scholarly journals Food and nutrient intake and diet quality among older Americans

2021 ◽  
pp. 1-10
Author(s):  
Yeon Jin Choi ◽  
Eileen M Crimmins ◽  
Jung Ki Kim ◽  
Jennifer A Ailshire

Abstract Objective: A suboptimal diet and nutritional deficiencies can have important influences on health with significant impact among older adults. This study aims to assess the presence of suboptimal dietary intake among older Americans and identify risk and protective factors influencing diet quality. Design: Cross-sectional secondary analysis. Setting: USA. Participants: A nationally representative sample of 5614 community-dwelling older adults over age 54 in the Health and Retirement Study – Health Care and Nutrition Survey. Results: Overall, only 10·7 % of respondents had a good quality diet (Healthy Eating Index score 81 and above); the majority had diets considered poor or needing improvement. Less than 50 % of respondents met dietary guidelines and nutritional goals for most individual food groups and nutrients. Respondents with low socio-economic status, fewer psychosocial resources and those who had limited access to healthy food outlets were more likely to have a diet of suboptimal quality. Conclusions: Efforts to remove identified barriers that put older adults at risk for poor nutrition and to provide resources that increase access to healthy food should be made to encourage healthy eating and enhance diet quality.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 921-921
Author(s):  
Yeon Jin Choi ◽  
Eileen Crimmins ◽  
Jung Ki Kim ◽  
Jennifer Ailshire

Abstract A suboptimal diet and nutritional deficiencies can have important influences on health with significant impact among older adults. This study aims to assess the presence of suboptimal dietary intake among older Americans and identify risk and protective factors influencing diet quality. For this study, data from a nationally representative sample of 5,614 community-dwelling older adults over age 54 in the Health and Retirement Study – Health Care and Nutrition Survey were used. Descriptive analyses were conducted to assess average intake of 17 food groups and nutrients and the percentage of respondents who consumed an optimal amount of food and nutrients. Differences in diet quality by sociodemographic, psychosocial, environmental, and geographic factors were assessed using chi-square and OLS regression was used to identify risk and protective factors for good quality diet. Overall, only 10.7% of respondents had a good quality diet (HEI score 81 and above); the majority had diets considered poor or needing improvement. Less than 50% of respondents met dietary guidelines and nutritional goals for most individual food groups and nutrients. Respondents with low socioeconomic status, fewer psychosocial resources, and those who had limited access to healthy food outlets were more likely to have a diet of suboptimal quality. Efforts to remove identified barriers that put older adults at risk for poor nutrition and to provide resources that increase access to healthy food should be made to encourage healthy eating and enhance diet quality.


Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3474
Author(s):  
Marhamah Jailani ◽  
Siti Masitah Elias ◽  
Roslee Rajikan

Healthy Eating Index (HEI) is a diet quality measure that assesses the population’s compliance towards dietary guidelines. In Malaysia, diet quality measure, though existing, has some limitations in terms of application and relevance. This study aims to develop a new standardized Malaysian Healthy Eating Index (S-MHEI) that can measure the diet quality of all Malaysians regardless of their energy requirement level. The Malaysian Dietary Guidelines (MDG) 2010 and MDG for Children and Adolescents (MDGCA) 2013 were used as main references in developing the index components. In addition, the latest Malaysian Adults Nutrition Survey (MANS) and Adolescent Nutrition Survey (ANS) were also referred to ensure the relevance of the components selected. For adequacy components, the least restrictive method was used in setting the standard for the scoring system. Meanwhile, the scoring system for moderation components was built based on the Recommended Nutrient Intake (RNI) 2017. The new S-MHEI comprises of 11 components with a maximum total score of 100. The least restrictive method allowed the index to be used across energy requirement levels. However, the index will not be sensitive towards adhering to the specific recommended amount of intake—which in effect, made the index focus on measuring diet quality rather than diet quantity.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1193-1193
Author(s):  
Hayven Brault ◽  
Derek Miketinas

