Identifying dietary differences between Scotland and England: a rapid review of the literature.

Objective: Rates of premature mortality have been higher in Scotland than in England since the 1970s. Given the known association of diet with chronic disease, the study objective was to identify and synthesise evidence on current and historical differences in food and nutrient intakes in Scotland and England. Design: A rapid review of the peer reviewed and grey literature was carried out. After an initial scoping search, Medline, Cinahl, Embase and Web of Science were searched. Relevant grey literature was also included. Inclusion criteria were: any date; measures of dietary intake; representative populations; cross-sectional or observational cohort studies; and English language publications. Study quality was assessed using the Quality Assessment Tool for Observational Cohort and Cross-sectional Studies. A narrative synthesis of extracted information was conducted. Results: Fifty publications and reports were included in the review. Results indicated that children and adults in Scotland had lower intakes of vegetables, and lower intakes of vitamins compared to those living in England. Higher intakes of salt in Scotland were also identified. Data was limited by small Scottish samples, difficulty in finding England-level data, lack of statistical testing and adjustment for key confounders. Conclusions: Further investigation of adequately powered and analysed surveys is required to examine more fully dietary differences between Scotland and England. This would provide greater insight into potential causes of excess mortality in Scotland compared with England, and suitable policy recommendations to address these inequalities.