Socio-economic status and fruit juice consumption in Canada

OBJECTIVES: The role of socio-economic status (SES) in fruit juice and fruit drink consumption is not well understood in a Canadian context. This study examines the relationship between SES and Canadian fruit juice and fruit drink consumption. METHODS: The Canadian Community Health Survey (2011-2012), a cross-sectional survey that employs multistage cluster sampling, provided relevant data for a sample of 103 125 Canadians, aged 12 and older, living in the 10 provinces. Household income level decile, ranked at the health region level, was used as a surrogate measure of SES. Fruit juice and fruit drink consumption data were collected via self-report in telephone/in-person interviews. Multivariable gamma regression was used to model the relationship between SES and frequency of fruit juice and fruit drink consumption, adjusting for age, sex, diabetes status, daily fruit and vegetable consumption, education level, racial identity and physical activity. RESULTS: A negative relationship was found, with a decreasing daily rate of fruit juice and fruit drink consumption associated with increasing SES. In the adjusted model, Canadians in the lowest SES category consumed fruit juice and fruit drinks at an average daily rate 1.18 times (95% CI: 1.14-1.23) that of Canadians in the highest SES category. CONCLUSION: The negative association between health region-adjusted SES and fruit juice and fruit drink consumption highlights the potentially important role of socio-economic factors at a local level. Canadian policy that aims to lower fruit juice and fruit drink consumption, and thus sugar intake, should target financial avenues (such as making fruit juice less financially attractive by lowering the cost of whole fruit and vegetables) in addition to communicating health benefits.