Socioeconomic differences in food habits among 6- to 9-year-old children from 23 countries—WHO European Childhood Obesity Surveillance Initiative (COSI 2015/2017)

Anne Siri Fismen, Marta Buoncristiano, Julianne Williams, Arnfinn Helleve, Márta Bakacs, Ingunn Holden Bergh, Vesselka Duleva, Anna Fijałkowska, Andrea Gualtieri, Tatjana Hejgaard, Jolanda Hyska, Cecily C. Kelleher, Lene Kierkegaard, Enisa Kujundžić, Marie Kunešová, Sanja Musić Milanović, Paola Nardone, Eha Nurk, Sergej M. Ostojic, Ausra PetrauskieneIvo Rakovac, Ana Isabel Rito, Harry Rutter, Elena Sacchini, Dragana Stojisavljević, Victoria Farrugia Sant'Angelo, Lela Shengelia, Angela Spinelli, Igor Spiroski, Maya Tanrygulyyeva, Daniel Weghuber, João Breda

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24 Citations (SciVal)


Background: Socioeconomic differences in children's food habits are a key public health concern. In order to inform policy makers, cross-country surveillance studies of dietary patterns across socioeconomic groups are required. The purpose of this study was to examine associations between socioeconomic status (SES) and children's food habits. Methods: The study was based on nationally representative data from children aged 6–9 years (n = 129,164) in 23 countries in the World Health Organization (WHO) European Region. Multivariate multilevel analyses were used to explore associations between children's food habits (consumption of fruit, vegetables, and sugar-containing soft drinks) and parental education, perceived family wealth and parental employment status. Results: Overall, the present study suggests that unhealthy food habits are associated with lower SES, particularly as assessed by parental education and family perceived wealth, but not parental employment status. We found cross-national and regional variation in associations between SES and food habits and differences in the extent to which the respective indicators of SES were related to children's diet. Conclusion: Socioeconomic differences in children's food habits exist in the majority of European and Asian countries examined in this study. The results are of relevance when addressing strategies, policy actions, and interventions targeting social inequalities in children's diets.

Original languageEnglish
Article numbere13211
JournalObesity Reviews
Issue numberS6
Early online date7 Jul 2021
Publication statusPublished - 30 Nov 2021


  • children
  • food habits
  • social inequalities
  • socioeconomic differences

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Public Health, Environmental and Occupational Health


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