Contribution of Take-Out Food Consumption to Socioeconomic Differences in Fruit and Vegetable Intake: A Mediation Analysis

Lower fruit and vegetable (FN) intake among socioeconomically disadvantaged groups has been well documented, and may be a consequence of a higher consumption of take-out foods. This study examined whether, and to what extent, take-out food consumption mediated (explained) the association between socioeconomic position and FN intake. A cross-sectional postal survey was conducted among 1,500 randomly selected adults aged 25 to 64 years in Brisbane, Australia, during 2009 (response rate 63.7%, N=903). A food frequency questionnaire assessed usual daily servings of F/V (0 to 6), overall takeout consumption (times per week), and the consumption of 22 specific take-out items (never to once per day or more). These specific take-out items were grouped into "less healthy" and "healthy" choices and indexes were " created for each type of choice (0 to 100). Socioeconomic position was ascertained by education. The analyses were performed using linear regression, and a bootstrap resampling approach estimated the statistical significance of the mediated effects. Mean daily servings of F/V were 1.89 +/- 1.05 and 2.47 +/- 1.12, respectively. The least educated group members were more likely to consume fewer servings of fruit (beta = -.39, P<0.001) and vegetables (beta = -.43, P<0.001) compared with members of the highest educated group. The consumption of "less healthy" takeout food partly explained (mediated) education differences in F/V intake; however, no mediating effects were observed for overall and "healthy" take-out consumption. Regular consumption of "less healthy" take-out items may contribute to socioeconomic differences in F/V intake, possibly by displacing these foods. J Am Diet Assoc. 2011;111:1556-1562.