Vol.2, No.11, 1327-1334 (2010)
doi:10.4236/health.2010.211198
Copyright © 2010 SciRes. http://www.scirp.org/journal/HEALTH/
Health
Openly accessible at
Gross domestic product and dietary pattern among 49
western countries with a focus on polyamine intake
Phan Nguyen Thanh Binh1,2, Kuniyasu Soda3*, Masanobu Kawakami4
1Department of Community Nutrition, HCMC Nutrition Center, Ho Chi Minh City, Vietnam;
2Department of Food and Nutrition, Japan Women’s University, Tokyo, Japan;
3Department of Cardiovascular Research Institute, Saitama Medical Center, Jichi Medical University, Saitama, Japan;
*Corresponding Author:
4Department of Internal Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Received 7 August 2010; revised 21 August 2010; accepted 6 September 2010.
ABSTRACT
Socioeconomic status is known to affect dietary
profile, and differences in food habits and choice
may affect polyamine intake due to significant
variations in the concentrations of the poly-
amines spermine, spermidine, and putrescine
present in different foods. The relationship be-
tween gross domestic product (GDP) and die-
tary profile, with a focus on polyamine intake,
was investigated for 49 different European and
other Western countries. The data for food sup-
ply and GDP were collected from the database
of the United Nations and the International Mo-
netary Fund, respectively, and the amount of
polyamine intake from food was estimated us-
ing polyamine concentrations listed in published
sources. Countries were divided equally accor-
ding to GDP values into two categories, higher
and lower, and the amount and composition of
food polyamines as well as dietary profile were
compared. Higher GDP countries supply animal
products and seafood in greater amounts than
lower GDP countries; however, whole milk sup-
ply per calorie was higher in lower GDP than
higher GDP countries. While crops supply was
relatively higher in lower GDP countries, fruit
supply was greater in higher GDP countries.
Higher GDP was associated with increased
amount of spermine and putrescine per total
calorie, although spermidine amount per calorie
was similar between higher and lower GDP
countries. GDP, as an indicator of countries’
socioeconomic status, is associated with the
amount and the composition of polyamines as
well as dietary pattern.
Keywords: GDP; Dietary Pattern; Polyamine
Intake; Western Countries
1. INTRODUCTION
Socioeconomic status, defined by economic activities
and social life, is closely associated with individual health
as well as the public disease burden, which would in-
clude cardiovascular disease [1-3], type 2 diabetes [4-5]
and some cancers [6-7]. At a national level, gross domes-
tic product (GDP) per capita is considered to reflect the
socioeconomic status of the country and is consistently
related to health conditions, namely, wealthier countries
generally have healthier populations [8-10]. Among the
many factors that are involved in the association be-
tween socioeconomic status and health, dietary pattern is
considered to be one of the most important. A number of
studies have shown an association between socioeco-
nomic status and dietary pattern as well as lifestyle [11,
12].
Among many nutrients and non-nutrients in foods,
recent studies have brought light the importance of food
polyamines, because recent studies have shown many
biological activities of polyamine and beneficial effects
for the health of mammals [13-15]. Polyamines, sper-
mine, spermidine, and putrescine are polycations syn-
thesized in almost all cells. Polyamines have been shown
to be absorbed from the intestinal lumen and distributed
to organs and tissues in the whole body [16-17]. Because
foods are comprised of cellular components from vari-
ous organisms, the majority of foods contain polyamines
but their concentration is wide-ranging [18-20]. Since
diets are built from a wide variety of foods and are also
affected by different methods of processing and cooking,
a community’s diet is influenced and shaped by multi-
dimensional factors, including socioeconomic status [21].
Therefore, the amount of polyamine intake must vary
considerably between regions.
In the present study, in order to investigate the asso-

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Copyright © 2010 SciRes. http://www.scirp.org/journal/HEALTH/Openly accessible at
1328
ciation between socioeconomic status and polyamine
intake as well as dietary pattern, the amounts and com-
positions of three polyamines were estimated from sev-
eral public database resources and previously published
papers, and their relative amount of intake, i.e., the
amount relative to calorie intake, were compared among
Western countries with relatively similar racial and eth-
nic composition and social and religious backgrounds.
