio Grande do Sul, Brazil. Food consumption was evaluated by a food frequency questionnaire of thirteen items, related to the consumption in the last week. We evaluated quality of the diet using the Adult Diet Quality Index (IQD-A). Healthy food received increasing scores while unhealthy food received decreasing scores, according to consumption frequency, amounting to scores from zero to 30. The total score was divided into tertiles. Individuals of the third tertile were classified with better quality of the diet. We investigated the association between quality of the diet and independent variables using multinomial logistic regression.

RESULTS

We interviewed 1,519 individuals with mean IQD-A of 17.1 points (SD = 3.3) and a median of 17.0 (range of 10 to 25 points). Although the population studied kept the consumption of staple foods, the intake of industrialized food such as soft drinks, artificial juices, and unhealthy foods such as sweets was high. Older individuals presented seven times (95%CI 4.20–12.48) more chance of having a better quality of the diet. Women, individuals with higher economic status, those who worked in the sale of animals, or those who had diabetes were approximately twice as likely to be in the group with the best quality of the diet. Individuals whose families worked with fishing presented a 70% lower chance of being in the group of better quality of the diet.

CONCLUSIONS

We identified that men, younger adults, individuals of lower socioeconomic level, and fishing families were in the group of higher vulnerability for the consumption of a diet with worse quality. Thus, public policies, especially educational policies, are needed to promote healthy eating in this group.

Adult; Aged; Food Consumption; Feeding Behavior; Socioeconomic Factors; Rural Population

Components of the IQD-A	Score by category of consumption
Healthy^a – fruits, vegetables, beans, milk, meat or chicken, whole food	0 – Did not eat in the last week
	1 – Ate 1–3 days/week
	2 – Ate 4–6 days/week
	3 – Ate everyday
Unhealthy^b – fried food, cured and/or preserved food, frozen food (industrialized), soft drinks, artificial juices, sweets	3 – Did not eat in the last week
	2 – Ate 1–3 days/week
	1 – Ate 4–6 days/week
	0 – Ate everyday

Variable	n	% (95%CI)
Sex
Male	734	48.3 (46.2–50.3)
Female	785	51.7 (49.7–53.7)
Age (years)
18–24	174	11.4 (10.0–12.9)
25–39	341	22.6 (18.9–26.1)
40–59	593	39.2 (36.8–41.6)
60 or over	411	26.8 (23.4–30.2)
Race
White	1,296	85.1 (79.6–90.6)
Non-white	223	14.9 (9.4–20.4)
Marital status
Without partner	920	60.3 (55.9–64.6)
With partner	599	39.7 (35.4–44.1)
Education level (full years)
0–4	582	38.7 (32.2–45.1)
5–8	558	36.9 (32.6–41.2)
9 or more	369	24.4 (18.0–30.9)
Number of residents
1	94	6.2 (4.5–7.9)
2	388	25.6 (20.2–31.1)
3	395	26.4 (22.1–30.6)
4 or more	635	41.8 (33.7–49.9)
Socioeconomic level (ABEP)
A or B	301	20.0 (14.3–25.7)
C	814	53.7 (48.2–59.3)
D or E	388	26.3 (20.1–32.4)
Work with fishing
No	1,448	95.1 (88.4–101.7)
Yes	64	4.9 (-1.7–11.6)
Selling of animals
No	1,341	89.0 (84.4–93.6)
Yes	171	11.0 (6.4–15.6)
Selling of agricultural products
No	1,010	67.3 (52.7–82.0)
Yes	502	32.7 (18.0–47.3)
SAH
No	994	65.7 (62.2–69.2)
Yes	522	34.3 (30.8–37.8)
DM
No	1,363	89.8 (88.3–91.3)
Yes	153	10.2 (8.7–11.7)

