Low economic status is associated with suboptimal intakes of nutritious foods by adults in the National Health and Nutrition Examination Survey 1999-2002

Abstract

Chronic diseases are the leading cause of death among older Americans. Many of the chronic health conditions that result in the loss of independence, disability, and reduced quality of life in older adults are preventable through healthful lifestyle including proper nutrition. Household income is a major economic factor that impacts food choices and nutritional status of individuals. The study examines the socioeconomic characteristics of adults, 60 years and older, and assesses the correlations between household income and food choices and nutritional status of adults. Adults (n = 2675) in the National Health and Nutrition Examination Survey, 1999 to 2002, were grouped into 1 of the 3 household income categories: low income ( 350% of poverty). Their sociodemographic characteristics and unadjusted mean nutrient and MyPyramid food group intakes were estimated. Multiple regression models were used to control for age and sex variability in mean estimations. Pairwise (t tests) mean comparisons were made among the income groups, at a priori α = .05 level of significance. Survey design effects were used in the analyses. There were 24.9%, 43.0%, and 32.1% adults in low-, medium-, and high-income groups, respectively. Only 77% of low-income adults were fully food-secure. Compared with medium- and high-income groups, the low-income group had a higher proportion of women (66.9%), Hispanics (20.1%) or non-Hispanic blacks (11.4%), adults having less than high-school-level education (34.2%), and adults who were widowed (40.6%) or divorced (12.1%). After controlling for age and sex, low-income adults consumed 526 kJ less than medium-income adults and 1050 kJ less than high-income adults. Lower proportion of low-income adults ate at or above the Adequate Intake or Estimated Average Intake levels for many micronutrients. They ate less fruit, vegetables, milk, meat, poultry, and fish than high-income adults. Older minority women living in low-income households are in urgent need for food assistance and nutrition intervention programs.