Family structure and affluence in adolescent eating behaviour: a cross-national study in forty-one countries

Objective: To investigate the family structure and affluence-related inequality in adolescent eating behaviour. Design: Multivariate binary logistic regression and path analyses were employed to evaluate the impact of family structure and affluence on the consumption of fruits, vegetables, sweets and soft drinks among adolescents. Setting: The cross-national Health Behaviour in School-aged Children study in 2013/2014 across forty-one countries. Participants: Adolescents aged 11-15 years old (n 192 755). Results: Adolescents from a non-intact family were less likely to eat daily fruits (OR 0·82; 95 % CI 0·80, 0·84), vegetables (OR 0·91; 95 % CI 0·89, 0·93) and sweets (OR 0·96; 95 % CI 0·94, 0·99), but were more likely to consume soft drinks (OR 1·14; 95 % CI 1·11, 1·17), compared with their counterparts from an intact family. Adolescents who had the lowest family affluence scores (FAS) were less likely to eat daily fruits (OR 0·51; 95 % CI 0·49, 0·53), vegetables (OR 0·58; 95 % CI 0·56, 0·60) and sweets (OR 0·94; 95 % CI 0·90, 0·97), but were more likely to consume soft drinks (OR 1·25; 95 % CI 1·20, 1·30), compared with their counterparts who had the highest FAS. Across countries, a wide range of social inequality in daily consumption of foods was observed. Conclusions: Among adolescents in Europe, Canada and Israel, there was a high level of family structure and family affluence inequalities in daily food consumption. Different aspects of family socio-economic circumstances should be considered at the national level designing effective interventions to promote healthy eating among adolescents