The Association of Unhealthy Diet with Socioeconomic Inequality in Children: A Study in Kurdistan, West of Iran

Background: The prevalence of obesity is an increasing public health problem. Objectives: The present study aimed at estimating the prevalence of unhealthy diet among children aged 10 - 12 years in Kurdistan, west of Iran and assessing the association of unhealthy diet with socioeconomic inequality. Methods: The present cross-sectional study was conducted on 2506 children living in Sanandaj city, west of Iran in 2015. The subjects were selected from the schools by multistage sampling method. The required data were collected using the food frequency questionnaire. The socioeconomic status (SES) was calculated by measuring household asset by using principal component analysis technique. The inequality was measured using concentration index, and Blinder-Oaxaca decomposition method was utilized to determine the proportion of different determinants causing inequality. Results: The prevalence of unhealthy diet was 50.75% (95% confidence interval (CI): 48.79 - 52.71). The concentration index for unhealthy diet was -0.14 (95% CI: -0.18, -0.09), indicative of concentration of unhealthy diet in the group with low SES (P < 0.001). The Blinder-Oaxaca decomposition analysis showed that the poor-rich gap in the prevalence of unhealthy diet was 27.77%, while 59.41% of the observed gap attributed to the explained component. The major causes of inequality were mother’s level of education and place of residence, respectively. Conclusions: The obtained results showed that the prevalence of unhealthy diet was higher in children with low SES. Increasing mothers’ awareness of health literacy and performing place-based interventions can be effective in decreasing socioeconomic inequalities in unhealthy diet and prevention of chronic diseases in children.