2. METHODS AND MATERIALS
2.1. Database
Dietary data were gathered from the online database
of the Statistics Division of the Food and Agriculture
Organization of the United Nations (FAOSTAT). Levels
of food supply in 2005 were used for estimation of na-
tional dietary pattern. The target populations included 49
countries in Europe, North America, and Oceania with
similar racial and ethnic composition and social and re-
ligious backgrounds. As one of the representative indi-
cators of socioeconomic status of the country, Gross
Domestic Product (GDP) (PPPPC: purchasing power
parity per capita) in 2005 was obtained from the Interna-
tional Monetary Fund (IMF).
To examine the relationship between socioeconomic
status and dietary pattern, these countries were divided
equally into two categories depending on their GDP va-
lues: higher GDP countries and lower GDP countries.
Higher GDP countries where GDP was greater than
20,000 (current international dollars) were Australia, Aus-
tria, Belgium, Canada, Cyprus, Czech Republic, Den-
mark, Finland, France, Germany, Greece, Iceland, Ire-
land, Israel, Italy, Malta, Netherlands, New Zealand, Nor-
way, Slovenia, Spain, Sweden, Switzerland, United King-
dom, and United States of America. Lower GDP coun-
tries had GDP values less than 20,000 and included Al-
bania, Armenia, Azerbaijan, Belarus, Bosnia and Her-
zegovina, Bulgaria, Croatia, Estonia, Georgia, Hungary,
Kazakhstan, Latvia, Lithuania, Poland, Portugal, Roma-
nia, Russian Federation, Slovakia, Tajikistan, The former
Yugoslav Republic of Macedonia, Turkey, Turkmenistan,
Ukraine, and Uzbekistan.
Concentrations of spermine, spermidine, and putre-
scine in foods were obtained from published reports of
concentrations measured in European foods [19-20].
When these reports did not show polyamine concentra-
tions for specific foods, or additional data were neces-
sary to obtain an average concentration in a food, we
used data from Nishibori et al. [18] (Table 1).
Because food supply data from WHO do not neces-
sarily indicate the net food consumption, the relative
amount of various foods and food elements was deter-
mined, e.g., food supply relative to total calorie. The
Table 1. Concentrations of three polyamines in foods (nmol/g
or nmol/mL)1.
Food items Spermine Spermidine Putrescine
Apple2 0 14.73 14.27
Banana 1 44.9 317.3
Lemon & lime 0.9 18.4 53.8
Citrus (other) 0.9 18.4 53.8
Pineapple 10.9 27 7.6
Grape3 1.6 22.5 26.25
Orange & mandarin4 41.4 1143.35 -
Other fruits5 3.02 25.5 11.55
Pulses6 66.46 179.7 69.64
Treenuts7 46.93 186.97 56.9
Groundnut 34.6 388.7 61.4
Cereals8 17.94 57.55 27.29
Potato9 7.9 64.7 68.73
Maize10 8 144 576
Onion11 2.5 41.2 38.85
Tomato12 0 19.35 380.2
Vegetables13 6.69 124.13 52.98
Stimulants14 12.5 61.4 18.98
Oil crops 0 0 0
Sugar 0 0 3
Coffee 0 0 0
Alcoholic beverages15 1 0 -
Beer16 0 0.5 18.6
Wine17 0 2.17 26.8
Animal fats 0 0 0
Beef 18 120.7 22.45 36
Butter & Ghee 0 0.5 0
Cephalopods19 86 13.5 82
Cheese20 21.581 145.337 589.71
Cream 0 0 0.3
Crustaceans21 0 1.98 4.48
Edible offals22 98.9 82.28 11.34
Eggs 0 0 20.5
Fish23 16.25 16.35 61.93
Honey 0 1 8
Meat24 110.53 29.68 32.78
Molluscs25 94.43 73.13 202.83
Mutton & Goat meat 131.3 39.7 8.2
Other Marine meat26 37.76 25.46 82.7
Pork 160.15 18.15 19.5
Poultry27 91.7 27.5 11.43
Whey28 1 1 0
Whole Milk 0 0 0.3

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1For the polyamine concentrations in each food, the mean concentrations in
the following foods were used; 2Jonagold, Golden, and Granny Smith; 3Red
grape and green grape; 4Orange and orange (Bardocz); 5Raisin, prune, pear,
