Baseline determinants of global diet quality in older men and women from the NuAge cohort

Elsevier BV - Tập 17 - Trang 419-425 - 2013
Bryna Shatenstein1,2, L. Gauvin3,4, H. Keller5, L. Richard6,7, P. Gaudreau4,8, F. Giroux2, K. Gray-Donald9, M. Jabbour2, J. A. Morais10, H. Payette11,12
1Département de nutrition, Université de Montréal, Montréal, Canada
2Centre de recherche, institut universitaire de gériatrie de Montréal, Montréal, Canada
3Département de médecine sociale et préventive, Université de Montréal, Montréal, Canada
4Centre de recherche du Centre hospitalier, de l'Université de Montréal, Montréal, Canada
5Department of Kinesiology, University of Waterloo, Waterloo, Canada
6Faculté des Sciences Infirmières, Université de Montréal, Montréal, Canada
7Institut de recherche en santé publique de l’Université de Montréal, Montréal, Canada
8Département de médecine, Université de Montréal, Montréal, Canada
9School of Human Nutrition and Food Sciences, McGill University, Montréal, Canada
10Division of Geriatric Medicine, McGill University, Montréal, Canada
11Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Canada
12Centre de recherche sur le vieillissement, CSSS-IUGS, Sherbrooke, Canada

Tóm tắt

Judicious food choices are of prime importance during aging. This study was conducted to identify individual and collective attributes determining global diet quality (DQ). Participants were 1,793 adults (52% women) from the NuAge study on nutrition and successful aging. Subjects aged 67 to 84 years in relatively good health were recruited from the Québec Medicare Database. Sociodemographic, affective, and cognitive data, health conditions, perceived physical health and functional status, dietary habits and dietary attributes and community resources were obtained using questionnaires. Body weight and height were measured and body mass index (BMI) was calculated. Three non-consecutive 24-hour diet recalls were collected at recruitment. DQ, assessed using the Canadian Healthy Eating Index (C-HEI, /100), was computed on the mean intakes from the diet recalls. Analyses were stratified by gender. Variables significantly related to DQ in bivariate analyses (p<.05) were entered into backward stepwise multiple regression analyses. Among men, the final model showed higher education (β=0.23, p=.01), diet knowledge (β=0.96, p<.0001), number of daily meals (β=1.91, p=.02) and perceived physical health (β=0.06, p=.01) to be positive determinants of DQ, whereas alcohol consumption (β=−2.25, p=.05), wearing dentures (β=−2.31, p=.01) and eating regularly in restaurants (β=− 1.65, p=.03) were negative determinants of DQ (adjusted R2 = 13.7%). Among women, higher education (β=0.29, p=.002), diet knowledge (β=0.54, p=.002), number of daily meals (β=3.61, p<.0001), and hunger (β=0.61, p<.0001) were positive determinants of global DQ; greater BMI (β=−0.16, p=.03) and chewing problems (β=−0.48, p=.03) were negative determinants of DQ (adjusted R2 = 7.8%). These results point to several key factors influencing global DQ in older adults and also show gender-based differences. More research must be done to better understand how these factors change with aging and exert their impact on diet, particularly since variance in DQ was largely unexplained. As diet knowledge was an independent predictor for both genders, targeted, sustainable interventions are needed to ensure good diet quality as people age.

