Socio-demographic variation in adherence to The Eatwell Guide within the UK Biobank prospective cohort study

The Eatwell Guide depicts the UK Governments healthy eating recommendations and is widely used in clinical practice and public health settings. There is limited evidence on whether adherence to the Eatwell Guide differs by socio-demographic characteristics. This study aimed to explore patterns of Eatwell Guide adherence across socio-demographic groups in the UK Biobank cohort. Eatwell Guide adherence scores were derived for 192,825 individuals from 24-hour dietary recall data (Oxford WebQ), and quantified using a graded, food-based scoring system. Eatwell Guide scores were compared between different age, sex, BMI, ethnicity, socioeconomic status and education groups. Data were analysed using independent sample t-tests, and one-way ANOVA with Tukey post-hoc tests. Eatwell Guide adherence was higher for older than younger, and female compared with male participants (both p<0.001). There was a main effect of BMI on total adherence (p<0.001), with the highest scores achieved by those with a healthy BMI. Eatwell Guide adherence was higher in white vs non-white participants (p<0.001), and differed significantly by education level (p<0.001), with the highest score achieved by participants with a higher education level. Total adherence scores differed by socio-economic status (all p<0.001), with the highest score achieved by the least deprived participants and the lowest score achieved by the most deprived participants. These data demonstrate that Eatwell Guide adherence differs significantly between socio-demographic groups in the UK Biobank. Exploring the consistency of these findings in other cohorts and developing strategies to increase adherence to the Eatwell Guide in groups with low adherence, are future research priorities.