Social inequality in food consumption between 2008 and 2019 in Brazil

Abstract

Objective: To analyse the trend of social inequality in food consumption among Brazilians from 2008 to 2019.

Design: Time series analyses using cross-sectional annual data from the Telephone Surveillance System (VIGITEL 2008-2019). Food consumption was evaluated through: (1) consumption of five or more portions of fruits and vegetables in ≥5 d/week; (2) consumption of beans in ≥5 d/week and (3) consumption of soft drinks or artificial juices in ≥5 d/week. Absolute inequality was assessed by the slope index of inequality (SII) and relative inequality by the concentration index (CIX). SII and CIX positive values indicate higher prevalence among more educated citizens and negative among less educated ones. Time trend was assessed by linear regression using weighted least squares.

Setting: 26 Brazilian state capitals and the Federal District.

Participants: 621 689 individuals ≥18 years.

Results: Fruits and vegetable consumption was more prevalent among the more educated citizens, while beans were mostly consumed by the less educated, and soft drinks or artificial juices was more prevalent among individuals with intermediate education. The highest absolute inequality was found for beans (SII2019 -25·9). In 12 years, the absolute inequality increased for fruit and vegetable consumption (from SII2008 12·8 to SII2019 16·2), remained for beans (SII2008 -23·1 to SII2019 -25·9) and reduced for soft drinks or artificial juices (SII2008 8·7 to SII2019 0·4). Relative inequality was low and constant.

Conclusion: Despite the advances reducing inequalities in soft drinks or artificial juice consumption, the increase in the social gap for adequate consumption of fruits and vegetables is troublesome.

Keywords: Education; Food consumption; Foods; Inequality; Surveillance.

Fig. 1

Consumption prevalence of fruits and vegetables, beans and soft drinks or artificial juices in Brazil, by years of education and survey year, VIGITEL 2008–2019 (equiplot). VIGITEL, Surveillance of Risk and Protective Factors for Chronic Diseases through Telephone Interviews. *Food consumption of 5 or more servings per day in 5 or more days of the week. ^†Food consumption in 5 or more days of the week. ^‡Lack of an available indicator in 2018. , 0–3; , 4–8; , 9–11; , ≥ 12

Fig. 2

Trends in the predicted slope index of educational inequality (SII) and predicted concentration index of educational inequality (CIX) for consumption prevalence of fruits and vegetables (a; b), beans (c; d) soft drinks or artificial juices (e; f) in Brazil, by sex and skin colour/race, VIGITEL 2008–2019. VIGITEL, Surveillance of Risk and Protective Factors for Chronic Diseases through Telephone Interviews. *Food consumption of 5 or more servings per day in 5 or more days of the week. ^†Food consumption in 5 or more days of the week. ^§ P < 0·05 (P-trend). , total; , female; , male; , White; , Black/Brown

Fig. 3

Consumption prevalence of fruits and vegetables, beans and soft drinks or artificial juices in Brazil, by sex and skin colour/race and the slope index of educational inequality (SII) (a) and concentration index of educational inequality (CIX) (b), VIGITEL 2019. VIGITEL, Surveillance of Risk and Protective Factors for Chronic Diseases through Telephone Interviews. *Food consumption of 5 or more servings per day in 5 or more days of the week. ^†Food consumption in 5 or more days of the week. , total; , female; , male; , White; , Black/Brown