Predictors of food variety and dietary diversity among older persons in Botswana

OBJECTIVE: We investigated whether food variety and diversity are associated with physical and cognitive functioning in older adults in Botswana and designed a simple set of screening questions that predict food variety in this population. METHODS: Data were collected (1998) as a national household survey of 1085 subjects 60 y and older. A food variety score, based on a food frequency checklist, was calculated by summing the frequency of weekly intakes of 16 food items (0 to 66). A dietary diversity score was calculated as the number of food groups consumed weekly (0 to 5). A representative subsample (n = 393) was randomly selected for the clinical component of the survey, and measurements on dependency and cognitive function were conducted. RESULTS: Low food variety was found: 35.2%, 59.3%, and 22.4% of subjects consumed no dairy products, fruits, and vegetables, respectively. A higher food variety score was associated with urban residence, ownership of cattle, higher education, and more frequent meals, and these indicators were used to construct a nutritional risk indicator. Higher food variety score was associated with better self-reported health and better cognitive function. Similarly, a higher score on the nutritional risk indicator screening tool was associated with desirable health outcomes. CONCLUSION: A limited number of foods is consumed, leading to an overall pattern of poor food variety. Higher food variety was associated with improved physical and cognitive functions. A screening tool that predicts food variety in this population has been developed and is recommended to be incorporated at a primary care level to identify older adults most at risk of a poor quality diet.     

Dietary Patterns Derived by Cluster Analysis are Associated with Cognitive Function among Korean Older Adults

The objective of this study was to investigate major dietary patterns among older Korean adults through cluster analysis and to determine an association between dietary patterns and cognitive function. This is a cross-sectional study. The data from the Korean Multi-Rural Communities Cohort Study was used. Participants included 765 participants aged 60 years and over. A quantitative food frequency questionnaire with 106 items was used to investigate dietary intake. The Korean version of the MMSE-KC (Mini-Mental Status Examination–Korean version) was used to assess cognitive function. Two major dietary patterns were identified using K-means cluster analysis. The “MFDF” dietary pattern indicated high consumption of Multigrain rice, Fish, Dairy products, Fruits and fruit juices, while the “WNC” dietary pattern referred to higher intakes of White rice, Noodles, and Coffee. Means of the total MMSE-KC and orientation score of the participants in the MFDF dietary pattern were higher than those of the WNC dietary pattern. Compared with the WNC dietary pattern, the MFDF dietary pattern showed a lower risk of cognitive impairment after adjusting for covariates (OR 0.64, 95% CI 0.44–0.94). The MFDF dietary pattern, with high consumption of multigrain rice, fish, dairy products, and fruits may be related to better cognition among Korean older adults.     

Nutrients, age and cognitive function

Many nutrients or indices of nutritional status are associated with cognitive functioning, although the size of the effects on cognitive performance may be small. Results from recent studies, however, seem consistently to indicate that supplementation with beta-carotene and alpha-tocopherol, substances that promote antioxidant vitamins A and E, respectively, can be beneficial to cognitive function in elderly people. Folate rather than vitamin B12 appears to be associated with cognitive functioning. Furthermore the daily intake of ginkgo biloba extract can enhance cognitive performance and has been proved to delay cognitive decline in dementia. A proper dietary composition with regard to the ratio of carbohydrates to proteins, as well as the inclusion of sufficient micronutrients, seems to be favourable in the maintenance of cognitive function in the elderly. Glucose can enhance cognitive function, but a rapid decline of glucose levels may impair cognitive function or may induce feelings of lack of energy. Low doses of caffeine may also enhance cognitive function, although most studies on caffeine and cognition, as with studies on glucose and cognition, have not been carried out in elderly individuals. The effects of nutritional supplements are modest but do not seem to be very different from those of medicinal or investigational cognition-enhancing or anti-dementia drugs.     