peach, apricot, kiwi, strawberry, and melon; 6French bean, red bean, garden
pea, soyabean (Bardocz), and red kidney bean (Bardocz); 7Hazelnut, al-
mond, and pistachio; 8Rice, semolina, pasta, white bread, oat bread, rye
bread, and whole wheat bread; 9Potato, skinned; potato with skin; and
potato (Bardocz); 10Maize (Nishibori); 11Onion and onion (Bardocz); 12To-
mato and tomato (Bardocz); 13Salsify, celery, carrot, green cabbage, beet,
beetroot, carrot, sorrel, radish, chicory, leek, escarole, red cabbage, green
leek, Brussels sprout, lettuce, chervil, cabbage, parsley, mushroom, and
button mushroom; 14Garlic, yellow pepper, green pepper, and red pepper;
15Whisky and Cognac; 16Lager beer, and stout beer; 17White (Burgundy),
white (Loire), red (Bordeaux), red (Cotes-du-Rhone), red (Touraine), and red
(Beaujolais) wines; 18Veal and beef; 19Squid and octopus (Nishibori); 20Soft
cheese, Swiss Emmental, French Emmental, goat cheese without rind, Brie
pasteurized without rind, graded cheese, Camembert, Brie pasteurized with
rind, goat cheese with rind, Roquefort, sweet Cantal with rind, Comte, Saint
Nectaire without rind, Saint Nectaire with rind, aged cheddar (Bardocz),
and fresh cheddar (Bardocz); 21Scampi, shrimp, crayfish, and crab claw;
22Ox tongue, liver mousse, chitterling, duck liver paste, and pork liver paste;
23Hake, cod, whiting, smoked salmon, mullet, fresh salmon, cod (Bardocz),
and trout (Bardocz); 24Veal, pork, turkey, chicken leg, rabbit, lamb, chicken
wing, and beef; 25Oyster, white scallop, coral scallop, and clam (Nishibori);
26Hake, cod, whiting, smoked salmon, mullet, fresh salmon, cod (Bardocz),
trout (Bardocz), scampi, shrimp, crayfish, crab, squid, octopus (Nishibori),
oyster, white scallop, coral scallop, and clam (Nishibori); 27Turkey wing,
chicken leg, and chicken wing; 28No available data, therefore data of ma-
tured yogurt were used. Concentrations of polyamines in foods with no
superscript indicate that they were from a single food. Polyamine concen-
trations were expressed as nmol/g or mL. 23The amount in fish was a sum
of the amounts in freshwater fish, and demersal, pelagic, and other marine
fish, and 26the amount in other marine meat was obtained by subtracting the
sum of the amounts in fresh water fish, demersal and pelagic fish, other
marine fish, crustaceans, mollusks, and cephalopods from the amount in
fish & seafood in the FOSTAT database. Aquatic animals and other aquatic
products were not consumed in surveyed countries. Polyamine concentra-
tions in foods were taken from Cipolla B.G., et al. Polyamine contents in
current foods: a basis for polyamine reduced diet and a study of its long
term observance and tolerance in prostate carcinoma patients. Amino Acids
2007; 33: 203-12. Those marked as (Bardocz) were from Bardocz S., et al.
Polyamines in food-implications for growth and health. J.Nutr.Biochem. 4:
66-71, 1993; and (Nishibori), from Nishibori N., et al. Amounts of poly-
amines in foods in Japan and intake by Japanese. Food Chem 2007; 100:
433-872.
relative amounts of foods as well as the amount of poly-
amines were compared between higher GDP and lower
GDP countries.
2.2. Statistics
Food supply and polyamine amount in higher GDP
and lower GDP countries were compared by Mann-
Whitney test and p values less than 0.05 were considered
significant. Analyses were done using StatView 5.0 (SAS
Institute Inc.) run on an Apple computer, and regression
coefficients greater than 0.4 and P values of less than
0.05 were considered significant.