Abstract Objectives Diet quality is associated with overall health and may reduce risks of certain diseases. People with mental health issues such as depression and anxiety may exhibit behavioral symptoms that can compromise diet quality and increase risk for nutritional deficiencies. The Healthy Eating Index (HEI) is a measure of diet quality that scores thirteen individual dietary components to assess how well a diet meets the Dietary Guidelines for Americans 2015–2016. The objective of this study was to compare HEI-2015 scores among individuals with varying degrees of self-reported anxiety and depression. Methods Data were analyzed from the 2015–2016 NHANES (National Health and Nutrition Examination Survey). Healthy Eating Index 2015 scores were calculated for each day of dietary intake. Usual intake for total HEI-2015 score was estimated using the NCI (National Cancer Institute) method. Usual HEI scores were compared across reported anxiety and depression levels using multiple linear regression. Covariates included age, sex, ethnicity, Family Income to Poverty ratio, and BMI. Results Mean HEI score for the total sample of adults (n = 5087) was 46.59. Mean HEI scores for individuals experiencing anxiety daily, weekly, monthly, and a few times a year were not significantly different from each other. Mean HEI scores for individuals experiencing feelings of depression daily (40.6 ± 1.8) were different (P < 0.05) from those experiencing depression weekly, monthly, yearly, or never (46.8 ± 1.1, 47.4 ± 0.9, 47.9 ± 0.5, and 46.1 ± 0.7, respectively). Conclusions Overall, the mean HEI scores for all individuals and subgroups examined were suboptimal. These results indicate that people who experience depression daily may be at increased risk for nutritional deficiencies and may require additional attention to improve intake and support overall health. Funding Sources No funding sources to declare.


2021 ◽  
pp. 1-39
Author(s):  
Nicole Dorrington ◽  
Rosalind Fallaize ◽  
Ditte A. Hobbs ◽  
Michelle Weech ◽  
Julie A. Lovegrove

Abstract Diet quality indexes (DQIs) are useful tools for assessing diet quality in relation to health and guiding delivery of personalised nutritional advice, however existing DQIs are limited in their applicability to older adults (aged ≥65 years). Therefore, this research aimed to develop a novel evidence-based DQI specific to older adults (DQI-65). Three DQI-65 variations were developed to assess the impacts of different component quantitation methods and inclusion of physical activity. The variations were: Nutrient and Food-based DQI-65 (NFDQI-65), NFDQI-65 with Physical Activity (NFDQI-65+PA) and Food-based DQI-65 with Physical Activity (FDQI-65+PA). To assess their individual efficacy, the NFDQI-65, NFDQI-65+PA and FDQI-65+PA were explored alongside the validated Healthy Eating Index-2015 (HEI-2015) and Alternative Healthy Eating Index-2010 (AHEI-2010) using data from the cross-sectional UK National Diet and Nutrition Survey (NDNS) rolling programme. Scores for DQI-65 variations, the HEI-2015 and AHEI-2010 were calculated for adults ≥65 years from years 2-6 of the NDNS (n=871). Associations with nutrient intake, nutrient status and health markers were analysed using linear and logistic regression. Higher DQI-65s and HEI-2015 scores were associated with increased odds of meeting almost all of our previously proposed age-specific nutritional recommendations, and with health markers of importance for older adults, including lower body mass index, lower medication use and lower C-reactive protein (P<0.01). Few associations were observed for the AHEI-2010. This analysis suggests value of all three DQI-65s as measures of dietary quality in UK older adults. However, methodological limitations mean further investigations are required to assess validity and reliability of the DQI-65s.


2021 ◽  
Vol 10 ◽  
Author(s):  
Zahra Esmaeily ◽  
Zahra Tajary ◽  
Sharzad Daei ◽  
Mahshid Rezaei ◽  
Atefeh Eyvazkhani ◽  
...  

Abstract Sarcopenia is associated with frailty and disability in older adults. Adherence to current dietary guidelines in addition to physical activity could prevent muscle wasting and weakness. The Healthy Eating Index-2015 (HEI) is a tool to assess diet quality. We aimed to investigate the association between HEI scores and probable sarcopenia (PS) among older adults in Tehran. 201 randomly selected older adults were included in this cross-sectional study between May and October 2019 in Tehran, Iran. A previously validated semi-quantitative food frequency questionnaire was used to estimate HEI scores and dietary intake. Handgrip strength (HGS) was measured to evaluate the PS. Statistical evaluation included descriptive analysis, logistic and linear regression. Those probably suffering from sarcopenia had significantly lower HEI scores (P=0⋅02). After adjusting for confounders, HEI scores and HGS were still significantly associated (adjusted R2=0⋅56, slope β=0⋅03, P=0⋅09). Older adults with a low PS had a higher ratio of monounsaturated and polyunsaturated to saturated fatty acids (P= 0⋅06) and ingested less added sugars and saturated fats (P=0⋅01 and P=0⋅02, respectively). Furthermore, consuming more total protein foods correlated positively with muscle strength (P=0⋅01, R=0⋅18). To sum up, HEI scores were associated with PS, measured by HGS, indicating that adhering to the HEI might improve muscle strength in aging individuals.


