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Providing perspectives on recent research into vitamins and nutritionals


Nutrition is Affected by Socioeconomic Status – Where is the Sense of Urgency?

By Michael McBurney

Nutritional vulnerability is consistently associated with socioeconomic status (SES).  And like genetics and age, we cannot immediately change our SES. Yes, education and opportunity may change the future but for the moment, people are  constrained by their current SES.

For those living under lower SES conditions, they carry a disproportionately heavy disease burden. Low SES individuals are more likely to experience periods when food choice and availability is limited. This may partially explain why lower SES individuals consume more energy-dense foods and fewer fruit and vegetables.

Low SES increases the risk of iron deficiency and anemia among Vietnamese women. Iron deficiency is a major cause of anemia. Inadequate intake of iron can be compounded by deficiencies of folate, vitamins B12 and vitamin A which also contribute to the development of anemia. As SES increased, so did red meat consumption and serum ferritin levels. Red meat is not required to prevent iron deficiency but people eating vegetarian diets may benefit from supplementation.

Maternal iron deficiency threatens the health of mothers and inhibits the development of their children. 25% of children under 5y have iron deficiency anemia in many countries. Low SES two-year old children are more likely to consume energy-dense foods.

Dietary patterns are influenced by older siblings (not in a positive manner) and the education of their grandparents as well as their parents. Children of less-educated parents have less healthy dietary patterns. Unless there is an economic windfall, it takes time for parents, and their children, to move up the SES continuum. It may takes years of education and economic improvement to overcome cultural and familial mores. While people strive to improve their SES status, it is important to be indifferent  to the means  – fortified foods and dietary supplementation – and to focus on improving nutritional status. The individual and societal consequences of hidden hunger don’t wait while the most vulnerable try to improve their situation. Time stops for no one.

Main Citations

Nguyen PH, Gonzalez-Casanova I, Nguyen H, Pham H, Truong TV, Nguyen S, Martorell R, Ramakrishnan U. Multicausal etiology of anemia among women of reproductive age in Vietnam. 2014 EJCN doi: 10.1038/ejcn.2014.181

Vilevl S, Oliveira A, Pinto E, Moreira P, Barros H, Lopes C. The influence of socioeconomic factors and Family contexto on energy-dense food consumption among 2-year-old children. 2015 EJCN doi: 10.1038/ejcn.2014.140

Fernandez-Alvira JM, Bornhorst C, Bammann K, Gwozdz W, Krogh v, Hebestreit A, Barba G, Reisch L, Eiben G, Iglesia I, Veidebaum T, Kourides YA, Kovacs E, Huybrechts I, Pigeot I, Moreno LA. Prospective associations between socio-economic status and dietary patterns in European children: the Identification and Prevention of Dietary- and Lifestyle-induced Health Effects in Children and Infants (IDEFICS) Study. 2015 Br J Nutr doi: 10.10.1017/S0007114514003663

Other Citations

Mackenbach JP, Stirbu I, roskam A-JR, Schaap MM, Menvielle G, Leinsalu M, Kunst AE. Socioeconomic inequalities in health in 22 European countries. 2008 NEJM doi: 10.1056/NEJMsa0707519

Darmon N, Drewnowski A. Does social class predict diet quality? 2008 Am J Clin Nutr 87(5):1107-1117

Anand T, Rahi M, Sharma P, Ingle GK. Issues in preventing iron deficiency anemia in India. 2014 Nutr doi: 10.1016/j.nut.2013.11.022

Black MM, Quigg AM, Hurley KM, Pepper MR. Iron deficiency and iron-deficiency anemia in the first two years of life: strategies to prevent loss of developmental potential. 2011 Nutr Rev doi: 10.1111/j.1753-4887.2011.00435.x