@article{fdi:010075516,
  title = {{G}ender inequalities in diet quality and their socioeconomic patterning in a nutrition transition context in the {M}iddle {E}ast and {N}orth {A}frica: a cross-sectional study in {T}unisia},
  author = {{A}bassi, {M}. {M}. and {S}assi, {S}. and {E}l {A}ti, {J}. and {B}en {G}harbia, {H}. and {D}elpeuch, {F}rancis and {T}raissac, {P}ierre},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground{I}n a context of nutrition transition and major shifts in lifestyle and diet, the {M}iddle {E}ast and {N}orth {A}frica features a marked gender excess adiposity gap detrimental to women. {I}n this setting, where gender issues are especially acute, we investigated gender differences in dietary intake with a focus on diet quality, and how the differences varied with the area of residence and socio-demographic characteristics.{M}ethods{T}he study was conducted in 2009-2010 in the {G}reater {T}unis region ({T}unisia), as a case study of an advanced nutrition transition context in the region. {A} cross-sectional survey used a random, stratified, clustered sample of households: 1689 women and 930 men aged 20-49years were analyzed. {D}ietary intake was assessed using a 3-day food record. {N}utrient content was derived from a specific {T}unisian food composition database. {W}e analysed the {D}iet {Q}uality {I}ndex-{I}nternational ({DQI}-{I}) and sub-scores (variety, adequacy, moderation and balance). {A} score of {DQI}-{I}>60 defined good diet quality. {I}nequality measures were women vs. men differences in means for interval variables and odds-ratios ({OR}) for {DQI}-{I}>60. {T}heir variation with socio-demographic characteristics was estimated using models featuring gender x covariate interactions.{R}esults{M}ean energy intake/day was 230015kcal for women vs. 2859 +/- 32kcal for men. {B}y 1000g/kcal/d women consumed more fruits and sweets but less red meat and soft drinks than men. {W}omen had a higher mean moderation sub-score than men (+1.8[1.4, 2.2], {P}<0.0001) but lower variety (-2.0[-2.3, -1.6], {P}<0.0001) and adequacy (-1.8[-2.0, -1.5], {P}<0.0001). {T}hus, the overall mean {DQI}-{I} was lower among women than men (58.6 +/- 0.3 vs. 60.4 +/- 0.3, -1.8[-2.6, -1.0], {P}<0.0001) as was the proportion of {DQI}-{I}>60 (45.2% vs. 55.7%, {OR}=0.7[0.5, 0.8], {P}<0.0001). {A}djusted gender differences in {DQI}-{I} decreased with age but were higher in larger households and extreme categories of education (no-schooling and university) vs. the middle categories.{C}onclusion {I}n this nutrition transition context with only average diet quality, it was somewhat lower for women. {S}ocioeconomic patterning of gender contrasts was mild. {B}eyond, that women had lower adequacy and variety scores but better moderation is a possible pathway for gender specific prevention messages.},
  keywords = {{G}ender inequality ; {N}utrition transition ; {D}iet quality ; {D}iet {Q}uality ; {I}ndex-{I}nternational ({DQI}-{I}) ; {M}iddle {E}ast and {N}orth {A}frica ; {TUNISIE}},
  booktitle = {},
  journal = {{N}utrition {J}ournal},
  volume = {18},
  numero = {},
  pages = {art. 18 [15 p.]},
  ISSN = {1475-2891},
  year = {2019},
  DOI = {10.1186/s12937-019-0442-6},
  URL = {https://www.documentation.ird.fr/hor/fdi:010075516},
}