Abstract

With this analysis, we aimed to examine the associations between social factors and dietary risk behavior in older adults. Data were collected through a full-population postal survey of German adults aged 65 years or older (n = 1687, 33% response proportion, 52% female, mean age = 76 years). Using principal component analysis (PCA), a data-driven Dietary Risk Behavior Index (DRB) was computed. Dietary risk behavior was defined as consumption frequencies of vegetables/fruit, whole grains, and dairy products below national dietary recommendations. By performing a multiple linear regression, we analyzed associations between sociodemographic, socioeconomic, psychosocial, and behavioral factors and dietary risk behavior. Physical activity, female gender, socioeconomic status, social support, and age (in the male sample) were negatively associated with dietary risk behavior. Alcohol consumption and smoking were positively associated with dietary risk behavior. A group-specific analysis revealed a higher goodness-of-fit for the low socioeconomic status group, older adults aged 65–79 years, and women. A comprehensive understanding of the relationships between social factors and dietary risk behavior in older adults assists the group-specific targeting of dietary-related interventions. Demand-oriented dietary interventions should account for underlying social conditions to reduce inequity in dietary risk behavior among older adults. The results of this work may be transferable to municipalities in high-income European countries.

Highlights

  • Dietary behavior has an important impact on the burden of non-communicable diseases (NCDs) [1–4]

  • Partnership status, and smoking status variables can be interpreted as a percentage of the distribution

  • Our analysis provides a comprehensive understanding of the relationships between social factors and dietary risk behavior, which can be useful for developing diet-related interventions in specific groups

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Summary

Introduction

Dietary behavior has an important impact on the burden of non-communicable diseases (NCDs) [1–4]. In 2017, NCDs such as cardiovascular diseases, cancers, and diabetes accounted for 11 million diet-related deaths [5]. 255 million attributable disability-adjusted life years (DALYs) [6] could be traced back to dietary risk factors. DALY is a widely accepted measure combining the time lived with disability and/or illness with time lost due to premature death [7]. In the Global Burden of Disease Study (GBD) 2017 [7], dietary risks were the dominant level 2 risk factor for deaths and the second-most common level 2 risk factor for DALYs. Level 2 of the GBD includes more specific categories for deaths and DALYs such as NCDs

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