3. RESULTS
3.1. Amount and Proportion of Three Food
Groups as Sources of Calories, Protein,
and Fat
Table 2 shows the amount of calories, protein, and fat
of total foods and of three food categories, and Figure 1
shows the proportions of calories, protein, and fat for
three food categories. Higher GDP countries tend to
prefer animal products and seafood products more than
lower GDP countries. Calories from animal and seafood
products represented 29.03 ± 4.55% and 1.56 ± 1.04%,
respectively, of total calorie in higher GDP countries and
were significantly higher (p < 0.001) than those in lower
GDP countries (21.61 ± 5.36% and 0.68 ± 0.14%, res-
pectively). Conversely, the proportion of crops calories
relative to total calories in lower GDP countries was
greater than that in higher GDP countries (77.71 ±
5.66% vs. 69.41 ± 5.13%, p < 0.001). Similar to calories,
protein from animal, seafood, and crops products ac-
counted for 53.91 ± 4.51%, 7.02 ± 4.15%, and 39.08 ±
5.06%, respectively, in higher GDP countries and 41.67
± 9.00%, 3.46 ± 3.38% and 54.87 ± 10.68%, respectively,
in lower GDP countries (these differences were signifi-
cant with p values of less than 0.001). The percentages
of fat from animals and crops relative to total fat were
similar (p = 0.358 and 0.230, respectively) for both
higher (53.49 ± 9.92% and 50.31 ± 10.69%) and lower
GDP countries (44.55 ± 11.08% and 48.86 ± 10.90%).
However, the proportion of fat from seafood relative to
total fat was higher (p < 0.001) in higher GDP countries
(1.96 ± 2.14%) compared to lower GDP countries (0.83
± 0.74%).
3.2. The Supply of Various Foods per
Total Calorie (Table 3)
The majority of the amount of animal and seafood pro-
High
0
20
40
60
80
100
Calorie source
animal
seafood
crops
Protein sourceFat source
Low High
0
20
40
60
80
100
Low High
0
20
40
60
80
100
Low
(%) (%)(%)
Figure 1. Percentage of calories, protein, and fat from crops,
seafood, and animal products relative to total amounts. All data
were obtained from the online database of the Statistics Divi-
sion of the Food and Agriculture Organization of the United
Nations (FAOSTAT). “High” indicates higher GDP countries
where the GDP (PPPPC) in 2005 was more than 20,000 (cur-
rent international dollars) and “Low” represents lower GDP
countries where the GDP (PPPPC) in 2005 was less than
20,000 (current international dollars).

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Table 2. Calorie, protein and fat supply.
Higher GDP countries Lower GDP countries All countries
Calorie supply (kcal/capita/day)
Animal calorie 996.22 ± 137.00 655.07 ± 210.23 829.13 ± 245.47
Seafood calorie 53.10 ± 33.88 21.88 ± 23.67 37.81 ± 33.03
Crops calorie 2397.57 ± 276.63 2310.54 ± 255.59 2354.94 ± 267.39
Total calorie 3446.89 ± 204.59 2987.49 ± 378.23 3221.88 ± 378.57
Protein supply (g/capita/day)
Animal protein 57.93 ± 5.98 36.96 ± 11.45 47.66 ± 13.89
Seafood protein 7.68 ± 5.20 3.31 ± 3.78 5.54 ± 7.84
Crops protein 42.04 ± 6.65 47.16 ± 8.26 44.55 ± 7.84
Total protein 107.65 ± 9.13 87.42 ± 14.47 97.74 ± 15.70
Fat supply (g/capita/day)
Animal fat 75.05 ± 12.63 47.36 ± 17.04 61.49 ± 20.36
Seafood fat 2.73 ± 2.93 0.84 ± 0.83 1.80 ± 2.36
Crops fat 63.77 ± 19.49 45.34 ± 13.96 54.74 ± 19.24
Total fat 141.55 ± 14.59 93.53 ± 25.17 118.03 ± 31.60
Data are expressed mean ± standard deviation (SD). Higher GDP countries indicate countries where GDP was greater than 20,000 (current international dollars).