Tài liệu tham khảo

Statistics Canada, “A Portrait of Seniors in Canada” (http://www.statcan.ca) and (http://www.statcan.gc.ca/ads-annonces/89-519-x/index-eng.htm. Consulted 2012-02-21). Furst T, Connors M, Bisogni CA, Sobal J, Winter Falk L. Food choice: A conceptual model of the process. Appetite 1996; 26:247–266. Payette H, Shatenstein B. Determinants of healthy eating in community-dwelling elderly people. Can J Public Health 2005;96(Suppl 3):S27–S31. Drewnowski A, Shultz JM. Impact of aging on eating behaviours, food choices, nutrition, and health status. J Nutr Health Aging 2001; 5(2):75–79. Wakimoto P, Block G. Dietary intake, dietary patterns, and changes with age: an epidemiological perspective. J Gerontol A Biol Sci Med Sci. 2001; 56 Spec No 2 (2):65–80. Keller HH, Ostbye T, Bright-See E. Predictors of dietary intake in Ontario seniors. Can.J.Pub. Health. 1997;88:305–309. Trichopoulou A, Kouris-Blazos A, Wahlqvist ML et al. Diet and overall survival in elderly people. BMJ 1995;311(7018):1457–1460. Shatenstein B. Impact of health conditions on food intakes among community-dwelling older adults. J Nutr Elderly 2008; 27(3/4):333–361. McKevith B. Diet and healthy ageing. J Br Menopause Soc 2005;11(4):121–125. Gillette Guyonnet S, Abellan Van Kan G, Andrieu S, Barberger Gateau P, Berr C, Bonnefoy M, Dartigues JF, de Groot L, Ferry M, Galan P, Hercberg S, Jeandel C, Morris MC, Nourhashemi F, Payette H, Poulain JP, Portet F, Roussel AM, Ritz P, Rolland Y, Vellas B. IANA task force on nutrition and cognitive decline with aging. J Nutr Health Aging. 2007;11(2):132–152. Review. Jylha, M. Old age and loneliness: cross-sectional and longitudinal analyses in the Tampere Longitudinal Study on Aging. Can J Aging 2004;23(2):157–168. Johnson CS. Nutritional considerations for bereavement and coping with grief. J Nutr Health Aging 2002;6(3):171–176. Keller HH, Dwyer JJM, Senson S, Edwards V, Edward HG. A social ecological perspective of the influential factors for food access described by low income seniors. J Hunger Environ Nutr 2006;1(3):27–44. Locher J, Ritchie C, Roth D et al. Social isolation, support, and capital and nutritional risk in an older sample: ethnic and gender differences. Soc Sci Med 2005;60:747–761. Ferry M, Sidobre B, Lambertin A, Barberger-Gateau P. The SOLINUT study: Analysis of the interaction between nutrition and loneliness in persons aged over 70 years. J Nutr Health Aging 2005;9(4):261–678. Lahmann PH, Kumanyika SK. Attitudes about health and nutrition are more indicative of dietary quality in 50- to 75-year-old women than weight and appearance concerns. J Amer Dietet Assoc. 1999;99(4):475–478. McBee S, Cotugna N, Vickery CE. Fruit and vegetable consumption in an elderly population. J Nutr Elderly, 2001;21(1):59–67. Elsner RJF. Changes in eating behavior during the aging process. Eating Behaviors 2002;3(1):15–43. Bates CJ, Benton D, Biesalski HK, Staehelin HB, van Staveren W, Stehle P, Suter PM, Wolfram G. Nutrition and aging: A consensus statement. J Nutr Health Aging. 2002;6(2):103–116. Holmes BA, Roberts CL. Diet quality and the influence of social and physical factors on food consumption and nutrient intake in materially deprived older people. Eur J Clin Nutr. 2011;65(4):538–45. Moos RH, Schutte K, Brennan P, Moos BS. Ten-year patterns of alcohol consumption and drinking problems among older women and men. Addiction. 2004 Jul;99(7):829–838. Larrieu S, Letenneur L, Berr C, Dartigues JF, Ritchie K, Alperovitch A, Tavernier B, Barberger-Gateau P. Sociodemographic differences in dietary habits in a population-based sample of elderly subjects: the 3C study. J Nutr Health Aging. 2004;8:497–502. Shatenstein B, Nadon S, Ferland G. Determinants of diet quality among Quebecers aged 55–74. J Nutr Health Aging. 2004;8(2):83–91. Wu B, Goins RT, Laditka JN, Ignatenko V, Goedereis E. Gender differences in views about cognitive health and healthy lifestyle behaviors among rural older adults. Gerontologist. 2009;49Suppl 1:S72–S78. Hughes G, Bennett KM, Hetherington MM. Old and alone: barriers to healthy eating in older men living on their own. Appetite 2004;43:269–276. de Groot LC, Verheijden MW, de Henauw S, Schroll M, van Staveren WA; SENECA Investigators. Lifestyle, nutritional status, health, and mortality in elderly people across Europe: a review of the longitudinal results of the SENECA study. J Gerontol A Biol Sci Med Sci. 2004;59(12):1277–1284. Kant AK. Indexes of overall diet quality: A review. J Am Diet Assoc. 1996;96:785–791. Kant AK. Dietary Patterns: biomarkers and chronic disease risk. Appl Physiol Nutr Metab. 2010;34(2):199–206. Wirt A, Collins CE. Diet quality — what is it and does it matter? Pub Health Nutr 2009;12(12):2473–2492. Gaudreau P, Morais JA, Shatenstein B, Gray-Donald K, Khalil A, Dionne I, Ferland G, Fülöp T, Jacques D, Kergoat M-J, Tessier D, Wagner R, Payette H. Nutrition as a Determinant of Successful Aging: Description of the Quebec Longitudinal Study NuAge and results from cross-sectional pilot studies. Post-Edmonton Aging Symposium. Rejuvenation Research 2007; 10(3):377–386. Levasseur M. Sources et justifications des questions utilisées dans l’Enquête Santé Québec, Cahier technique 87-03, Ministère de la Santé et des Services sociaux, Gouvernement du Québec, 1987. Fillenbaum GG, Smyer MA. The development, validity and reliability of the OARS multidimensional functional assessment questionnaire. J Gerontol 1981;36:428–434. Lennie TA, Neidig JL, Stein KF, Smith BA. Assessment of hunger and appetite and their relationship to food intake in persons with HIV infection. J Assoc Nurses AIDS Care. 2001;12(3):66–74. Teng EL, Chui HC. The modified mini-mental state (3MS) examination. J Clin Psychiatry 1987; 48:314–318. Yesavage JA, Brink TL, Rose TL et al. Development and validation of geriatric screening scale: A preliminary Report. J Psychiatr Res 1983;17:37–49. