Education and lifestyle predict change in dietary patterns and diet quality of adults 55\u2009years and over

Maree G Thorpe,David Crawford,Sarah A Mcnaughton,Catherine M Milte

doi:10.1186/s12937-019-0495-6

Abstract

BackgroundDiet is a key risk factor for chronic disease, and an increasing concern among older adults. We aim to examine the changes in dietary patterns using principal component analysis and a diet quality index among older adults and examine the predictors of dietary change over a 4 year period.MethodsData was obtained via a postal survey in a prospective cohort, the Wellbeing Eating and Exercise for a Long Life (WELL) study. Australian adults aged 55 years and over (n = 1005 men and n = 1106 women) completed a food frequency at three time points and provided self-reported personal characteristics. Principal component analysis was used to assess dietary patterns and diet quality was assessed using the 2013 Revised Dietary Guideline Index. The relationships between predictors and change in dietary patterns were assessed by multiple linear regression.ResultsTwo dietary patterns were consistently identified in men and women at three time points over 4 years. One was characterised by vegetables, fruit and white meat, and the other was characterised by red and processed meat and processed foods. Reduced consumption of key food groups within the principal component analysis-determined dietary patterns was observed. An increase in diet quality over 4 years was observed in men only. Reported higher education levels and favourable lifestyle characteristics, including not smoking and physical activity, at baseline predicted an increase in healthier dietary patterns over 4 years.ConclusionsThere was stability in the main dietary patterns identified over time, however participants reported an overall decrease in the frequency of consumption of key food groups. Compliance with the Australian Dietary Guidelines remained poor and therefore targeting this population in nutritional initiatives is important. Design of nutrition promotion for older adults need to consider those with lower socioeconomic status, as having a lower level of education was a predictor of poorer dietary patterns. It is important to consider how nutrition behaviours can be targeted alongside other lifestyle behaviours, such as smoking and inadequate physical activity to improve health.

Highlights

Diet is a key risk factor for chronic disease, and an increasing concern among older adults
Participants were excluded from the analysis if they did not provide their date of birth or sufficient dietary intake data resulting in the following sample sizes used to determine dietary patterns; 2010: n = 1888 men and 2071 women; 2012: n = 1269 men and 1428 women and 2014: n = 1183 men and 1309 women
Scores on these dietary patterns decreased over the 4 years in men and women, indicating that participants may have reported an overall decrease in the frequency of consumption of key food groups

Summary

Introduction

Diet is a key risk factor for chronic disease, and an increasing concern among older adults. Chronic disease is a major health concern among older adults [2] and of particular concern are those within the peri-retirement age group where these conditions begin to manifest. This is a period of major life transition, with experiences such as changed work-loads, marital transitions, and children leaving home occurring. Transitional life stages may impact health behaviours including diet [3,4,5], and may provide a window of opportunity to promote dietary change [6] Improving diet within this age group will help to reduce the burden of disease and improve quality of life in older adults [7]. Applying multiple methods within the same data set may increase our understanding of the use of these methods and the implication of using different methodologies [11]

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