Submitted to: Journal of Nutrition Health and Aging
Publication Type: Peer reviewed journal
Publication Acceptance Date: 4/2/2012
Publication Date: 7/1/2012
Citation: Hsiao, P., Mitchell, D.C., Coffman, D.L., Allman, R.M., Locher, J.L., Sawyer, P., Jensen, G.L., Hartman, T.J. 2012. Dietary patterns and diet quality among diverse older adults: The University of Alabama at Birmingham study of aging. Journal of Nutrition Health and Aging. 7:1-7. Interpretive Summary: Little is known about dietary patterns in culturally diverse older adults. Three distinct dietary patterns were identified in a population of older adults residing in Alabama. More healthful dietary patterns were characterized by higher intakes of fruits, vegetables, whole grains, eggs, nuts, legumes and dairy and were lower in energy density. A “Western-like” dietary pattern and a Low produce, high sweets pattern were also characterized. Understanding the distinct dietary patterns of subsets of culturally diverse population provides valuable dietary targets that could potentially be useful to intervene on obese older adults who are not meeting nutrient recommendations and have poor overall dietary quality.
Technical Abstract: Objectives: To characterize dietary patterns among a diverse sample of older adults (= 65 years). Design: Cross-sectional. Setting: Five counties in west central Alabama. Participants: Community-dwelling Medicare beneficiaries (N=416; 76.8 ± 5.2 years, 56% female, 39% African American) in the University of Alabama at Birmingham (UAB) Study of Aging. Measurements: Dietary data collected via three, unannounced 24-hour dietary recalls was used to identify dietary patterns. Foods were aggregated into 13 groups. Finite mixture modeling (FMM) was used to classify individuals into three dietary patterns. Differences across dietary patterns for nutrient intakes, socio demographic and anthropometric measurements were examined using chi-square and general linear models. Results: Three dietary patterns were derived. A “More healthful” dietary pattern, with relatively higher intakes of fruit, vegetables, whole grains, eggs, nuts, legumes and dairy, was associated with lower energy density, higher quality diets as determined by Healthy Eating Index (HEI)-2005 scores and higher intakes of fiber, folate, vitamins C and B6, calcium, iron, magnesium, and zinc. The “Western like” pattern was defined by an intake of starchy vegetables, refined grains, meats, fried poultry and fish, oils and fats and was associated with lower HEI-2005 scores. The “Low produce, high sweets” pattern was characterized by high saturated fat, and low dietary fiber and vitamin C intakes. The strongest predictors of better diet quality were female gender and non-Hispanic white race. Conclusion: The dietary patterns identified may provide a useful basis on which to base dietary interventions targeted at older adults. Examination of nutrient intakes regardless of the dietary pattern suggests that older adults are not meeting nutrient recommendations and should continue to be encouraged to choose high quality diets.