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36) I. Conceptual framework and item selection. Med Care 1992;30:473–483. Slade GD Spencer A J Development and evaluation of the Oral Health Impact Profile. Community Dental Health, 1994;11:3–11 Hébert R, Desrosiers J, Dubuc N et al Le Système de Mesure de l’Autonomie Fonctionnelle (SMAF). Revue de Gériatrie 2003; 28(4): 323–336. American Dietetic Association “Nutrition and You: Trends 2002” Questionnaire. Prepared by Wirthlin Worldwide, October 2002. © 2002 American Dietetic Association. Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85–94. Avila-Funes JA, Gray-Donald K, Payette H. Association of Nutritional Risk and Depressive Symptoms with Physical Performance in the Elderly: The Quebec Longitudinal Study of Nutrition as a Determinant of Successful Aging (NuAge). J Amer Coll Nutr 2008;27(4):492–498. Duke University Center for the Study of Aging and Human Development. OARS Social Resource Scale. Multidimensional Functional Assessment: The OARS Methodology. Durham, N.C.: Duke University, 1978. Lefrançois R, Leclerc G, Dubé M et al. Valued activities of everyday life among the very old: A one-year trend. Activities, Adaptation, and Aging. 2001;25(3–4):19–35. Shatenstein B, Nadon S, Godin C, Ferland G. Diet quality of Montreal-area adults needs improvement: estimates from a self-administered food frequency questionnaire furnishing a dietary indicator score. J Am Diet Assoc. 2005;105(8):1251–1260. Kennedy ET, Ohls J, Carlson S, Fleming K. The Healthy Eating Index: Design and applications. J Am Diet Assoc. 1995;95:1103–1108. Health Canada. Eating well with Canada’s Food Guide. © Her Majesty the Queen in Right of Canada, represented by the Minister of Health Canada, 2007. HC Pub.: 4667. Cat.: H164-38/2-2007E 2007. Health & Welfare Canada. Nutrition Recommendations. The Report of the Scientific Review Committee. Catalogue H-49-42/1990E. Minister of Supply and Services Canada, 1990. Katsarou A, Tyrovolas S, Psaltopoulou T, Zeimbekis A, Tsakountakis N, Bountziouka V, Gotsis E, Metallinos G, Polychronopoulos E, Lionis C, Panagiotakos D. Socio-economic status, place of residence and dietary habits among the elderly: the Mediterranean islands study. Public Health Nutr. 2010 Oct;13(10):1614–21. Raffensperger S, Kuczmarski MF, Hotchkiss L, Cotugna N, Evans MK, Zonderman AB. Effect of race and predictors of socioeconomic status on diet quality in the HANDLS Study sample. J Natl Med Assoc. 2010 Oct;102(10):923–930. Appleton KM, McGill R, Neville C, Woodside JV. Barriers to increasing fruit and vegetable intakes in the older population of Northern Ireland: low levels of liking and low awareness of current recommendations. Public Health Nutr. 2010 Apr;13(4):514–21. Huy C, Schneider S, Thiel A. Perceptions of aging and health behavior: determinants of a healthy diet in an older German population. J Nutr Health Aging 2010;14(5):381–385. Dean M, Raats MM, Grunert KG, Lumbers M; Food in Later Life Team. Factors influencing eating a varied diet in old age. Pub Health Nutr 2009;12(12):2421–2427. Thomas L Jr, Almanza B, Ghiselli R. Nutrition knowledge of rural older populations: can congregate meal site participants manage their own diets? J Nutr Elder. 2010;29(3):325–344. Savoca MR, Arcury TA, Leng X, Chen H, Bell RA, Anderson AM, Kohrman T, Gilbert GH, Quandt SA. Association between dietary quality of rural older adults and self-reported food avoidance and food modification due to oral health problems. J Am Geriatr Soc. 2010;58(7):1225–1232. Tardivo AP, Nahas-Neto J, Nahas EA, Maesta N, Rodrigues MA, Orsatti FL. Associations between healthy eating patterns and indicators of metabolic risk in postmenopausal women. Nutr J. 2010;9:64:(1–9). Riediger N, Moghadasian M. Patterns of fruit and vegetable consumption and the influence of sex, age and socio-demographic factors among Canadian elderly. J Am Coll Nutr 2008;27:306–313. Lee CJ, Templeton S, Wang C. Meal skipping patterns and nutrient intakes of rural southern elderly. J Nutr Elder. 1996;15(2):1–14. ISQ. Institut de la statistique du Québec. Enquête sociale et de santé 1998. Les Publications du Québec, Québec Qc. http://www.stat.gouv.qc.ca/publications/sante/e_soc-sante98.htm Accessed 2012-02-28.. Rosenbloom CA, Whittington FJ. The effects of bereavement on eating behaviors and nutrient intakes in elderly widowed persons. J Gerontol:Soc Sci 1993;48(4)S223–S229. Burns C, Bentley R, Thornton L, Kavanagh A. Reduced food access due to a lack of money, inability to lift and lack of access to a car for food shopping: a multilevel study in Melbourne, Victoria. Public Health Nutr 2011;14:1017–1023. McKie L. Older people and food: independence, locality and diet. Br Food J. 1999;101:528–536.