居民膳食营养状况与食管癌和肝癌死亡率关系

目的了解食管癌与肝癌低发地区山东省淄博市桓台县、食管癌高发地区江苏省淮安市楚州区、肝癌高发地区广西壮族自治区扶绥县等3个地区居民的膳食营养状况,探讨膳食营养状况与食管癌、肝癌之间的关系。方法在3个地区各抽取1个自然村,选择年龄25~65岁,一般健康状况良好者作为调查对象,采用食物频率法,实地入户进行膳食调查。结果3个地区居民营养素的摄入有较大差异。江苏淮安楚州区调查对象的胡萝卜素、硫胺素、维生素E以及硒元素摄入量均低于山东桓台县,广西扶绥县调查对象的蛋白质、脂肪、视黄醇、硫胺素、钙、磷、硒以及膳食纤维摄入量均低于山东桓台县;山东地区调查对象的膳食营养状况明显好于其他2个地区。结论膳食营养因素可能与食管癌、肝癌的发生有一定关系。     

华北煤炭医学院学生膳食营养状况

目的了解医科大学生的主要营养问题,以便采取有效干预措施。方法随机整群抽取420名医科大学生进行5 d膳食称重调查和体格检查,并从中随机抽取190人进行营养生化指标检查。结果调查人群每天各类食物摄取量偏低;能量、核黄素和钙摄入不足,硫胺素和维生素C摄取严重不足;蛋白质质量较好;视黄醇和铁的摄取量充足但食物来源较差;中餐能量不足而晚餐能量偏高。尿负荷试验和尿钙排出量测定,大学生体内硫胺素、核黄素、维生素C和钙水平较低,女生贫血率为11.1%。结论应采取相应措施,改善学生膳食结构,特别增加奶类和蔬菜水果摄入量;女生应注意血红素铁的补充。     

Dietary glycemic index and glycemic load and the risk of type 2 diabetes in older adults

BACKGROUND: It is unclear whether immediate dietary effects on blood glucose influence the risk of developing type 2 diabetes. OBJECTIVE: The objective of this study was to examine whether the dietary glycemic index (GI) and glycemic load (GL) were associated with the risk of type 2 diabetes in older adults. DESIGN: The Health, Aging, and Body Composition Study is a prospective cohort study of 3075 adults who were 70-79 y old at baseline (n=1898 for this analysis). The intakes of specific nutrients and food groups and the risk of type 2 diabetes over a 4-y period were examined according to dietary GI and GL. RESULTS: Dietary GI was positively associated with dietary carbohydrate and negatively associated with the intakes of protein, total fat, saturated fat, alcohol, vegetables, and fruit. Dietary GL was positively associated with dietary carbohydrate, fruit, and fiber and negatively associated with the intakes of protein, total fat, saturated fat, and alcohol. Persons in the higher quintiles of dietary GI or GL did not have a significantly greater incidence of type 2 diabetes. CONCLUSIONS: These findings do not support a relation between dietary GI or GL and the risk of type 2 diabetes in older adults. Because dietary GI and GL show strong nutritional correlates, the overall dietary pattern should be considered.     

Low Protein Intakes and Poor Diet Quality Associate with Functional Limitations in US Adults with Diabetes: A 2005–2016 NHANES Analysis

Type 2 diabetes is associated with an increased risk for sarcopenia. Moreover, sarcopenia correlates with increased risk for falls, fractures, and mortality. This study aimed to explore relationships among nutrient intakes, diet quality, and functional limitations in a sample of adults across levels of glycemic control. Data were examined from 23,487 non-institutionalized adults, 31 years and older, from the 2005–2016 National Health and Nutrition Examination Survey. Hemoglobin A1c (%) was used to classify level of glycemic control: non-diabetes (<5.7%); pre-diabetes (5.7–6.4%); diabetes (≥6.5%). Dietary data were collected from a single 24-h dietary recall. Participants were categorized as meeting or below the protein recommendation of 0.8 g/kg of body weight. Physical functioning was assessed across 19-discrete physical tasks. Adults below the protein recommendation consumed significantly more carbohydrate and had lower diet quality across all glycemic groups compared to those who met the protein recommendation (p < 0.001). Adults with diabetes who did not meet protein recommendations had significantly poorer diet quality and significantly higher mean number of functional limitations. A greater percent of adults with diabetes who did not meet the protein recommendation reported being physically limited for most activities, with more than half (52%) reporting limitations for stooping, crouching, and kneeling. This study underscores the potential for physical limitations associated with low protein intakes, especially in adults with diabetes. In the longer term, low protein intakes may result in increased risk of muscle loss, as protein intake is a critical nutritional factor for prevention of sarcopenia, functional limitations, and falls.     

