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Title: Diet-related practices and BMI are associated with diet quality in older adults

Author
item FORD, DARA - Pennsylvania State University
item HARTMAN, TERRYL - Emory University
item STILL, CHRISTOPHER - Geisinger Medical Center
item WOOD, CRAIG - Geisinger Medical Center
item MITCHELL, DIANE - Pennsylvania State University
item HSIAO, PAO - Pennsylvania State University
item BAILEY, REGAN - National Institutes Of Health (NIH)
item SMICIKLAS-WRIGHT, HELEN - Pennsylvania State University
item COFFMAN, DONNA - Pennsylvania State University
item JENSEN, GORDON - Pennsylvania State University

Submitted to: Public Health Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/29/2013
Publication Date: 8/1/2013
Citation: Ford, D.W., Hartman, T.J., Still, C., Wood, C., Mitchell, D., Hsiao, P.Y., Bailey, R., Smiciklas-Wright, H., Coffman, D.L., Jensen, G.L. 2013. Diet-related practices and BMI are associated with diet quality in older adults. Public Health Nutrition. 2:1-5.

Interpretive Summary: As the population continues to age, the concurrent increase in morbidity and mortality is of concern. High quality diets have been associated with decreased development or attenuation of symptoms of chronic diseases and have also been inversely associated with mortality. Our goal was to identify targetable factors that contribute to diet quality in older adults. This paper examined the association between diet-related practices, BMI and diet quality controlling for gender, age, education, smoking and self-v. proxy reporting in a population of adults aged =74 years. We found that individuals with a low BMI (<18.5), and those who reported concerns about food sufficiency, skipping breakfast, having chewing difficulties or a decline in intake in the previous 6 months had significantly lower diet quality scores than individuals who were of normal weight or did not report any of the aforementioned diet-related problems. The findings from this research indicate specific areas that could be targeted to improve overall diet quality in older adults. Because the majority of individuals self-report diet that is of poor or borderline quality, there is ample room for improvement. Improvements in diet quality in the aged may have far-reaching effects.

Technical Abstract: Objective: To assess the association of diet-related practices and BMI with diet quality in rural adults aged $74 years. Design: Cross-sectional. Dietary quality was assessed by the twenty-five-item Dietary Screening Tool (DST). Diet-related practices were self-reported. Multivariate linear regression models were used to analyze associations of DST scores with BMI and diet-related practices after controlling for gender, age, education, smoking and self- v. proxy reporting. Setting: Geisinger Rural Aging Study (GRAS) in Pennsylvania, USA. Subjects: A total of 4009 (1722 males, 2287 females; mean age 81.5 years) participants aged =74 years. Results: Individuals with BMI, 18.5 kg/m2 had a significantly lower DST score (mean 55.8, 95% CI 52.9, 58.7) than those individuals with BMI < 18.5–24.9 kg/m2 (mean 60.7, 95% CI 60.1, 61.5; P=0.001). Older adults with higher, more favorable DST scores were significantly more likely to be food sufficient, report eating breakfast, have no chewing difficulties and report no decline in intake in the previous 6 months. Conclusions: The DST may identify potential targets for improving diet quality in older adults including promotion of healthy BMI, breakfast consumption, improving dentition and identifying strategies to decrease concern about food sufficiency.