Adherence to dietary guidelines for fruit, vegetables and fish among older Dutch adults; the role of education, income and job prestige

OBJECTIVES: Little is known about socio-economic differences in dietary intake among older adults. In this study we describe self-reported dietary adherence to the fruit, vegetables and fish guidelines among older Dutch adults and investigate the independent associations of three socio-economic status (SES) indicators with adherence to these guidelines. DESIGN: Cross sectional data-analyses. SETTINGS: The Longitudinal Aging Study Amsterdam (LASA), the Netherlands. SUBJECTS: 1057 community dwelling older adults, aged 55–85 years. MEASUREMENTS: Fruit, vegetable and fish intake was assessed using a short food frequency questionnaire. We measured SES using self-reported levels of education, household income and occupational prestige. RESULTS: 82.5% of the respondents reported to adhere to the fruit guideline, 65.1% to the vegetables guideline, and 31.7% to the fish guideline. After adjustment for confounders and the other two SES indicators, respondents in the lowest education group adhered less often to the vegetables guideline (OR 0.39 (95% CI 0.22–0.70)) compared to those in the highest education group. Respondents in the lowest income group adhered less often to the fruit (0.44 (95 % CI 0.22–0.91) and fish guideline (OR 0.55 (95% CI 0.33–0.91) compared to those in the highest groups. Occupational prestige was not independently associated with adherence any the guidelines. CONCLUSION: Selfreported adherence to the fruit, vegetables and fish guidelines among older adults can be improved and particularly in those with a low SES. Education and income have independent and unique contributions to dietary adherence. Future research should investigate potential pathways through which these specific SES indicators influence dietary adherence.