Nutrients ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 519 ◽  
Author(s):  
Ingrid Richards Adams ◽  
Wilson Figueroa ◽  
Irene Hatsu ◽  
James Odei ◽  
Mercedes Sotos-Prieto ◽  
...  

A healthy diet is associated with lower risk of chronic disease. African Americans generally have poor diet quality and experience a higher burden of many chronic diseases. We examined the associations of demographic and psychosocial factors and barriers to diet quality among African American adults. This cross-sectional study included 100 African American adults in a southeastern metropolitan area. Psychosocial factors (social support, self-efficacy), and barriers to healthy eating were assessed with validated measures. Diet quality was assessed using the Healthy Eating Index (HEI-2010). Nested linear regressions were used to examine the association between the variables of interest and HEI scores. Participants reported having social support (M (mean) = 2.0, SD (standard deviation) = 0.6, range 0–3), high levels of self-efficacy (M = 3.1, SD = 0.7, range 1–4), and low barriers (M = 1.4, SD = 0.6, range 0–4) to engage in healthy eating but total mean HEI scores needed improvement (M = 54.8, SD = 10.9, range 27.1–70.0). Participants consumed significantly higher empty calories and lower whole fruits, dairy, and total protein foods than the national average. Barriers to healthy eating (b = −12.13, p = 0.01) and the interaction between age and barriers (b = 0.25, p = 0.02) were most strongly associated with lower HEI scores. Younger African Americans with the highest barriers to healthy eating had the lowest HEI scores. Culturally appropriate interventions targeting empty calories, barriers to healthy eating, and knowledge of the Dietary Guidelines for Americans are needed for African Americans.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Victoria Miller ◽  
Patrick Webb ◽  
Renata Micha ◽  
Dariush Mozaffarian

Abstract Objectives Meeting most of the UN Sustainable Development Goals (SGDs) will require a strong focus on tackling all forms of malnutrition─ addressing maternal and child health (MCH) as well as diet-related non-communicable diseases (NCDs). Yet, the optimal metrics to define a healthy diet remain unclear. Our aim was to comprehensively review diet metrics and assess the evidence on each metric's association with MCH and NCDs. Methods Using comprehensive searches and expert discussions, we identified metrics that i) are used in ≥3 countries to link diet to health, ii) quantify the number of foods/food groups consumed and/or iii) quantify recommended nutrient intakes. We reviewed and summarized each metric's development, components and scoring. For each identified metric, we systematically searched PubMed to identify meta-analyses or narrative reviews evaluating these metrics with nutrient adequacy and health outcomes. We assessed validity by grading the number of studies included and the consistency of the diet metric-disease relationship. Results We identified 6 MCH, 13 NCD and 0 MCH/NCD metrics. Most were developed for describing adherence to dietary guidelines or patterns, and others were developed for predicting micronutrient adequacy. On average, the metrics included 14 food groups/nutrients (range 4–45), with 10 food-group only metrics and 0 nutrient-only metrics. The most frequent metric components were grains/roots/tubers, fruits and vegetables. We identified 16 meta-analyses and 14 narrative reviews representing 102 metric-disease relationships (98 metric-NCD and 4 metric-MCH relationships, respectively). We found 5 metrics that have been consistently validated in meta-analyses and narrative reviews for NCDs, 1 metric with limited evidence for MCH, but 0 metrics for both. Of the metrics, the Alternative Healthy Eating Index (aHEI), Dietary Approaches to Stop Hypertension (DASH), Healthy Eating Index (HEI), and Mediterranean Diet Score (MED) were most commonly validated, especially for all-cause mortality and cardiovascular disease (Figure 1). Conclusions Few diet metrics have been used in multiple countries to define a healthy diet. This suggests a serious gap in global analyses of diet quality relating to malnutrition in all its forms, which hinders effective policy action. Funding Sources Gates Foundation. Supporting Tables, Images and/or Graphs


2020 ◽  
Author(s):  
Shang-Ling Wu ◽  
Yan-Bin Ye ◽  
Long-Yun Peng ◽  
Yu-Ming Chen ◽  
Fang-Fang Zeng ◽  
...  

