Are there differences in the quality of the diet of working and stay-at-home women?

Assumpção, Daniela de; Senicato, Caroline; Fisberg, Regina Mara; Canesqui, Ana Maria; Barros, Marilisa Berti de Azevedo

doi:10.11606/S1518-8787.2018052000104

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Original Article • Rev. Saúde Pública 52 • 2018 • https://doi.org/10.11606/S1518-8787.2018052000104 copy

Are there differences in the quality of the diet of working and stay-at-home women?

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

To verify whether there is an association between the quality of the diet and the inclusion of women in the labor market and whether the education level would modify this association. We have analyzed the differences according to education level and evaluated whether the insertion or not in the market modifies the association between the quality of the diet and education level.

METHODS

This is a cross-sectional population-based study that has used data from the Campinas Health Survey (2008 ISACamp). We have evaluated the diet of 464 women, aged 18 to 64 years, using the Brazilian Healthy Eating Index – Revised. We have estimated the means of the total score and index components using simple and multiple linear regression.

RESULTS

We have observed no difference in the quality of diet of working and stay-at-home women. The analysis stratified by education level showed a lower intake of fruits among stay-at-home women in the segment of lower education level, in relation to working women. Among all women, a lower education level was associated with lower overall quality of the diet, higher intake of sodium, and lower intake of fruits, vegetables, whole grains, milk, and saturated fat. On the other hand, the inclusion in the labor market changed the effect of the education level on the quality of the diet. In the stay-at-home stratum, a low education level was associated with poorer quality of the diet and lower consumption of fruits, dark green and orange vegetables, and whole grains. Among the working women, a low education level was associated with higher intake of sodium and lower intake of vegetables, whole grains, and milk and dairy products.

CONCLUSIONS

The results show inequities in the profile of food in relation to education level and inclusion in the labor market, which shows the relevance of public policies that increase the access to education and provide guidance on a healthy diet.

DESCRIPTORS
Women; Women, Working; Healthy Diet; Socioeconomic Factors; Health Inequalities; Diet Surveys

Components of the BHEI-R	Score range (minimum to maximum)	Criteria of the minimum score	Criteria of the maximum score
Adequacy (higher score means higher consumption)
1. Total fruits^a a Represents the consumption of fruit in the form of natural juice.	0 to 5	No consumption	1.0 portion/1,000 kcal
2. Whole fruits	0 to 5	No consumption	0.5 portion/1,000 kcal
3. Total vegetables	0 to 5	No consumption	1.0 portion/1,000 kcal
4. Dark green and orange vegetables	0 to 5	No consumption	0.5 portion/1,000 kcal
5. Total grains	0 to 5	No consumption	2.0 portions/1,000 kcal
6. Whole grains	0 to 5	No consumption	1.0 portion/1,000 kcal
7. Milk and dairy products	0 to 10	No consumption	1.5 portion/1,000 kcal
8. Meat and eggs^b b Legumes were excluded from the component of meats and eggs.	0 to 10	No consumption	1.0 portion/1,000 kcal
9. Oils^c c Includes oil and fish fat.	0 to 10	No consumption	0.5 portion/1,000 kcal
Moderation (higher score means lower consumption)
10. Saturated fat	0 to 10	≥ 15% of TEV	≤ 7% of TEV
11. Sodium	0 to 10	≥ 2.0 g/1,000 kcal	≤ 0.75 g/1,000 kcal
12. SoFAAS	0 to 20	≥ 35% of TEV	≤ 10% of the TEV
Total BHEI-R	0 to 100