Lower GDP countries indicate countries where GDP values less than 20,000 (current international dollars).
ducts per total calorie was higher in higher GDP coun-
tries than in lower GDP countries. While supply of dairy
products, especially cheese, was greater in higher GDP
countries than lower GDP countries, whole milk supply
per calorie was significantly higher in lower GDP coun-
tries than higher GDP countries. The majority of crops
supply per calorie was higher in lower GDP countries,
although fruit and tomato supply was greater in higher
GDP countries compared to lower GDP countries. In
addition, alcoholic drinks, especially wine and beer, were
preferred in greater amounts in higher GDP countries
relative to lower GDP countries.
0%
20%
40%
60%
80%
100%
Hi ghL ow
Sp ermine
Spermidine
Putresci ne
Figure 2. Percentage of spermine, spermidine, and
putrescine relative to total polyamine intake in higher
GDP countries (High, countries where GDP in 2005
was more than 20,000) and lower GDP countries (Low,
countries where GDP in 2005 was less than 20,000).
The polyamine amounts were calculated using values
from public databases. Dietary data were gathered from
FAOSTAT, and polyamine concentrations are indicated
in Table 1.
3.3. Amount and Proportion of Three
Polyamines
The average amounts of spermine, spermidine, and
putrescine in foods were 38.48 (range 17.61-54.82),
89.05 (range 59.69-132.23), and 184.32 (range 71.82-
419.17) µmol/day/capita, respectively, in all targeted
countries; 46.23 ± 5.37, 90.87 ± 15.72, and 236.58 ±
69.47 µmol/day/capita, respectively, in higher GDP
countries and 30.39 ± 8.09, 87.15 ± 16.28, and 129.89 ±
37.59 µmol/day/capita, respectively, in lower GDP coun-
tries.
between the two groups of countries (12.84 ± 2.68% in
higher GDP countries, and 12.41 ± 2.45% in lower GDP
countries), and the proportion of spermidine was sig-
nificantly lower in higher GDP countries compared to
lower GDP countries (24.75 ± 3.35% vs. 35.64 ± 4.24%,
p < 0.001), while putrescine was significantly higher in
higher GDP countries relative to lower GDP countries
(62.41 ± 5.52% vs. 51.96 ± 4.37%, p < 0.001).
When the proportions of each of the three polyamines
accounting for total polyamines were compared (Figure
2), the percentage of spermine was similar (p = 0.810)
Openly accessible at

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Table 3. Calorie, protein and fat supply.
Higher GDP countries Lower GDP countries p-value
A. Animal meat (g) per total calorie (1000kcal)
Bovine 17.09 ± 6.95 11.15 ± 5.40 0.004
Pork 28.56 ± 11.48 15.40 ± 12.20 < 0.001
Mutton&Goat 4.13 ± 5.76 2.75 ± 3.99 0.39
Poultry 21.08 ± 10.46 11.98 ± 6.10 < 0.001
Offals 3.05 ± 2.20 3.26 ± 1.52 0.459
Other meats 1.73 ± 1.70 0.66 ± 1.03 0.001
Dairy products 199.17 ± 49.43 164.73 ± 45.12 0.012
Cheese 12.49 ± 4.94 4.58 ± 3.08 < 0.001
Whole milk 65.98 ± 30.02 110.40 ± 52.25 < 0.001
Butter & Ghee 2.76 ± 1.62 1.61 ± 1.19 0.009
Honey 0.59 ± 0.30 0.52 ± 0.39 0.327
Egg 8.70 ± 2.49 8.66 ± 3.09 0.81
B. Seafoods (g) per total calorie (1000kcal)
Demersal fish 6.57 ± 5.03 2.50 ± 5.03 < 0.001
Pelagic fish 6.38 ± 7.47 3.92 ± 4.31 0.02
Fresh water fish 2.86 ± 2.17 1.13 ± 0.87 < 0.001
Other marine fish 0.79 ± 0.76 0.60 ± 0.73 0.418
All fish 16.60 ± 10.69 8.15 ± 8.23 < 0.001
Molluscs 1.61 ± 1.56 0.24 ± 0.53 < 0.001
Cephalopods 0.82 ± 1.30 0.25 ± 0.66 0.017
Crustaceans 2.64 ± 3.00 0.55 ± 1.47 < 0.001
Seafood total 21.73 ± 13.61 9.22 ± 9.66 < 0.001
C. Crops (g) per total calorie (1000kcal)
Cereals 93.06 ± 16.67 147.14 ± 42.34 < 0.001
Fruits 97.27 ± 22.47 61.25 ± 23.73 < 0.001
Vegetables 94.21 ± 36.04 127.12 ± 51.14 0.083
(Fruits&Vegetables) 191.47 ± 49.29 188.37 ± 65.83 0.447
Pulses 2.42 ± 1.60 2.04 ± 2.47 0.139
Potato (All) 55.57 ± 14.46 75.16 ± 34.67 0.052
Tomato 16.87 ± 9.85 8.28 ± 9.61 < 0.001
Beer 61.03 ± 29.36 38.31 ± 25.40 0.008