Variable	Quality of the diet^a

	Intermediary		Better

	OR (crude)	p^c	OR (crude)	p^c
Sex		0.142		< 0.001
Male	1.00		1.00
Female	1.21 (0.93–1.59)		2.23 (1.62–3.07)
Age (years)		< 0.001^d		< 0.001^d
18–24	1.00		1.00
25–39	1.54 (1.00–2.39)		1.78 (1.10–2.90)
40–59	2.24 (1.54–3.26)		2.79 (1.85–4.19)
60 or over	2.87 (1.97–4.17)		7.49 (4.51–12.44)
Race		0.320		0.126
White	1.00		1.00
Non-white	0.82 (0.55–1.23)		0.74 (0.50–1.09)
Marital status		0.011		0.047
Without partner	1.00		1.00
With partner	0.70 (0.54–0.92)		0.77 (0.59–0.99)
Education level (full years)		0,161		0,161
0–4	1.00		1.00
5–8	0.72 (0.52–0.99)		0.67 (0.49–0.92)
9 or more	0.80 (0.58–1.09)		0.93 (0.68–1.29)
Number of residents		0.698^d		0.001^d
1	1.22 (0.91–1.64)		2.67 (1.51–4.72)
2	1.08 (0.74–1.57)		2.10 (1.33–3.30)
3	1.01 (0.51–2.00)		1.71 (1.19–2.48)
4 or more	1.00		1.00
Socioeconomic level (ABEP)^b		0.545^d		0.049^d
A or B	1.18 (0.71–1.94)		1.83 (0.99–3.4)
C	1.05 (0.67–1.65)		1.08 (0.74–1.58)
D or E	1.00		1.00
Work with fishing		0.001		0.018
No	1.00		1.00
Yes	0.48 (0.32–0.71)		0.27 (0.09–0.78)
Selling of animals		0.158		0.053
No	1.00		1.00
Yes	1.33 (0.88–2.01)		1.55 (0.99–2.41)
Selling of agricultural products		0.552		0.098
No	1.00		1.00
Yes	1.11 (0.78–1.58)		0.61 (0.34–1.10)
SAH		0.133		< 0.001
No	1.00		1.00
Yes	1.21 (0.94–1.56)		1.91 (0.54–1.04)
DM		0.038		< 0.001
No	1.00		1.00
Yes	1.78 (1.03–3.07)		3.34 (1.96–5.69)

Variable	Quality of the diet^a

	Intermediary		Better

	OR (adjusted)	p^b	OR (adjusted)	p^b
Sex		0.129		< 0.001
Male	1.00		1.00
Female	1.25 (0.93–1.69)		2.35 (1.61–3.44)
Age (years)		< 0.001^c		< 0.001^c
18–24	1.00		1.00
25–39	1.57 (1.02–2.42)		1.82 (1.18–2.80)
40–59	2.37 (1.64–3.42)		2.86 (1.86–4.39)
60 or over	3.19 (2.12–4.80)		7.23 (4.20–12.48)
Socioeconomic level (ABEP)		0.769^c		0.001^c
A or B	1.08 (0.67–1.76)		2.37 (1.49–3.76)
C	0.97 (0.60–1.57)		1.34 (1.01–1.78)
D or E	1.00		1.00
Number of residents		0.056		0.056
1	0.83 (0.39–1.74)		1.78 (1.22–2.58)
2	0.85 (0.55–1.31)		1.40 (0.87–2.26)
3	1.25 (0.92–1.70)		1.90 (1.01–3.59)
4 or more	1.00		1.00
Work with fishing		< 0.001		0.005
No	1.00		1.00
Yes	0.48 (0.33–0.70)		0.30 (0.14–0.67)
Selling of animals		0.193		0.020
No	1.00		1.00
Yes	1.33 (0.86–2.05)		1.84 (1.11–3.06)
Selling of agricultural products		0.937		0.051
No	1.00		1.00
Yes	0.99 (0.67–1.44)		0.57 (0.32–1.00)
DM		0.199		0.003
No	1.00		1.00
Yes	1.41 (0.82–2.40)		2.13 (1.33–3.42)

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[1] Correspondence: Mayra Pacheco Fernandes. Rua Marechal Deodoro, 1160 3º piso Centro. Caixa Postal 464. 96020-220 Pelotas, RS, Brasil. E-mail: pfmayra@hotmail.com