Association of sociodemographic factors and a healthy and sustainable dietary pattern in adult population in Mexico, United States, and Canada: a cross-sectional study

Abstract

Background

Evaluating diet in terms of health and environmental impact is crucial to transform current food systems to encourage a healthier and more sustainable approach.

Objectives

In this study, we analyzed the association between a healthy and sustainable dietary pattern and sociodemographic factors in adults from Mexico, the United States, and Canada.

Methods

This cross-sectional study included adults aged ≥20 y. We assessed the dietary quality on health and environment dimensions using the World Index for Sustainability and Health (WISH). Dietary information was collected using a 24-h recall from national surveys in Mexico, the United States, and Canada. Compliance with the recommendations of 13 food groups was estimated to obtain a total score of 130. Multiple linear regression models were used to estimate the association between the total score and sociodemographic factors.

Results

The total WISH score was low in Mexico (47.6 ± 0.78), Canada (44.2 ± 0.29), and the United States (41.3 ± 0.31). The highest scores in protective foods were whole grains (4.8 ± 0.25) in Mexico. In limiting foods, the lowest scores were: red meat (4.4 ± 0.10) and added sugars (3.0 ± 0.10) in the United States and saturated fat in Canada (5.5 ± 0.09). Being female [β: 2.4, 95% confidence interval (CI): 1.4, 3.5], or over 60 y old (β: 3.1, 95% CI: 1.8, 4.3) and having a higher educational level (β: 2.5, 95% CI: 1.4, 3.6) were associated with higher scores.

Conclusions

Mexico, the United States, and Canada have an unhealthy and high environmental impact dietary pattern. The groups with lower compliance are males, younger individuals, and those with lower educational attainment.