The Effects of Fruit-Derived Polyphenols on Cognition and Lung Function in Healthy Adults: A Systematic Review and Meta-Analysis

Polyphenols are plant derived nutrients that influence oxidative stress and inflammation and therefore may have positive benefits on cognition and lung function. This systematic review and meta-analysis aimed to evaluate the effects of fruit derived polyphenol intakes on cognition and lung capacity in healthy adults. In August 2020 and October 2021, Medline and Google Scholar were used to search for relevant studies examining the effects of fruit derived polyphenol intakes on cognition and/or lung function in healthy adults (<70 years old). Fourteen studies related to cognition (409 healthy subjects) and seven lung/respiratory studies (20,788 subjects) were used for the systematic review using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The meta-analysis (using six cognition and three lung function studies) indicated a protective effect on lung function from dietary intakes of fruit-derived polyphenols. Neither a benefit nor decrement from fruit-derived polyphenol intakes were detected for cognition. Human intervention trials examining the effects of polyphenol supplementation on lung function in healthy adults are scarce and intervention studies are warranted. More conclusive results are needed to provide recommendations for polyphenol supplementation to support aspects of cognition.     

The Association of Healthful Diets and Cognitive Function: A Review

The association of diet with mild cognitive impairment has not been extensively studied. Consumption of a healthful diet may help to attenuate age-related decline in older adults. Published studies have suggested that greater adherence to a Mediterranean-style dietary pattern is associated with a lower risk of developing Alzheimer's disease and with a slower rate of cognitive decline with age. However, published findings are inconsistent. The discrepancies most likely can be explained by the variations in both dietary and cognitive methodologies. It is not clear how diet contributes to the development of neurocognitive changes with age. This review will update available knowledge on the relationship between adherence to healthful diets and cognition and document the need for researchers to adopt more coherent and uniform methodology to allow for better quantification of the association of diet with cognitive function. There appears to be a relationship between diet and cognition.     

Inadequate nutrient intakes are common and are associated with low diet variety in rural, community-dwelling elderly

Poor dietary habits and inadequate nutrient intakes are of concern in the elderly. The nutritional characteristics of those who survive to become the oldest are not well defined. Our goal was to describe dietary habits, nutrient intakes and nutritional risk of community-dwelling, rural Iowans, 79 y of age and older. Subjects were interviewed (n = 420) using a standardized format on one occasion in their homes and instructed to complete 3-d diet records (n = 261) after the in-home interview. Standardized interviews assessed demographic information, cognitive function and dietary habits (Nutrition Screening Initiative Checklist). Adequate nutrient intake was defined as consumption of the nutrient's estimated average requirement, 67% adequate intake or 67% recommended dietary allowance. Mean age was 85.2 y, 57% lived alone and 58% were widowed. Subjects completing 3-d diet records were younger, more cognitively intact and less likely to be at nutritional risk than subjects not completing diet records. The percentage of subjects with inadequate intakes of selected nutrients was 75% for folate, 83% for vitamin D and 63% for calcium. Eighty percent of subjects reported inadequate intakes of four or more nutrients. Diet variety was positively associated with the number of nutrients consumed at adequate intakes (r = 0.498), total energy (r = 0.522) and dietary fiber (r = 0.421). Our results suggest that rural, community-dwelling old have inadequate intakes of several nutrients. Recommendations to increase diet variety and consume a nutrient supplement may be necessary for elderly people to achieve adequate nutrient intakes.     

