Awareness and use of nutrition information predict measured and self-rated diet quality of older adults in the USA

Authors: VAUDIN, ANNA - University Of Maryland; WAMBOGO, EDWINA - University Of Maryland; Moshfegh, Alanna; SAHYOUN, NADINE - University Of Maryland

Submitted to: Public Health Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/12/2020
Publication Date: 11/18/2020
Citation: Vaudin, A., Wambogo, E., Moshfegh, A.J., Sahyoun, N. 2020. Awareness and use of nutrition information predict measured and self-rated diet quality of older adults in the USA. Public Health Nutrition. 1-11. https://doi.org/10.1017/S1368980020004681.
DOI: https://doi.org/10.1017/S1368980020004681

Interpretive Summary: Nutrition knowledge may help older adults achieve higher diet quality, but research is limited on the relationship between these two factors. Cross-sectional analysis of 2009-2014 What We Eat in America, NHANES data on adults 60+ years of age (n=4,493) showed that nutrition awareness and use of nutrition information were both significantly associated with diet quality, based on the 2015 Healthy Eating Index (HEI) and on diet quality self-report. Women were more economically vulnerable than men, but reported better nutrition awareness and use of nutrition information, and had higher HEI scores. Relationships of characteristics with reported and measured diet quality differed between men and women. Nutrition awareness and use of nutrition information are significantly related to diet quality in older adults, even when controlling for other factors. 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.

Technical Abstract: Nutrition knowledge may help older adults achieve higher diet quality, but research is limited on the relationship between these two factors. 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, and 3) factors associated with HEI score and self-rated diet quality. Data from What We Eat in America, NHANES 2009-2014 on adults 60+ years of age (n=4,493) who completed two 24-hr recalls were used to calculate mean 2015 Healthy Eating Index scores and assess self-reported dietary quality. T-tests and ANOVA were used to compare means. Logistic and linear regression were used to test for associations with diet quality, controlling for potential confounders. 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 were nutritionally aware (53.7% vs. 41.1%, p<0.0001), and used nutrition information (19.3% vs. 9.2%, p<0.0001). 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. Nutrition awareness and use of nutrition information are significantly related to diet quality in older adults, even when controlling for other factors. 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.