Topical Area: Community and Public Health Nutrition
Rural populations are generally older, sicker, and poorer than their urban counterparts. Few studies have examined differences in dietary patterns by urbanization that may mirror differences in health by urbanization. Our objective is provide national estimates of dietary patterns among adults by urbanization level.
Methods : Using a single 24 hour recall from NHANES 2013-2016, we estimated the mean consumption of fruits, vegetables, percent of calories from added sugars and percent of calories from saturated fats, by age, sex, education, race and Hispanic origin, and urbanization level among US adults aged 20 and over (n=9939). We used SUDAAN to conduct all analyses and we evaluated differences between groups using a t statistic and tests of trend across ordinal variables using orthogonal contrast matrices.
Results : During 2013-2016, the average fruit intake (cup equivalence) was 0.9 (SE 0.03) for both men and women. After adjustment by age, education level, and race and Hispanic origin, fruit intake increased with higher level of urbanization, from 0.6 (SE 0.07) in rural areas, to 0.9 (SE 0.05) in medium or small urban areas, to 1.0 (SE 0.04) in large urban areas among men. After adjustment, differences by urbanization were not significant for women. The average percent of calories from added sugars on a given day was 12% (SE 0.2) for both men and women. After adjustment, added sugars intake decreased with higher level of urbanization, from 14.0% (SE 0.9) in rural areas, to 12.6% (SE 0.3) in medium to small urban areas, to 12.0% (SE 0.2) in large urban areas among women. A similar pattern was also observed among men. There were no differences in vegetable consumption or percent of energy from saturated fat by level of urbanization.
Conclusions : Disparities in dietary patterns exist by urbanization. Additional research may show how these differences impact health and identify opportunities to improve health in rural communities.
Funding Sources :
The National Center for Health Statistics and the US Centers for Disease Control and Prevention funded this study.