Wine 16.87 ± 9.85 8.28 ± 9.61 < 0.001
Data are expressed mean ± standard deviation (SD). Higher GDP countries indicate countries where GDP was greater than 20,000 (current international dollars).
Lower GDP countries indicate countries where GDP values less than 20,000 (current international dollars).
Foods in higher GDP countries seemed to contain sper-
mine and putrescine in greater amounts than those in low-
er GDP countries (Table 4). Conversely, foods in lower
GDP countries tended to contain spermidine in much
greater amounts compared to higher GDP countries. Sim-
ple regression analyses revealed that GDP has positive
correlations with total polyamine per total calorie (r =
0.503, p < 0.01), total spermine per total calorie (r =
0.677, p < 0.01), and total putrescine per total calorie (r
= 0.608, p < 0.01). However, there was a negative

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Table 4. Comparison of polyamine amount (µmol) per total
calorie (1000 kcal/day).
Higher GDP
countries
Lower GDP
countries p-value
Spermine 13.43 ± 1.54 10.07 ± 1.76 < 0.001
Spermidine 26.30 ± 3.77 29.35 ± 5.45 0.018
Putrescine 68.43 ± 18.38 43.26 ± 9.91 < 0.001
SPM + SPD 39.73 ± 4.25 39.42 ± 5.39 0.719
Total polyamine 108.16 ± 21.1182.69 ± 13.63 < 0.001
Data are expressed mean ± standard deviation (SD). Higher GDP countries
indicate countries where GDP was greater than 20,000 (current international
dollars). Lower GDP countries indicate countries where GDP values less
than 20,000 (current international dollars). SPM: spermine; SPD: spermidine.
correlation between GDP and total spermidine per total
calorie (r = –0.498, p < 0.01). Individuals in higher GDP
countries preferred foods rich in polyamine, especially
spermine and putrescine, while individuals in lower GDP
countries preferred foods rich in spermidine.
3.4. Proportion of Three Food Groups as
Sources of Three Polyamines (Figure 3)
The high percentage (73.26 ± 4.57%) of food-based
spermine originated in animal products in higher GDP
countries, and its proportion was significantly higher (p
< 0.001) than that for lower GDP countries (55.40 ±
13.72%). Spermine from crops represented 23.05 ±
4.20% and 43.24 ± 14.35% of total spermine in higher
and lower GDP countries, respectively (p < 0.001). The
majority of spermidine and putrescine originated in
crops; 83.85 ± 3.61% of spermidine and 83.74 ± 5.57%
of putrescine in higher GDP countries, and 92.59 ±
3.49% of spermidine and 89.86 ± 5.39% of putrescine in
lower GDP countries. The proportion of crops sper-
midine and putrescine relative to total amounts was
higher (p < 0.001 for both) in lower GDP countries
compared to higher GDP countries. Spermidine from
animal products accounted for 14.57 ± 3.28% and 6.94 ±
3.16% of total spermidine, while the percentage of pu-
trescine from animal products was 14.10 ± 5.53% and
9.12 ± 5.01% of total putrescine in high and lower GDP
countries, respectively (p < 0.001 for spermidine and p =
0.003 for putrescine). The amounts of spermine, sper
midine, and putrescine from seafood in each total
amount were small: 3.70 ± 2.03%, 1.59 ± 0.94%, and
2.16 ± 1.12%, respectively, for higher GDP countries,
and were only 1.36 ± 1.99%, 0.47 ± 0.75%, and 1.02 ±
1.26%, respectively, for lower GDP countries. The per-
centages for higher GDP countries were greater than
those for lower GDP countries (p < 0.001). Individuals
in higher GDP countries took these three polyamines
from animal and seafood products much more than did
High
0
20
40
60
80
100
Spermine source
animal
seafood
crops
Spermidine sourcePutrescine source
Low High
0
20
40
60
80
100
Low High
0
20
40
60
80
100
Low
Figure 3. Percentage of crops, seafood, and animal products
relative to total amounts of spermine, spermidine, and putre-
scine in higher GDP countries (High) and lower GDP countries
(Low).