中国成年居民营养素摄入状况的评价

目的使用ISU方法计算营养素的日常摄入量(UI),评估中国成年居民的营养素摄入状况。方法使用"2002年中国居民营养与健康状况调查"数据,采用美国爱荷华州立大学(Iowa State Unirersity,ISU)方法计算43 672名成年居民的碳水化合物、蛋白质、钙、铁、锌、硒、镁、维生素B1和维生素B2的UI,并将UI与平均需要量(EAR)比较,评估这些营养素摄入不足的比例;将宏量营养素供能比的UI与可接受宏量营养素分布范围(AMDRs)或适宜摄入量(AI)比较,评估宏量营养素摄入是否合理。结果我国成年居民碳水化合物和蛋白质供能比UI均值均在推荐范围之内,脂肪供能比UI均值稍高于AI上限;碳水化合物供能比低于AI下限的比例约为40%,蛋白质供能比低于AMDRs下限的比例约为20%,脂肪供能比高于AI上限比例约为50%。我国成年居民钙、锌、硒、镁、维生素B1和维生素B2摄入不足比例均较高,其中钙摄入不足的比例超过95%,维生素B1和维生素B2摄入不足的比例均达到了80%以上。结论我国成年居民宏量营养素供能比例不合理,膳食钙、锌、硒、镁、维生素B1和维生素B2摄入不足状况较为严重。     

Dietary protein and resistance training effects on muscle and body composition in older persons

The regular performance of resistance exercises and the habitual ingestion of adequate amounts of dietary protein from high-quality sources are two important ways for older persons to slow the progression of and treat sarcopenia, the age-related loss of skeletal muscle mass and function. Resistance training can help older people gain muscle strength, hypertrophy muscle, and increase whole body fat-free mass. It can also help frail elderly people improve balance and physical functioning capabilities. Inadequate protein intake will cause adverse metabolic and physiological accommodation responses that include the loss of fat-free mass and muscle strength and size. Findings from controlled feeding studies show that older persons retain the capacity to metabolically adjust to lower protein intakes by increasing the efficiency of nitrogen retention and amino acid utilization. However, they also suggest that the recommended dietary allowance of 0.8 g protein x kg(-1) x d(-1) might not be sufficient to prevent subtle accommodations and blunt desired changes in body composition and muscle size with resistance training. Most of the limited research suggests that resistance training-induced improvements in body composition, muscle strength and size, and physical functioning are not enhanced when older people who habitually consume adequate protein (modestly above the RDA) increase their protein intake by either increasing the ingestion of higher-protein foods or consuming protein-enriched nutritional supplements.     

Dietary Intake and Representativeness of a Diverse College-Attending Population Compared with an Age-Matched US Population

Young adults typically gain more dietary autonomy as they start college, though this can also present nutritional challenges; however, research on the generalizability of their dietary intake data is scarce. To address this representativeness concern, we compared food and nutrient intakes reported by college freshmen attending a large, diverse university to an age-matched sample from the National Health and Nutrition Examination Survey (NHANES). We studied 269 students 18–24 years old recruited through the Mason: Health Start Here (HSH) study, a population-based cohort study of college students. Diet was assessed using a diet history questionnaire (DHQ-III) and estimated with food source composition tables. The NHANES sample of 835 adults was the reference dataset. Reported dietary intakes were weighted and compared with national intakes via t-tests. We observed comparable energy, carbohydrate, fat, and protein intakes in both groups; however, the HSH cohort reported a higher density intake of most micronutrients than the NHANES sample. Differences between these samples in intake, mode of dietary assessment administration, and reactivity may help explain the differences detected. These results demonstrate that when appropriately contextualized in terms of methodology and potential sources of bias, single college studies can be useful for understanding nutrition in young adults more broadly.     

Multivitamin-multimineral supplements: who uses them?

Dietary supplement use is increasingly common in the United States. Multivitamin formulations with or without minerals are typically the most common type of dietary supplement reported in surveys and studies that collect data relating to dietary supplement use. In the National Health and Nutrition Examination Survey (NHANES) 1999-2000, 52% of adults reported taking a dietary supplement in the past month, and 35% reported regular use of a multivitamin-multimineral (MVMM) product. NHANES III data indicate an overall prevalence of dietary supplement usage of 40%, with prevalence rates of 35% in NHANES II and 23% in NHANES I. Women (versus men), older age groups, non-Hispanic whites (versus non-Hispanic blacks or Mexican Americans), and those with a higher education level, lower body mass index, higher physical activity level, and more frequent consumption of wine had a greater likelihood of reporting use of MVMM supplements in NHANES 1999-2000. Data from children suggest a similar prevalence rate, but lower prevalence rates of usage were reported in studies of adolescents. Individuals who use dietary supplements (including MVMM formulations) generally report higher dietary nutrient intakes and healthier diets in studies in which dietary data were also collected. Among adults with a history of breast or prostate cancer, usage rates for dietary supplements in general and MVMMs are considerably higher (eg, 56-57% for MVMMs), and these subgroups are more likely to also report use of single vitamin and mineral supplements. Thus, MVMM use contributes a considerable proportion of nutrient intakes in the United States and may contribute to risk of excessive intakes.     

