Local deprivation is associated with the spatial distribution of poor diet quality in adults: a population-based cross-sectional study in Switzerland

Santa-Ramírez HA, Bilal U, Marques-Vidal P, Nehme M, Guessous I, Stringhini S, Joost S.

Local-scale deprivation is associated with the spatial distribution of poor diet quality in adults: A cross-sectional population-based study in Switzerland. Soc Sci Med. 2025 Jun;374:117926. doi: 10.1016/j.socscimed.2025.117926. Epub 2025 Mar 5. PMID: 40203563.

Abstract :

Background and objective: Low dietary quality is associated with non-communicable diseases and mortality. We sought to assess the spatial dependence of diet quality and its association with local deprivation in adults.

Methods: We used data from the 2016-2019 waves of the Bus Santé population-based study conducted in Geneva (n = 4,453). Diet quality was assessed using the Alternate Healthy Eating Index (AHEI), and its spatial dependence using local indicators of spatial association (LISA or Moran local I). Bivariate LISA analyses and geographically weighted regression models were used to assess associations with socio-demographic variables and disadvantage on a small geographical scale. Regression models of diet and metabolic health variables were used to confirm the validity of spatial groupings of low dietary quality.

Results: A total of 4,248 participants were included (mean age 47 ± 14 years, 50.7% women). The mean AHEI score was 35.2 (SD 10.8). Forty per cent of the participants had low dietary quality. Food quality was spatially structured across the canton of Geneva, with identified clusters of low food quality (mean AHEI score 27.8 ± 6.24) and high food quality (mean AHEI score 43.8 ± 6.8). The low food quality clusters persisted after adjustment for individual variables. The largest cluster of low food quality was associated with a higher level of local deprivation.

Conclusion: Our study highlights the role of local deprivation as an independent contextual determinant of diet in a high-income European city.

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