Topical Area: Nutritional Epidemiology
This study aimed to investigate: 1) the diet quality of older adults, using the Healthy Eating Index 2015 (HEI-2015) and self-rated diet quality, 2) characteristics associated with reported awareness and use of nutrition information, 3) factors associated with HEI-2015 score and self-rated diet quality, including the relationship with awareness and use of nutrition information.
Methods : A cross-sectional analysis of 24-hour recall and questionnaire data from the National Health and Nutrition Examination Survey 2009-2014, including 4,493 subjects, aged 60 years and older. The population ratio method was used in SAS 9.4 to calculate mean HEI scores. Data was stratified by gender, then t-tests and ANOVA were used to compare means and chi-squares were used to compare proportions. Logistic and linear regression were used to test for associations with diet quality, controlling for potential covariates.
Results : The mean total HEI score for men was significantly lower than for women (63.7± 0.8 vs. 66.6 ± 0.8 respectively, p< 0.0001). Compared to men, more women reported nutrition awareness (53.7% vs. 41.1%, p< 0.0001), and use of nutrition information (19.3% vs. 9.2%, p< 0.0001). Nutrition awareness was also associated with race, age, education, socioeconomic status, and food security. In bivariate analyses, nutrition awareness and use of nutrition information were significantly associated with both HEI score and self-rated diet quality in both men and women. In multivariate analyses, nutrition awareness remained a significant predictor of HEI for women but not men, and remained a significant predictor of self-reported diet quality in men but not women.
Conclusions : Nutrition awareness and use of nutrition information are significantly related to diet quality in older adults, even when controlling for other factors. There are differences in these relationships for older adult men versus women. Gaps in awareness, indicating need for nutrition education, exist in men, non-whites, those participating in nutrition assistance programs, and those with lower education and socioeconomic status. Closing these gaps may lead to improved diet quality in segments of the older adult population.
Funding Sources : Agricultural Research Service, United States Department of Agriculture