Dietary Protein and Resistance Training Effects on Muscle and Body Composition in Older Persons

The regular performance of resistance exercises and the habitual ingestion of adequate amounts of dietary protein from high-quality sources are two important ways for older persons to slow the progression of and treat sarcopenia, the age-related loss of skeletal muscle mass and function. Resistance training can help older people gain muscle strength, hypertrophy muscle, and increase whole body fat-free mass. It can also help frail elderly people improve balance and physical functioning capabilities. Inadequate protein intake will cause adverse metabolic and physiological accommodation responses that include the loss of fat-free mass and muscle strength and size. Findings from controlled feeding studies show that older persons retain the capacity to metabolically adjust to lower protein intakes by increasing the efficiency of nitrogen retention and amino acid utilization. However, they also suggest that the recommended dietary allowance of 0.8 g protein · kg^?1 · d^?1 might not be sufficient to prevent subtle accommodations and blunt desired changes in body composition and muscle size with resistance training. Most of the limited research suggests that resistance training-induced improvements in body composition, muscle strength and size, and physical functioning are not enhanced when older people who habitually consume adequate protein (modestly above the RDA) increase their protein intake by either increasing the ingestion of higher-protein foods or consuming protein-enriched nutritional supplements.     

Energy,Macronutrients, Dietary Fibre and Salt Intakes in Older Adults in Ireland: Key Sources and Compliance with Recommendations

The global population is rapidly ageing. Adequate nutritional status can play a key role in preventing or delaying the progression of age-related diseases. The aim of this study was to estimate the usual intake of energy, macronutrients, dietary fibre and salt in order to determine compliance with recommendations and to identify the sources of these nutrients in older adults (≥65 years) in Ireland. This study is based on data from the cohort of older adults aged ≥65 years (n = 226) in the Irish National Adult Nutrition Survey (NANS) (2008–2010) which estimated food and nutrient intakes in a representative sample of adults 18–90 years using a 4 day weighed food record. This study found that while intakes of macronutrients are generally sufficient in this population group, older adults in Ireland have high intakes of total fat, saturated fat, sugar and salt and low intakes of dietary fibre. Future strategies to address the nutritional issues identified in older adults could include the promotion of healthy food choices together with improvements of the food supply including reformulation (fat, sugar and salt) to support successful ageing of our population.     

Contribution of Snacking to Older Adults' Vitamin, Carotenoid, and Mineral Intakes

Decreased food and beverage consumption among older adults can lead to inadequate intakes of energy and numerous micronutrients. Although older adults are prone to having inadequate diets, little research attention has been directed at their dietary behaviors, such as snacking. The purpose of this study was to examine the association between snacking frequency and older adults' daily intakes of vitamins, carotenoids, and minerals. Cross-sectional data for 2,056 older adults (65 years and older) from the 2003-2006 National Health and Nutrition Examination Survey were used for this study. Dietary data were collected through two 24-hour dietary recall interviews. Participants' snacking occasions and daily nutrient intakes were averaged during the two 24-hour recalls. Using linear regression models to adjust for multiple covariates, mean vitamin, carotenoid, and mineral intakes by snacking category were estimated. As snacking frequency increased, daily intakes of vitamins A, C, and E and beta carotene increased. Older adults' daily intakes of magnesium, copper, and potassium also increased as snacking frequency increased. As older adults' snacking frequency increased, their daily intake of selenium decreased, and their snacking frequency was not associated with their daily intakes of the B-complex vitamins, vitamin K, lycopene, phosphorus, iron, and zinc. Providing healthy snacks on a regular basis has practical implications for institutions, centers, or organizations that serve older adults; however, nutritional benefits obtained from snack food and beverages warrant their inclusion in older adults' diet.     

