Intermediate socioeconomic status is associated with a healthier dietary pattern compared to other socioeconomic groups: a study based on the MASHAD cohort study

Abstract Introduction: Socioeconomic status (SES) can be defined by a combination of demographic factorsincludingeducationalstatus, income, and place of residence, household size and occupation. Different factors may be affected by income and occupation including access to a high-quality diet. Therefore, we aimed to evaluate the relationship between SES and dietary patterns (DPs) in a sample of adults from northeastern Iranian. Methods : In this cross-sectional study, participants aged 35 to 65 years oldwere recruited andLatent Class Analysis (LCA) was used to cluster them based on SES.LCA is a multivariate statistical method used to identify homogeneous subgroups in a population with a chosen set of discrete indicators. All necessary information including the patient’s socio-demographic characteristics and lifestyle factors (PAL and tobacco use) were collected according to a comprehensive questionnaire.The dietary patterns of all participants were assessed based on the validated and reliable FFQ encompassing 65 food items. Frequency (per month, per week, per day, rarely and never) and portion size of each food item were completed via face-to-face interviews by skilled nutritionists. The analysis was performed based on the principal componentsfactor analysis (PCA) method.Logistic regression analysis was performed to evaluate the.association of social level and dietary patterns among the study population. Results: After adjustment for confounding factors, results showed that people with high SES had a balanced DP in comparison to those with an intermediate SES; while, SES was not associated with adherenceto the western DP. ( p <0.001). Participants with a low SES compared to those with an intermediate SES, had a lower odds of consuming a balanced DP ( p <0.001). There was no significant association between SES and consumption of the western DP. Conclusion: In middle-aged Iranian adults, people with intermediate SES were more adherent to a balanced DP than individuals with either low or high SES.