Towards a better understanding of listeriosis risk among older adults in the United States: Characterizing dietary patterns and the sociodemographic and economic attributes of consumers with these patterns

Authors: WAMBOGO, E - University Of Maryland; VAUDIN, A - University Of Maryland; Moshfegh, Alanna; SPUNGEN, J - Food And Drug Administration(FDA); VAN DOREN, JM - Food And Drug Administration(FDA); SAHYOUN, NR - University Of Maryland

Submitted to: Journal of Food Protection
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/12/2020
Publication Date: 6/23/2020
Citation: Wambogo, E.A., Vaudin, A.M., Moshfegh, A.J., Spungen, J.H., Van Doren, J.M., Sahyoun, N.R. 2020. Towards a better understanding of listeriosis risk among older adults in the United States: Characterizing dietary patterns and the sociodemographic and economic attributes of consumers with these patterns. Journal of Food Protection. 83(7):1208-1217. https://doi.org/10.4315/JFP-19-617.
DOI: https://doi.org/10.4315/JFP-19-617

Interpretive Summary: Older adults are at higher risk of invasive listeriosis compared with the general population. Some foods are more likely than others to be contaminated with or contain high levels of Listeria monocytogenes. Information is lacking on the characteristics of older adults who are more likely to consume foods associated with higher risk of listeriosis. National health and nutrition data were combined with food safety data to determine the characteristics of older adults whose dietary patterns contain foods that are associated with relatively higher risks of listeriosis. Dietary data from the What We Eat in America, National Health and Nutrition Examination Survey 2009-2014 of 4,967 adults ages 60 and older were used to generate five dietary patterns. These patterns were ranked based on relative risk of listeriosis using epidemiological and risk assessment data. Patterns associated with the largest relative risk of listeriosis included ones associated with consumption of fruits and vegetables or milk and cereals (based on 2013 outbreak illness attribution) and one associated with meats and cheeses (based on the 2003 Joint FDA-FSIS Quantitative Risk Assessment). Individuals in these dietary patterns differed in sex, race, food security, self-rated diet quality, and self-rated health. Linking consumption pattern data with epidemiological or risk assessment data provides new information that can be leveraged to develop targeted educational messages for reducing listeriosis risk.

Technical Abstract: Older adults are at higher risk of invasive listeriosis compared with the general population. Some foods are more likely than others to be contaminated with or contain high levels of Listeria monocytogenes. Information is lacking on the characteristics of older adults who are more likely to consume foods associated with higher risk of listeriosis. The objectives of this research were to determine dietary consumption patterns among older adults, evaluate sociodemographic and economic characteristics of older adults associated with each pattern, determine intake of foods associated with larger relative risk of listeriosis within these patterns, and rank these patterns based on risk. Dietary and sociodemographic data on adults 60+ years of age (n=4.967) from the What We Eat in America, National Health and Nutrition Examination Surveys (NHANES) 2009-2014 were used to determine dietary patterns and intakes of foods associated with listeriosis. Dietary patterns were based on 24-hour dietary recall per adults. Cluster analysis was used to define dietary patterns. Multiple Comparison Tests in ANOVA with Dunnett’s method of adjustment were used to evaluate significant differences in mean intake of foods. Patterns were ranked based on relative risk of listeriosis using outbreak illness attribution and risk assessment data. Five distinct dietary patterns were identified. Patterns ranked at highest relative risk of listeriosis, based on 2013 outbreak illness attribution data, were characterized by (1) relatively higher intakes of fruits, vegetables, and vegetable oils (~22% respondents) or (2) relatively higher intakes of cereal, milk, and yogurt (16% respondents); and, based on 2003 risk assessment data, (3) relatively higher intakes of breads, cheese, and cured meats (~9.6% respondents). Individuals consuming these dietary patterns differed in sex, race, food security, self-rated diet quality, and self-rated health. Cluster analysis, despite methodological limitations, provides new information on consumption, sociodemographic, and economic characteristics of subgroups within susceptible populations that can be used to target educational messages.