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International Journal of Epidemiology 2000;29:438-448
© International Epidemiological Association 2000

Socioeconomic differences in fat intake in a middle-aged population: report from the Malmö Diet and Cancer Study

Martin Lindströma, Bertil S Hansona, Eric Brunnerb, Elisabet Wirfältc, Sölve Elmståhla, Irene Mattissonc and Per-Olof Östergrena

a Department of Community Medicine, University Hospital MAS, Lund University, S 205 02 Malmö, Sweden. E-mail: Martin.Lindstrom{at}smi.mas.lu.se
b International Centre for Health and Society, Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WCIE 6BT, UK.
c Department of Medicine, Surgery and Ortopedics, University Hospital MAS, Lund University, S 205 02 Malmö, Sweden.

Reprint requests to: M Lindstrom, Department of Community Medicine, University Hospital MAS, Lund University, S 205 02 Malmö, Sweden. E-mail: Martin.Lindstrom{at}smi.mas.lu.se

Background The objective was to investigate whether socioeconomic differences in fat intake may explain socioeconomic differences in cardiovascular diseases.

Methods The Malmö Diet and Cancer Study is a prospective cohort study. The baseline examinations used in the present cross-sectional study were undertaken in 1992–1994. Dietary habits were assessed using a modified diet history method consisting of a 7-day menu book and a 168-item questionnaire. A subpopulation of 11 837 individuals born 1926–1945 was investigated. This study examined high fat intake, defined as >35.9% among men and >34.8% among women (25% quartile limit) of the proportion of the non-alcohol energy intake contributed by fat. The subfractions saturated, mono-unsaturated and poly-unsaturated fatty acids and the P:S ratio (polyunsaturated/saturated fatty acids) were analysed in the same way. The uppermost quartile (75%) of total and subgroup fat intake was also studied. Socioeconomic differences before and after adjustment for low energy reporting (LER), defined as energy intake below 1.2 x Basal Metabolic Rate, were examined.

Results No socioeconomic differences in fat intake were seen between the SES groups, except for self-employed men, and male and female pensioners. Approximately 20% in most SES groups were LER. The LER and body mass index were strongly related. The SES pattern of fat intake remained unchanged after adjustment for age, country of origin and LER in a logistic regression model. The results for the subfractions of fat and the P:S ratio did not principally differ from the total fat results.

Conclusions This study provides no evidence that fat intake contributes to the inverse socioeconomic differences in cardiovascular diseases.

Accepted 1 December 1999


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