Fifteen-year trends in the prevalence of barriers to healthy eating in Switzerland
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Fifteen-year trends in the
prevalence of barriers to healthy
eating in Switzerland
Carlos de Mestral
Swiss Public Health Conference, Basel - November 2017
PhD candidate in the Division of Chronic Diseases, Institute of Social and Preventive Medicine, Lausanne, Switzerland
IUMSP – Institut universitaire de
médecine sociale et préventive 1
Background
Healthy eating:
- World Health Organization, 2016
IUMSP – Institut universitaire de
médecine sociale et préventive 2
Background
Most people do not eat healthfully
• Low adherence to dietary recommendations for most foods groups
• menuCH sample:
• 18% - fruits & vegetables
• 22% - total meat
• 6% - Nuts, seeds, olives…
- Chatelan et al., 2017. Nutrients.
• Bus Santé sample:
• Substantial deviation from recommended optimal macro and micro
nutrient intake
- de Abreu et al., 2012. Clinical Nutr.
IUMSP – Institut universitaire de
médecine sociale et préventive 3
Background
Higher
Socioeconomic
Diet quality
gradient in diet
quality
Lower
Lower Socioeconomic Position Higher
- Darmon & Drewnowski, 2008. AJCN; Wang et al, 2010. JAMA Internal Med.
IUMSP – Institut universitaire de
médecine sociale et préventive 4
Background
• In Switzerland, several barriers to healthy eating are:
1. highly prevalent (≥20%)
2. demographically and socioeconomically patterned
IUMSP – Institut universitaire de
médecine sociale et préventive 5
Background
Price 43.2
Prevalence of 35.8
barriers to healthy 39.8
Daily habits, constraints 37.5
eating in Switzerland,
by sex, Swiss Health Fondness of goodTaste
food 38.8
51.0
Survey, 2012
Barriers to healthy eating
34.8
Time constraint 29.0
22.0
Lack of willpower 21.2
19.5 Women
Limited options in restaurants 17.1
11.0 Men
Fondness of abundant food 16.4
No social support 7.8
6.1
Limited options at market 5.9
6.1
Social group opposition 3.0
1.8
0 10 20 30 40 50 60 70 80
Prevalence (%) and 95% CI
IUMSP – Institut universitaire de
médecine sociale et préventive 6
Objective
• To assess fifteen-year trends in the prevalence of self-reported
barriers to healthy eating, overall and according to demographic
and socioeconomic indicators.
IUMSP – Institut universitaire de
médecine sociale et préventive 7
Methods
Swiss Health Survey
• Four surveys: 1997, 2002, 2007, 2012
• “Please identify which of the following barriers prevent you from
having a healthy diet…”
1. Time constraint 6. Social group opposition
2. Limited options at markets 7. Taste
3. Limited options in restaurants/cafes/cafeterias 8. Fondness of abundant food
4. Price 9. Daily habits and constrains
5. Lack of social support 10. Lack of willpower
IUMSP – Institut universitaire de
médecine sociale et préventive 8Methods
• Trends assessed according to:
1. Gender
2. Age (18-35, 36-50, 51-65, >65)
3. Income (quartiles)
4. Education (primary, secondary, tertiary)
• Multivariable adjusted logistic regression
• Statistical significance at pResults
Trends in prevalence of barriers to healthy eating in Switzerland, 1997-2012, SHS
IUMSP – Institut universitaire de
médecine sociale et préventive 10Results
• Trends in prevalence were similar for all barriers irrespective of sex
and age
IUMSP – Institut universitaire de
médecine sociale et préventive 11Results
• Trends in prevalence were similar for all barriers irrespective of
education and income
IUMSP – Institut universitaire de
médecine sociale et préventive 12Limitations
• Self-reported answers
• No assessment of “healthy eating” understanding
• Excluded participants (29%)
IUMSP – Institut universitaire de
médecine sociale et préventive 13Conclusion
• Over a 15-year period, several barriers to healthy eating
remained highly prevalent in the adult Swiss population
• Trends in prevalence evolved similarly irrespective of sex, age,
education, and income.
IUMSP – Institut universitaire de
médecine sociale et préventive 14Thank you for your attention
IUMSP – Institut universitaire de
médecine sociale et préventive 15Source: Swiss Federal Statistical Office – Consumer Price Index. Available at:
http://www.bfs.admin.ch/bfs/portal/en/index/themen/05/02/blank/key/basis_aktuell.html
IUMSP – Institut universitaire de
médecine sociale et préventive 16Item German French Italian English translation Abridged statement
Hofer Zeitaufwand für Les achats et la préparation Troppo tempo per gli acquisti Shopping and preparation
1 “Time”
Einkaufen und Zubereitung. prennent beaucoup de temps. e la preparazione dei pasti. takes too much time.
Zu wenig Angebote in den L’offre dans les magasins est L’offerta nei negozi è troppo Options are too limited at the “Limited options at
2
Geschäften. trop restreinte. scarsa. store. markets”
L’offre dans les restaurants,
Zu wenig Angebote in L’offerta nei ristoranti, mense, Options are too limited in
3 cantines, etc. est trop “Limited options”
Restaurants, Kantinen, usw. ecc. è troppo scarsa. restaurants, cafeterias, etc.
restreinte.
Gesundes Essen ist relativ Une alimentation saine est Il costo dell’alimentazione
4 Healthy eating is expensive. “Price”
teuer. relativement chère. sana è relativamente alto.
Zu wenig Unterstützung durch Le manque de soutien de la Poco aiuto dalle persone Lack of support from my
5 “No social support”
Mitmenschen. part de mon entourage. circonstanti. social group.
Mon entourage fait Ostacoli da parte delle Opposition from my social
6 Mitmenschen halten davon ab. “Social opposition”
opposition. persone circonstanti. group.
Grosse Vorliebe für gutes Grande preferenza per il
7 J’aime bien manger. Fondness of good food. “Taste”
Essen. mangiare bene.
Grosse Vorliebe für reichliches Grande preferenza per il “Fondness of
8 J’aime beaucoup manger. Fondness of abundant food.
Essen. mangiare molto. abundant food”
Le abitudini e le esigenze della
Gewohnheiten und Zwänge des Les habitudes et contraintes Habits and constraints of daily
9 vitaquotidiana lo “Daily habits”
Alltags. de la vie quotidienne. life.
impediscono.
Fehlender Wille, fehlender Le manque de volonté, pas Poca volontà e scarsa fiducia
10 Lack of willpower. “Lack of willpower”
Glaube an Erfolg. convaincu de l’efficacité. in un risultato positivo.
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