Variable		Total		Working women		Stay-at-home women		p^a a Rao-Scott chi-square test.
Variable		n	%	n	%	n	%	p^a a Rao-Scott chi-square test.
	Total	464		316		148
Age group (years)								0.0001
	18–29	151	32.3	116	34.0	35	27.9
	30–39	102	28.6	82	32.6	20	18.9
	40–49	85	23.2	58	22.6	27	24.9
	50–64	126	15.9	60	10.8	66	28.3
Education level (years of study)								< 0.0001
	0–8	198	39.2	102	30.3	96	60.9
	9 or more	266	60.8	214	69.7	52	39.1
Family income per capita (MW^b b Minimum wage (MW) valid at the time of the research: January to April/2008: R$415.00; May/2008 to April/2009: R$450.00. )								0.0001
	< 1	180	38.4	106	31.5	74	55.3
	≥ 1	284	61.6	210	68.5	74	44.7
Race (self-reported)^c c Four women who self-reported as yellow were excluded.								0.4057
	White	344	76.1	232	74.7	112	79.6
	Black	28	6.6	24	7.9	4	3.6
	Brown	88	17.3	57	17.4	31	16.8
Marital status								< 0.0001
	Married	220	47.8	123	41.0	97	64.1
	Living together/Cohabitating	68	16.7	45	16.0	23	18.5
	Divorced/Separated/Widowed	53	10.2	36	10.2	17	10.1
	Single	123	25.3	112	32.8	11	7.3
Number of children								< 0.0001
	Zero	132	28.6	125	38.4	7	4.9
	1	98	23.2	68	23.7	30	22.0
	2	118	25.4	64	20.9	54	36.1
	3 or more	116	22.8	59	17.0	57	37.0
Number of persons in the household								0.0584
	1 to 2	122	22.2	88	25.4	34	14.6
	3 to 4	213	49.6	146	49.1	67	50.6
	5 or more	129	28.2	82	25.5	47	34.8
Housekeeper								0.3707
	No	417	90.3	282	89.4	135	92.5
	Yes	47	9.7	34	10.6	13	7.5

Components of the BHEI-R	Means (95%CI)		Beta coefficients (p)
Components of the BHEI-R	Working women^a a Reference category used for comparison.	Stay-at-home women	Crude	Adjusted^b b Adjusted for age, education level, income, marital status, and number of children.
Total fruits	2.11 (1.77–2.46)	1.77 (1.34–2.19)	-0.35 (0.135)	-0.35 (0.110)
Whole fruits	2.12 (1.72–2.52)	2.09 (1.59–2.59)	-0.03 (0.901)	0.03 (0.891)
Total vegetables	3.20 (2.99–3.42)	2.82 (2.38–3.26)	-0.38 (0.050)	0.0004 (0.998)
Dark green and orange vegetables	1.59 (1.35–1.83)	1.16 (0.80–1.53)	-0.43 (0.028)	-0.25 (0.277)
Total grains	4.63 (4.52–4.74)	4.65 (4.47–4.83)	0.02 (0.832)	0.04 (0.658)
Whole grains	0.26 (0.12–0.40)	0.27 (0.07–0.46)	0.01 (0.928)	0.003 (0.981)
Milk and dairy products	4.72 (4.18–5.27)	4.35 (3.69–5.00)	-0.38 (0.361)	0.23 (0.529)
Meat and eggs	8.27 (7.97–8.57)	8.21 (7.71–8.70)	-0.06 (0.810)	-0.11 (0.705)
Sodium	2.42 (2.07–2.76)	2.11 (1.67–2.54)	-0.31 (0.218)	-0.22 (0.448)
Oils	8.48 (8.04–8.92)	9.05 (8.51–9.59)	0.57 (0.098)	0.38 (0.334)
Saturated fat	5.67 (5.19–6.16)	6.44 (5.71–7.17)	0.77 (0.074)	0.58 (0.201)
SoFAAS	9.31 (8.57–10.05)	10.51 (9.31–11.70)	1.20 (0.077)	0.68 (0.322)
Total BHEI-R	52.79 (51.24–54.34)	53.42 (50.97–55.86)	0.63 (0.590)	1.03 (0.436)

Components of the BHEI-R	Adjusted analyses^a a Adjusted for age, income, marital status, and number of children.
	Up to 8 years			9 years or more
	Working women^b b Reference category used for comparison.	Stay-at-home women	β (p)	Working women^b b Reference category used for comparison.	Stay-at-home women	β (p)
Total fruits	1.99	1.42	-0.81 (0.004)	2.17	2.31	0.25 (0.567)
Whole fruits	1.90	1.52	-0.71 (0.015)	2.21	2.97	0.82 (0.081)
Total vegetables	2.49	2.55	-0.01 (0.974)	3.52	3.24	-0.01 (0.977)
Dark green and orange vegetables	1.31	0.86	-0.52 (0.053)	1.71	1.64	0.12 (0.786)
Total grains	4.56	4.67	0.10 (0.442)	4.66	4.62	-0.10 (0.452)
Whole grains	0.16	0.10	-0.14 (0.186)	0.30	0.54	0.20 (0.430)
Milk and dairy products	3.48	3.82	0.27 (0.636)	5.27	5.18	0.03 (0.957)
Meat and eggs	8.53	8.09	-0.57 (0.154)	8.16	8.38	0.28 (0.475)
Sodium	2.12	1.88	-0.09 (0.807)	2.54	2.46	-0.38 (0.364)
Oils	8.64	9.08	0.54 (0.241)	8.40	9.00	0.36 (0.429)
Saturated fat	6.34	6.74	0.17 (0.750)	5.39	5.98	1.12 (0.123)
SoFAAS	9.90	11.40	0.86 (0.249)	9.05	9.11	0.24 (0.807)
Total BHEI-R	51.44	52.13	-0.91 (0.593)	53.37	55.42	2.93 (0.226)

