Does food-related cultural capital contribute to diet inequality in rural Australia? A pilot cross-sectional study

Objective Regional Australians have a poorer quality of diet compared to people living in metropolitan areas. Food-related cultural capital is one potential mechanism linking social determinants and nutrition. Relationships between food-related cultural capital and diet were investigated as an explanation for nutritional inequalities in regional New South Wales (NSW). Design A cross-sectional survey of rural NSW adults was conducted from 12 th October 2019 to 31 st March 2020 focusing on diet, socio-economic factors and cultural capital. Three dietary outcomes were assessed: fruit consumption, vegetable consumption, and a healthy diet score. Food-related cultural capital was analysed as objectivised and total incorporated cultural capital separately. The survey was distributed online with social media promotion. Setting Regional south-eastern and western NSW Participants 448 adults (median age 57 years) of whom 93% were female. Results In unadjusted analysis, both total incorporated and objectivised cultural capital had strong correlations with all three diet outcomes, with low cultural capital associated with poorer nutrition. After adjusting for sociodemographic confounders, low total incorporated cultural capital showed modest associations with low fruit consumption (OR = 1.69, 95%CI = 1.00 – 2.87), low vegetable consumption (OR = 2.94, 95%CI = 1.69 – 5.11) and low diet score (OR = 3.35, 95% CI = 1.59 – 4.71). Conclusions Food-related cultural capital, particularly incorporated cultural capital, was independently associated with healthy food consumption in regional NSW. This new finding presents potential avenues to improve the diet of rural Australians through diet-related education, promoting food participation and reducing barriers to healthy food access.