Socioeconomic mobility, Mediterranean diet adherence and ultra-processed food consumption

Background

Socioeconomic position across the life course influences dietary behaviours, but the role of socioeconomic mobility in shaping Mediterranean diet (MD) adherence and ultra-processed food (UPF) consumption is unclear.

Methods

We analysed 21,836 adults from the Moli-sani Study (Italy, 2005-2010). Life-course socioeconomic trajectories combined, for each individual, childhood (at age 8) material SES with adult SES, assessed through educational attainment and material resources and dichotomized as low/high. Participants were classified into stable, upward, and downward trajectories. Diet was assessed at baseline using a validated FFQ, MD adherence and UPF consumption were analyzed as binary outcomes. Multivariable logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI), across trajectories (with stable as reference), adjusting for demographic, lifestyle, and clinical factors.

Results

Among individuals with low childhood SES (n = 10,602), upward mobility (both educational and material) was associated with both higher MD adherence (OR = 1.24; 95%CI 1.10–1.41) and higher UPF consumption (OR = 1.30; 95%CI 1.16–1.45). Among those with high childhood SES (n = 11,234), downward mobility (both educational and material) was associated with both lower MD adherence (OR = 0.81; 95%CI 0.73–0.90) and lower UPF consumption (OR = 0.69; 95%CI 0.63–0.77).

Conclusions

Socioeconomic mobility is differentially associated with dietary behaviors. Upward mobility was associated, as it might have been expected, with better MD adherence but also, quite surprisingly, higher UPF intake. Downward mobility showed the opposite pattern. Improvements in SES may not necessarily translate into healthier dietary behaviors, highlighting the need for strategies addressing both diet quality and UPF reduction across socioeconomic groups.

Key messages

• Socioeconomic mobility is associated with both Mediterranean diet adherence and UPF consumption, with heterogeneous patterns across upward and downward trajectories.

• Dietary changes across socioeconomic trajectories are not uniform, indicating complex links between social mobility and food choices.