Are we Including Equity in Policies Aiming at Improving Dietary Patterns? A Systematic Review of Socioeconomic Inequalities in Diet in Chile

Understanding the socioeconomic inequalities in dietary intake is crucial when addressing the socioeconomic gradient in obesity rates and non-communicable diseases. Our paper aimed to systematically assess, for the first time, the association between socioeconomic position (SEP) and dietary intake in Chile.
We searched for peer-reviewed and grey literature from inception until 31st
ecember 2019 in PubMed, Scopus, PsycINFO, Web of Sciences and LILACS databases. Observational studies published in English and Spanish, reporting the comparison of at least one dietary factor between at least two groups of different SEP in the general Chilean population, were selected. Two researchers independently conducted data searches, screening, extraction and assessed study quality using an adaptation of the Newcastle Ottawa Quality Assessment Scale. Our results suggested 21 articles (from 18 study samples) were included. Study quality was considered low, medium and high for 24, 52 and 24% of articles respectively. Moderate-to-large associations were observed indicating a lower intake of fruit and vegetables, dairy products and fish/seafood and higher pulses consumption among the lower SEP adults. Conversely, mixed evidence of association was found for energy intake and macronutrients, in both children and adults.
Our findings highlight socioeconomic inequalities in diets in Chile, with less healthy food more commonly consumed by lower SEP groups. Further action is required to incorporate an equity-based perspective into existing and new policies aiming at improving population dietary intakes. Broader and complementary policies should also consider tackling the unequal distribution of factors affecting healthy eating among the lower SEP groups. These findings also provide important insights for developing strategies to reduce dietary inequalities in Chile and other countries that have undergone similar nutritional transitions.