those in lower GDP countries, while lower GDP coun-
tries obtained polyamines from crops.
4. DISCUSSION
Differences in socioeconomic status are known to af-
fect the dietary pattern of individuals [22-25]. In this
ecological study, we illustrate the relationship between
GDP and dietary pattern on the basis of country. The
results of the study where data were obtained from open
databases have several similarities to those of previous
epidemiological studies using personal and collective
databases. Namely, higher socioeconomic status is asso-
ciated with increased intake of fruits, seafood, and cheese.
In the present study, despite the higher supply of crops
products in lower GDP countries compared to higher
GDP countries, fruits are preferred in higher GDP coun-
tries. It is widely accepted that higher socioeconomic
status is associated with increased intake of fruits and
vegetables [11,23,26-31]. Similarly, as observed in the
present study, many studies have shown a positive asso-
ciation between socioeconomic status and seafood intake
[28-29,32]. Although the association between dairy pro-
ducts and socioeconomic status is not so apparent, some
epidemiological studies have shown that skimmed milk
is mainly consumed by the higher socioeconomic groups
whereas the lower groups consume full-fat milk [11,31].
While we had insufficient information about the fat con-
tent of dairy products, our findings that individuals in
higher GDP countries consumed more cheese than whole
milk are consistent with previous studies [22,30].
This study delineates the relationship between food
polyamines and socioeconomic status of countries. The
absolute amounts of three polyamines in all targeted
countries obtained from database information are also
similar to those of the previous studies in which about 35
µmol spermine, 55 µmol spermidine, and 160 µmol pu-

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trescine were estimated to be consumed [33], and those
in higher GDP countries were also similar to those of
previous reports for higher GDP countries, Britain, Italy,
Spain, Sweden, and Netherlands in which 350 to 500
µmol polyamines were estimated to be consumed [34].
The present study shows that individuals in higher
GDP countries prefer foods rich in polyamine, especially
spermine and putrescine, much more than those in lower
GDP countries. Increased spermine supply in higher GDP
countries seems due mainly to the increased supply of
animal meat, in which spermine is abundant. Increased
putrescine supply in higher GDP countries seems to be
due to the increased supply of vegetables and fruit, where
the putrescine concentration is high.
This ecological study showed that socioeconomic sta-
tus is associated not only with dietary pattern but also
with the amount and proportion of polyamines. The dif-
ference in food choice is considered to have some role in
the prevalence of several diseases [35-47], and our pre-
vious studies showed that increased polyamine intake
contributes to decreases in age-associated pathological
changes in mice [13]. Therefore, increased polyamine in-
take may have some role on the difference in the preva-
lence of diseases associated with socioeconomic dispar-
ity. However, this is an ecological study and data do not
necessarily indicate the personal food consumption, so,
there may be confounding factor(s) between polyamine
amount and socioeconomic status. Further analyses us-
ing personal database are desired.
5. ACKNOWLEDGEMENTS
Statement of conflicts of interest and funding: We have no conflict
of interest to disclose. Sources of funding: This research received no
specific grant from any funding agency in the public, commercial, or
non-profit sectors.
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