Dietary Energy Density, Not Caloric Intake, Is Associated with Sedentary Behavior in Older US Adults

Abstract

Abstract Objectives National surveillance data has demonstrated that fewer than 1 in 5 older adults meet physical activity (PA) guidelines, despite research showing that PA is associated with decreased functional limitations in older adults. Most strategies for healthy eating focus on caloric intake as opposed to overall diet quality. Energy density (ED; kcal/g) is an established indicator of diet quality as well as an established risk factor for chronic disease. Studies in children and adolescents have also demonstrated that dietary ED is associated with physical functioning, however there has been minimal research in older adults. The objective of the present study was to evaluate the association between dietary energy density and physical activity in a nationally representative sample of older adults. Methods Using data from a sample of 4484 adults > 60y who participated in the 2014–2016 NHANES, the association between dietary ED and physical functioning was assessed. During the NHANES, participants were asked to report whether or not they engaged in moderate PA (mPA) and report hours of sedentary behaviors. All data were analyzed using SAS 9.4 survey procedures to account for the unequal sampling probability and complex survey design of the NHANES. Results Energy-dense diets were associated with sedentary behavior and lower physical abilities in older adults. Individuals who reported engaging in mPA had a significantly lower dietary ED than those who did not engage in any mPA; this was observed in men (1.71 vs. 1.87, P = 0.03) and women (1.61 vs. 1.72, P = 0.02) after controlling for age, education, race/ethnicity, and beverage ED. Further, each unit increase in dietary energy density was associated with a 39% decrease in probability of engaging in mPA (P < 0.001). In contrast, there was no association between caloric intake and sedentary behavior in this population Low-ED diets were also lower in saturated fat; higher in vegetable, fiber and micronutrient content, offering additional health benefits. Conclusions These results indicate the energy density of the diet is associated with diet quality and active lifestyle behaviors. Strategies that promote low-ED diets may be effective tools in the promotion of healthy aging in the US population. Funding Sources None.