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# Race, socioeconomic status, and nutrition

## Problem

Significant dietary and nutritional differences can be found among racial and socioeconomic groups in the United States. These nutritional behavioral differences are the foci of many studies since they contribute to racial disparities in the incidence and prevalence of chronic disease and premature morbidity.
Using survey data of over 60,000 participants collected by the US Department of Agriculture, Study 1 compared the dietary trends among 32,406 Black and White nonpregnant adults (18 years or older) of varying socioeconomic status (SES). The primary outcome was the score (0-16) on the Diet Quality Index (DQI), a composite of eight food-and-nutrient-based recommendations from the National Academy of Sciences, including areas such as “eating 5 or more servings daily of vegetables and fruits” and “limit total daily intake of sodium to 2400 mg or less”. For each recommendation a person could score 0-2, according to specified intake amounts. A total score of 4 or less was considered to indicate a more healthy diet, and a value of 10 or more indicates a relatively less healthy diet.
Categories of SES were based on education and income. Respondents with over 12 years of education and an income level over 350, percent of poverty level were categorized as “high SES”, and those with less than a high-school education and income less than 185, percent were classified as “low SES”. Three time periods were taken into account: 1965 ( I ), 1977-1978 ( II ), and 1989-1991 ( III ), to observe trends over time. Table 1 displays some results.
More recently Study 2 adjusts for SES, and directly explores the association between race and nutrition. Using data from the 1993-1999 California Dietary Practices Survey, a researcher examines the differences between the nutritional behavior of Blacks and Whites (n=3,350). The researcher attempts to observe whether Blacks differ significantly from Whites in terms of health-related nutritional behaviors that have established associations to the development of heart disease, cancer, stroke, and diabetes. The results indicate that, even within the same SES group, Whites are more likely, on average, to exhibit healthy nutritional behaviors such as the consumption of at least five fruits, dairy products, high fiber cereals, lowfat dairy products, and avoiding the consumption of deep-fried foods and snacks (statistically significant). However, for categories such as “consuming wholegrain products” or “consuming beans” no significant differences were found among the two racial groups in the same SES groups.
Sources: Adapted from Popkin, B.M., Siega-Riz, A.M. & Haines, P.S. (1996). A Comparison of Dietary Trends among Racial and Socioeconomic Groups in the United States. New England Journal of Medicine, 335, 716-720. Bahr, P.R. (2007). Race and nutrition: an investigation of Black-White differences in health-related nutritional behaviors. Sociology of Health and Illness, 29(6), 831-856.
According to Table 1, which of the following is true?