Abstract Background The evidence regarding the impact of the healthy eating index on the risk of cardiovascular events among patients with type 2 diabetes (T2D) is limited. To examine the associations of adherence to the Chinese and American dietary guidelines and the risk of cardiovascular disease (CVD) among Chinese individuals with T2D. Methods This 1:1 matched case-control study included 419 enrolled pairs hospital-based CVD cases and controls who were matched by age and sex, in Guangdong province, China, all of whom had T2D. A structured questionnaire and a 79-item food-frequency questionnaire was used to collect general information and dietary intake information. Diet quality scores were calculated according to the Chinese Healthy Eating Index (CHEI) and the Healthy Eating Index-2015 (HEI-2015). Results After adjustment for various confounding factors, the higher diet quality scores on the CHEI and HEI-2015 showed a significant association with a lower risk of CVD. The odds ratios (95% confidence interval) per 5-score increment were 0.88(0.83,0.92) in the CHEI and 0.80(0.74,0.88) in the HEI-2015, respectively. In stratified analyses, the protective associations remained significant in the subgroups of sex, smoking status, tea-drinking, hypertension state, dyslipidemia state, BMI, and T2D duration, but not among the drinkers in CHEI. Conclusion Greater adherence to the most recent Chinese or American dietary guidelines were associated with a lower risk of CVD incidents among Chinese patients with T2D.


2021 ◽  
Author(s):  
Atiyeh Nayebi ◽  
Davood Soleimani ◽  
Shayan Mostafaei ◽  
Negin Elahi ◽  
Homayoun Elahi ◽  
...  

Abstract Objective: Healthy Eating Index-2015 (HEI-2015) is a multidimensional criterion of diet quality utilized to evaluate how well people’s dietary behaviors align with major recommendations of the 2015–2020 Dietary Guidelines for Americans. We aim to investigate the association between the diet quality and Rheumatoid arthritis (RA) activity.Design: Cross-sectional studySetting: This study was done on 184 patients with RA in rheumatology clinic in Kermanshah city, Iran, in 2020. RA was diagnosed according to the criteria of the 2010 American College of Rheumatology/ European League against Rheumatism. The overall quality diet was extracted from a validated 168-item food frequency questioner (FFQ) to calculate the HEI-2015 score. RA disease activity was assessed using Disease Activity Score 28 (DAS28) scores. One-way ANOVA and ANCOVA were done to find the associations.Participants: RA patientsResults: Individuals in the highest HEI-2015 quartile had a lower mean Erythrocyte Sedimentation Rate (ESR) than those in the lowest quartiles of the HEI scores (P-value: 0.014). A linear trend towards decreasing waist circumference in patients was observed with increasing quartiles of the HEI-2015 scores (P-value= 0.005). After controlling for all potential confounders, patients in the highest HEI-2015 quartile had the lowest DAS28 scores than those in the lowest quartile of the HEI-2015 scores (Q1= 3.65; 95% CI= 3.29 – 4.02 vs. Q4= 2.35; 95% CI= 1.94 - 2.67; P-value<0.001).Conclusion: Our results indicated that following a high diet quality might be one of the therapeutic strategies to control or reduce the disease activity in RA patients.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 278-278
Author(s):  
Kavitha Shankaranarayanan ◽  
Derek Miketinas

Abstract Objectives Nutritious and well-balanced school meals are critical to curbing the obesity epidemic in school-aged children while also providing adequate nutrition to sustain healthy growth and development. The school lunch program underwent a significant revamp in 2012 to align the menu with the US Dietary Guidelines. The Healthy Eating Index (HEI) is a metric that measures this alignment. The purpose of this study is to calculate usual HEI scores for children and compare HEI scores across frequency of school meals consumed using NHANES 2015–2016. Methods Children 18y and younger were included in the analyses and categorized into one of five groups for breakfast and lunch, each. Either consuming no school breakfast/lunch or consuming school breakfast/lunch 1–5 times daily. Usual HEI scores and standard errors were determined using the NCI method. Independent samples t-tests were computed for pairwise comparisons between no school breakfast/lunch consumption and increasing frequency of consumption. All analyses were performed using SAS version 9.4. Results Mean HEI scores for children consuming 0, 1, 2, 3, 4, 5 school breakfasts per week was 44.7 ± 0.8, 44 ± 1.9, 41.4 ± 2.4, 43.9 ± 1.4, 40.8 ± 2.3, 42.7 ± 1.0 and the mean HEI score for children consuming 0, 1, 2, 3, 4, 5 lunches per week was 44.7 ± 0.8, 46.7 ± 0.8, 42.3 ± 2.5, 45.0 ± 0.9, 46.1 ± 0.9, 43.3 ± 0.8, respectively. These results indicate that there are no significant differences across children who consumed these meals at various frequencies with those that do not consume school meals. Although there were no observed differences, overall diet quality was poor for those who do and do not consume school breakfast/lunch. Conclusions Although children and adolescents who consumed school breakfast/lunch did not appear to have greater diet quality than those who did not, overall diet quality was poor for all groups. Therefore, additional efforts are needed to improve diet quality in children and adolescents. Funding Sources Texas Woman's University.


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