Exploring socioeconomic and demographic inequalities in adherence to government dietary guidance among adult National Diet and Nutrition Survey (NDNS) participants (2008-2018)

Parker, Laura, O'Flaherty, Martin ORCID: 0000-0001-8944-4131, Loopstra, Rachel, Capewell, Simon ORCID: 0000-0003-3960-8999 and Colombet, Zoe ORCID: 0000-0001-6179-7517 (2026) Exploring socioeconomic and demographic inequalities in adherence to government dietary guidance among adult National Diet and Nutrition Survey (NDNS) participants (2008-2018) JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH. jech-2025-224929-. ISSN 0143-005X, 1470-2738

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Abstract

<h4>Objective</h4>Tackling unhealthy diets is a public health priority. This study describes adherence to government dietary guidance (GDG) in adults in England and explores sociodemographic associations.<h4>Methods</h4>We used National Diet and Nutrition Survey (NDNS) dietary data collected between 2018 and 2019 using 4-day food diaries with estimated portion weights to measure GDG adherence using a food and macronutrient-based adherence score (possible range 0-12). We used multivariable linear regression analysis to identify explanatory variables independently associated with adherence after adjusting for confounders.<h4>Results</h4>Participant GDG adherence scores ranged from 1 to 11 (mean 6.08 (SE 0.03)). Women had higher adherence scores compared to men (+0.32, 95% CI 0.22 to 0.42). Adults in older age groups had higher adherence scores compared with adults in the youngest age group (19-28 years), with the highest average scores observed in participants aged 59-68 years (+0.93, 95% CI 0.74 to 1.20) and 49-88 years (+0.89, 95% CI 0.70 to 1.07). Adherence scores in the least deprived quintile were higher than that in the most deprived quintile (+0.25, 95% CI 0.10 to 0.40). White ethnicity was associated with lower adherence scores than non-white participants (-0.42, 95% CI -0.58 to -0.26). Participants from study years 2014/2015 to 2018/2019 had higher adherence scores when compared with participants from study year 2008/2009 (ranging from +0.30 to +0.50), suggesting improvement in adherence over time.<h4>Conclusions</h4>Our study suggests adherence to GDG among adults in England was poor, especially in younger, white, males and more deprived groups. These findings highlight the need to develop equitable policy interventions to help reduce inequalities in diet-mediated morbidity and mortality.

Item Type:	Article
Uncontrolled Keywords:	DIET, Health inequalities, NUTRITION, POLICY, PUBLIC HEALTH
Divisions:	Faculty of Health & Life Sciences Faculty of Health & Life Sciences > Inst. Population Health Faculty of Health & Life Sciences > Inst. Population Health > Public Health, Policy & Systems Faculty of Health & Life Sciences > Inst. Population Health > Inst. Population Health (T&R Staff)
Depositing User:	Symplectic Admin
Date Deposited:	13 Jul 2026 07:34
Last Modified:	29 Jul 2026 19:31
DOI:	10.1136/jech-2025-224929
Related Websites:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3199380
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