Relative validity of the geisinger rural aging study food frequency questionnaire

Objective: To determine the relative validity of a population specific food frequency questionnaire (FFQ) and evaluate the effectiveness of the instrument for assessing nutritional risk in older adults. Design: A cross-over design with participants completing two different dietary assessment instruments in random order. Setting: The Geisinger Rural Aging Study (GRAS), a longitudinal study of over 20,000 adults living in the central, northern and eastern counties of Pennsylvania. Participants: A subset of GRAS consisting of 245 older adults (60% women) ranging in age from 70 to 95 years. Measurements: Energy and nutrient intakes were assessed from two instruments: a population specific food frequency questionnaire (FFQ) and four 24-hour dietary recalls conducted over a two week period. Results: Pearson correlation coefficients between the FFQ and dietary recalls for most nutrients were 0.5 or higher which suggests that the FFQ provided relatively valid estimates of macro and micronutrient intakes examined. Bland-Altman plots were generated to examine the agreement between instruments. Data are shown for energy, folate and zinc with close agreement at lower intakes indicative of risk for folate and zinc. Sensitivity results also showed that the FFQ was able to correctly classify individuals adequately at risk for most nutrients examined. Conclusion: This population specific FFQ appears to be a valid instrument for use in in evaluating risk for many nutrients that are of particular concern in older adults residing throughout many predominately rural counties in Pennsylvania.     

Intakes of whole grain in an Italian sample of children,adolescents and adults

Purpose

There is wide evidence that regular consumption of whole grain foods may reduce the risk of chronic diseases. The aim of this work was to quantify the intake of whole grains and identify main dietary sources in the Italian population.

Methods

Whole grain intakes were calculated in a sample of 2830 adults/older adults and of 440 children/adolescents from the last national survey INRAN-SCAI 2005–06. Food consumption was assessed from a 3-day food record. The whole grain content of foods was estimated mainly from quantitative ingredient declarations on labels.

Results

Mean whole grain intakes were 3.7 g/day in adults/older adults and 2.1 g/day in children/adolescents. Overall, 23 % of the sample reported consumption of whole grain foods during the survey, among which mean whole grain intakes ranged from 6.0 g/day in female children to 19.1 g/day in female older adults. The main sources of whole grains were breakfast cereals in children/adolescents (32 %) and bread in adults/older adults (46 %). Consumption of whole grain among adults was associated with significantly higher daily intakes and adequacy of dietary fibre, several vitamins (thiamine, riboflavin, vitamin B₆) and minerals (iron, calcium, potassium, phosphorus, zinc, magnesium) compared to non-consumption. Among children, whole grain intake was associated with significantly higher intakes of iron and magnesium.

Conclusions

The study reveals very low whole grain intakes across all age groups of the Italian population. Considering the positive association in consumers between whole grain intakes and fibre and micro-nutrient intakes, public health strategies to increase whole grain consumption should be considered.

     

Diet, nutritional status, and cancer risk in American blacks

About 35% (10-70%) of all cancers may be associated with nutritional causes (1). However, while natural or added substances in foods may be carcinogenic, nutritional deficiencies or excesses may promote carcinogenesis. We compared data from blacks and whites using dietary and nutritional status surveys in the United States to determine whether the poorer dietary patterns and nutritional status of American blacks may be associated with their higher incidence and mortality from certain cancers (compared with whites). Our review indicates that blacks eat more nitrate and animal foods and not enough fiber in relation to protein, fat, and carbohydrate. Blacks also have poorer nutritional status with respect to getting enough thiamine, riboflavin, vitamins A and C, and iron, to being obese (females), and to being underweight (males). This is in agreement with hypotheses regarding the interactions between diet and cancer (associations found in whites) and dose-response relationships reported for some cancers for which blacks have a higher incidence and mortality than whites. More large-scale prospective case-control and cohort studies are needed in both blacks and whites to elucidate the contribution of specific dietary and nutritional factors to the risk of specific cancers in these population groups. However, such studies must be preceded by methodological research to obtain more valid measures of dietary and nutritional status.