Components of the BHEI-R	Means (95%CI)		Beta coefficients (p)
Components of the BHEI-R	9 years or more^a a Reference category used for comparison.	Up to 8 years	Crude	Adjusted^b b Adjusted for age, income, marital status, and number of children.
Total fruits	2.21 (1.83–2.60)	1.76 (1.38–2.14)	-0.45 (0.078)	-0.57 (0.035)
Whole fruits	2.41 (1.98–2.83)	1.75 (1.31–2.19)	-0.65 (0.017)	-0.83 (0.002)
Total vegetables	3.41 (3.17–3.65)	2.63 (2.25–3.01)	-0.78 (0.001)	-0.73 (0.005)
Dark green and orange vegetables	1.66 (1.36–1.97)	1.27 (0.93–1.60)	-0.39 (0.084)	-0.28 (0.250)
Total grains	4.63 (4.51–4.76)	4.61 (4.46–4.76)	-0.02 (0.825)	-0.02 (0.873)
Whole grains	0.38 (0.22–0.54)	0.12 (0.03–0.21)	-0.26 (0.004)	-0.36 (0.002)
Milk and dairy products	5.29 (4.77–5.80)	3.66 (3.11–4.22)	-1.62 (0.000)	-1.66 (0.000)
Meat and eggs	8.04 (7.67–8.41)	8.32 (7.94–8.69)	0.27 (0.283)	0.19 (0.554)
Sodium	2.63 (2.28–2.99)	2.00 (1.66–2.34)	-0.64 (0.007)	-0.72 (0.005)
Oils	8.41 (8.00–8.82)	8.92 (8.41–9.43)	0.51 (0.111)	-0.04 (0.911)
Saturated fat	5.61 (5.10–6.12)	6.59 (6.00–7.18)	0.98 (0.012)	0.98 (0.030)
SoFAAS	9.03 (8.31–9.76)	10.88 (9.87–11.88)	1.84 (0.003)	0.86 (0.205)
Total BHEI-R	53.73 (52.10–55.36)	52.52 (50.53–54.50)	-1.21 (0.300)	-3.17 (0.013)

Components of the BHEI-R	Adjusted analyses^a a Adjusted for age, income, marital status, and number of children.
	Stay-at-home women			Working women
	Up to 8 years	9 years or more^b b Reference category used for comparison.	β (p)	Up to 8 years	9 years or more^b b Reference category used for comparison.	β (p)
Total fruits	1.42	2.31	-0.88 (0.066)	1.99	2.17	-0.42 (0.235)
Whole fruits	1.52	2.97	-1.60 (0.001)	1.90	2.21	-0.56 (0.153)
Total vegetables	2.55	3.24	-0.79 (0.118)	2.49	3.52	-0.94 (0.002)
Dark green and orange vegetables	0.86	1.64	-1.04 (0.014)	1.31	1.71	-0.07 (0.827)
Total grains	4.67	4.62	0.12 (0.505)	4.56	4.66	-0.14 (0.314)
Whole grains	0.10	0.54	-0.67 (0.040)	0.16	0.30	-0.30 (0.009)
Milk and dairy products	3.81	5.18	-1.29 (0.115)	3.48	5.27	-1.84 (0.001)
Meat and eggs	8.09	8.38	-0.82 (0.089)	8.53	8.16	0.66 (0.084)
Sodium	1.88	2.46	-0.09 (0.799)	2.12	2.54	-0.75 (0.028)
Oils	9.01	8.99	-0.03 (0.947)	8.64	8.40	-0.18 (0.689)
Saturated fat	6.74	5.98	0.83 (0.319)	6.34	5.39	0.86 (0.164)
SoFAAS	11.40	9.11	0.43 (0.694)	9.90	9.04	0.12 (0.889)
Total BHEI-R	52.13	55.42	-5.83 (0.026)	51.44	53.37	-3.54 (0.075)

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[1] Correspondence: Daniela de Assumpção, Rua Tessália Vieira de Camargo, 126, Cidade Universitária, 13083-887 Campinas, SP, Brasil E-mail: danideassumpcao@gmail.com