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Title: Dietary patterns and relationship to obesity-related health outcomes and mortality in adults 75 years of age or greater

Author
item HSIAO, PAO - Pennsylvania State University
item MITCHELL, DIANE - Pennsylvania State University
item COFFMAN, D - Pennsylvania State University
item WOOD, G - Geisinger Medical Center
item HARTMAN, T - Pennsylvania State University
item STILL, CHRISTOPHER - Geisinger Medical Center
item JENSEN, GORDON - Pennsylvania State University

Submitted to: Journal of Nutrition Health and Aging
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/27/2012
Publication Date: 1/21/2013
Citation: Hsiao, P.Y., Mitchell, D.C., Coffman, D.L., Wood, G.C., Hartman, T.J., Still, C., Jensen, G.L. 2013. Dietary patterns and relationship to obesity-related health outcomes and mortality in adults 75 years of age or greater. Journal of Nutrition Health and Aging. 17(6):566-572.

Interpretive Summary: There are an increasing number of older adults with adverse health outcomes related to obesity. While there is considerable research showing the importance of diet in relation to obesity there is very little data that shows the association between diet and prevalence of obesity related outcomes such as heart disease, diabetes or hypertension; particularly in older adults. This research showed that there was not a strong association between dietary patterns and most adverse health outcomes examined or mortality in older adults. The research did show that there was an increase in the odds of having hypertension in those with diets that were less healthy. The findings support the potential value of a healthier diet pattern in the management of hypertension in older adults.

Technical Abstract: Background: The prevalence of obesity-related adverse health outcomes is increasing among older adults. Because it is thought that nutrition plays an important role in successful aging, there has been considerable interest in the association between dietary patterns of older adults and obesity-related health outcomes. Objective: This study examined the association between dietary patterns and mortality and prevalence of obesity-related health outcomes, namely cardiovascular disease (CVD), type 2 diabetes mellitus, hypertension, and metabolic syndrome (MetSyn), over a 5-year follow-up period in adults aged 75 years or greater. Design: A longitudinal observational study with cross-sectional dietary assessment. Setting: Rural Central Pennsylvania. Participants: Community-dwelling older adults (N = 449; 76.5 years old; 57% female). Measurements: Multiple, unannounced, 24-hour dietary recalls were used to collect dietary intake. Cluster analysis was used to derive dietary patterns. Prevalence of CVD, diabetes mellitus, hypertension, and MetSyn was extracted from outpatient electronic medical records. Logistic regression was used to examine the associations between dietary patterns and health outcomes and mortality. Results: ‘Sweets and Dairy’, ‘Health-Conscious’ and ‘Western’ dietary patterns were identified. Compared to the ‘Health-Conscious’ pattern, those in the ‘Sweets and Dairy’ pattern had increased odds of hypertension over the follow-up period; adjusted odds ratio (95% CI) was 2.18 (1.11-4.30). No significant associations were found for CVD, diabetes mellitus, MetSyn or mortality with dietary patterns. Conclusions: These findings support the potential value of healthy dietary patterns in the management of hypertension in older adults. We did not observe any other strong associations between dietary patterns and health outcomes or mortality in persons = 75 years of age; thus failing to support the use of overly restrictive diet prescriptions for older persons, especially where food intake may be inadequate.