Dietary patterns and socioeconomic disadvantage: an analysis of food consumption patterns and their determinants in Cochabamba, Bolivia

饮食模式与社会经济劣势:玻利维亚科恰班巴市食物消费模式及其决定因素分析

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Abstract

BACKGROUND: In low- and middle-income countries, socioeconomic disadvantages often shape the dietary patterns of the people living in them, frequently towards a diet rich in calories and poor in nutrients. In Bolivia, very little is known about the dietary patterns of household; in this regard, this study aimed to identify the dietary patterns of the population in the Municipality of Cochabamba and to analyze their relationship with socioeconomic, and demographic characteristics. METHODS: We conducted a cross-sectional observational study, with data collection conducted between October 2022 and March 2023. The sampling was done through a representative complex survey design of the Cochabamba urban population (n = 4496). Dietary patterns were constructed by combining principal component analysis and cluster analysis. Given their multidimensionality, socioeconomic, and demographic variables, the prevalence of cardio-metabolic diseases and food preferences were synthesized in a standardized index. This index was constructed by applying principal component analysis and multiple correspondence analysis. The association between dietary patterns and their determinants was analyzed using multivariate logistic regression considering a significance level of 0.05. RESULTS: Two distinct dietary patterns were identified: whole-grain and plant-based foods (37%) and a calorie-rich but nutrient-poor diet (63%). This last one was statistically significantly associated with belonging to a medium-low socioeconomic stratum (p < 0.01), poor housing conditions (p < 0.05), informal occupational category (p < 0.05), food preferences for processed foods (p < 0.01), and a marginal association of interest with the prevalence of cardiometabolic diseases (p < 0.1). In this study, the peripheral areas of Cochabamba concentrated the population with the highest adherence to the calorie-rich but nutrient-poor diet. CONCLUSIONS: To our knowledge, this is the first study to analyze the relationship between socioeconomic disadvantages and dietary patterns in Cochabamba, Bolivia. Belonging to a lower socioeconomic group was the main determinant of dietary patterns. The presence of a dietary pattern composed mainly of highly processed foods highlights the need to implement public policy measures and interventions to limit the supply of these products, given their expected negative impact on health.

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