Caregiver Status and Diet Quality in Community Dwelling Older Adults

Abstract Objectives Prior studies on caregivers have focused mainly on the diet quality of their recipients, especially children. We investigated both cross-sectional and longitudinal associations of caregiver status and diet quality in older adults (mean 53.0 ± 9.0 years). Methods We studied participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (57.7% women, 62% African American) between wave 3 (2009–2013) and wave 4 (2013–2018). Caregiving was assessed at both waves, starting at wave 3. Healthy Eating Index-2010 (HEI2010) score, a measure of diet quality, was assessed from two 24-hour recalls at each wave on both occasions (mean 4.1 years follow-up). Baseline caregiving (at wave 3) was examined in relation to change in HEI between waves 3 and 4. Multivariable linear regression was performed for cross-sectional analysis; mixed-effects regression was performed for longitudinal analyses. Results are expressed as β-coefficients ± standard error of means (β±SE). Results After adjusting for age, sex, race and poverty status, more time spent taking care of grandchildren (N = 2033) was associated with poor diet quality (–1.51 ± 0.55, P = 0.006) in cross-sectional analysis (wave 4 caregiving and wave 4 HEI). However, in a separate cross-sectional analysis (wave 4 only) on dual (caring for both grandchildren and an elderly person) vs. single caregivers (either grandchildren or elderly) (N = 73; 24 men & 49 women) we found no difference in diet quality. The longitudinal analyses (N = 1848) demonstrated that diet quality did not change with caregiving over time for either grandchildren (P = 0.16) or others (not children & grandchildren) (P = 0.88). Overall, women tended to have better quality diet (P < 0.001) than men. Conclusions Among relatively older caregivers, cross-sectional analyses revealed an inverse effect of caregiving with diet quality. Longitudinal research is needed to evaluate the temporal associations of dual caregiving with subsequent diet quality changes over time. Funding Sources The first author is supported by a Postdoctoral Fellowship from the Intramural Research Program (IRP) at the National Institute on Aging (NIA). HANDLS is supported by the Intramural Research Program, National Institute on Aging, National Institutes of Health, grant Z01-AG000513.

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Are neighborhood restaurants related to frequency of restaurant meals and dietary quality?: Prevalence and changes over time in the Multi-Ethnic Study of Atherosclerosis

Public Health Nutrition ◽

10.1017/s1368980021002196 ◽

2021 ◽

pp. 1-29

Author(s):

Amy H. Auchincloss ◽

Jingjing Li ◽

Kari A. B. Moore ◽

Manuel Franco ◽

Mahasin S. Mujahid ◽

...

Keyword(s):

Healthy Eating Index ◽

Dietary Quality ◽

Longitudinal Analyses ◽

Cross Sectional ◽

Cross Sectional Analysis ◽

Eating Out ◽

Restaurant Meals ◽

Sectional Analysis ◽

Over Time

Abstract Objective: To examine whether the density of neighbourhood restaurants affected the frequency of eating restaurant meals and subsequently affected diet quality. Design: Cross-sectional and longitudinal designs. Structural equation models assessed the indirect relationship between restaurant density (≤3 miles (4.8 km) of participant addresses) and dietary quality (Healthy Eating Index 2010 (HEI)) via the frequency of eating restaurant meals, after adjustment for sociodemographics, select health conditions, region, residence duration and area-level income. Setting: Urbanised areas in multiple regions of the USA, years 2000–2002 and 2010–2012. Participants: Participants aged 45–84 years were followed for 10 years (n 3567). Results: Median HEI (out of 100) was 59 at baseline and 62 at follow-up. Cross-sectional analysis found residing in areas with a high density of restaurants (highest ranked quartile) was associated with 52% higher odds of frequently eating restaurant meals (≥3 times/week, odds ratio [OR]:1.52, 95% confidence interval [CI] 1.18-1.98) and 3% higher odds of having lower dietary quality (HEI lowest quartile<54, OR:1.03,CI:1.01-1.06); associations were not sustained in longitudinal analyses. Cross-sectional analysis found 34% higher odds of having lower dietary quality for those who frequently ate at restaurants (OR:1.34,CI:1.12-1.61); and more restaurant meals (over time increase ≥1 times/week) was associated with higher odds of having worse dietary quality at follow-up (OR:1.21,CI:1.00-1.46). Conclusions: Restaurant density was associated with frequently eating out in cross-sectional and longitudinal analyses but was associated with the lower dietary quality only in cross-sectional analyses. Frequent restaurant meals were negatively related to dietary quality. Interventions that encourage less frequent eating out may improve population dietary quality.

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Characterisation of breakfast, lunch, dinner and snacks in the Japanese context: an exploratory cross-sectional analysis

Public Health Nutrition ◽

10.1017/s1368980020004310 ◽

2020 ◽

pp. 1-13 ◽

Cited By ~ 1

Author(s):

Kentaro Murakami ◽

Nana Shinozaki ◽

M Barbara E Livingstone ◽

Aya Fujiwara ◽

Keiko Asakura ◽

...

Keyword(s):

Diet Quality ◽

Healthy Eating Index ◽

Alcoholic Beverages ◽

Background Information ◽

Cross Sectional ◽

Fish Meat ◽

Cross Sectional Analysis ◽

Sweetened Beverages ◽

Dietary Record ◽

Sectional Analysis

Abstract Objective: To characterise different meal types by examining the contribution of specific meals to the total intakes and the nutritional quality of each meal. Design: A cross-sectional analysis was conducted based on dietary data collected using 4-d dietary record. Diet quality was assessed by the Healthy Eating Index-2015 and Nutrient-Rich Food Index 9.3. Setting: Japan. Participants: Adults aged 20–81 years (n 639). Results: Diet quality was, on average, highest for dinner, followed, in order, by lunch, breakfast and snacks. Breakfast, lunch, dinner and snacks, on average, accounted for 21 %, 32 %, 40 % and 11 % of total energy intake, respectively. For many nutrients, the percentage contribution to total intake did not vary within each meal, broadly in line with that for energy: 18–24 % for breakfast, 26–35 % for lunch, 35–49 % for dinner and 4–15 % for snacks. However, intakes of many foods largely depended on one meal type. The foods mainly eaten at dinner were potatoes, pulses, total vegetables, fish, meat and alcoholic beverages (52–70 %), in contrast to noodles (58 %) at lunch and bread (71 %) and dairy products (50 %) at breakfast. The foods mainly eaten at snacks were confectioneries (79 %) and sugar-sweetened beverages (52 %). Conversely, rice and eggs were more evenly distributed across three main meals (19–41 % and 30–38 %, respectively), while fruit and non-energetic beverages were more evenly distributed across all meal types (17–30 % and 19–35 %, respectively). Conclusions: These findings provide the background information on each meal type in Japanese and may help inform the development of meal-based guidelines and public health messages.

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