Subjective Well-Being Is Associated with Food Behavior and Demographic Factors in Chronically Ill Older Japanese People Living Alone

Aging-related changes in protein and fat intake and their related meal types factors by longitudinal birth cohort analysis using the National Health and Nutrition Survey in Japan from 2001 to 2019

BACKGROUND

To provide seamless nutritional support from early adulthood to late adulthood in Japan, this study aimed to identify aging-related changes in protein and fat intake and meal types.

METHODS

Birth cohort analysis was conducted in this study. The protein intake, protein-to-energy ratio, fat intake, and fat-to-energy ratio in men and women from their 20s to 60s in 2001 was calculated using the data of the National Health and Nutrition Survey in Japan between 2001 and 2019 (n = 139,876, 47.0% men, mean age: 54.9 and 55.4 years for men and women, respectively). The intakes were calculated for every subsequent year, the aging-related changes were identified by age group, and the 99 food groups were classified into staple-focused meal types through factor analysis. The weighted average component value per 1 g of each food group was calculated, multiplied by the food weight, and totaled to determine the mean intake by meal type and to confirm the aging-related changes. The year when the slope changed before and after was identified through Joinpoint regression analysis.

RESULTS

The protein intake, protein-to-energy ratio, fat intake, and fat-to-energy ratio initially declined or remained unchanged with aging in almost all generations (20s to 60s in 2001) but began to increase after 8-15 years. The food groups were classified into rice, noodle, and bread types. The protein and fat intake from the noodle type initially showed a decreasing trend but began to increase with aging after 8-15 years in almost all generations in both sexes (p < 0.05 for difference in slope).

CONCLUSIONS

The increase of protein intake and protein-to-energy ratio and fat intake and fat-to-energy ratio over time observed among Japanese adults may be related to the increased intake of food groups from noodle type meals. Thus, considering the type of staple food (i.e., rice, noodles, or bread) and its combination with other foods when adhering to a balanced diet is necessary.

The joy of eating: how eating experiences enhance the well-being of older adults

Introduction

The active aging strategy has as its policy implications the health, security, and participation of older people. The joy of eating is the main goal of establishing community-based service facilities for older people, as well as a source of health and well-being and a sense of meaning in the lives of older people.

Methods

Based on the theory of human-environment relations and cognitive-emotional personality systems (CAPS), the study constructed a structural equation model of the eating experience, nostalgia, place attachment, and the well-being of the older adults in the community canteens as an interactive situation, and explored the relationship between the eating experience and the well-being of older people in the community canteens through the partial least squares structural equation modeling (PLS-SEM).

Results

The results of the study show that the older adults' eating experience has a significant positive effect on their well-being, and "eating" can make older adults feel happy. Older adults' eating experience has a significant effect on nostalgia, place attachment, and well-being, but nostalgia does not have a significant effect on older adults' well-being, and place attachment in the community canteens can enhance older adults' well-being. Meanwhile, the study further confirmed that place attachment plays a mediating role in the effect of eating experience on older adults' well-being.

Discussion

The findings of the study promote the development of the fields of healthy eating, quality of life assessment, and dietary memory management for older people to a certain extent and provide an important reference for promoting the balanced layout and effective spatial design of community service facilities for older people.

Adhere to the Chinese dietary guidelines associated with better subjective well-being: evidence from a cross-sectional survey and a daily diary investigation

BACKGROUND

Subjective well-being (SWB) plays an essential role in general health. Although beneficial effects of selected micronutrients and foods on SWB have been reported, they do not reflect the impact of the habitual diet on SWB. Therefore, the purpose of this study is to investigate the association between adherence to the Chinese Dietary Guidelines (CDG) with SWB.

METHODS

This study combined a cross-sectional survey and a daily diary investigation. The cross-sectional survey was conducted on 1,433 students from 8 universities in southern China between October and November 2020. The daily diary investigation was conducted in November 2022, collecting 10-day daily data from 115 students at two universities in southern China over ten consecutive days, resulting in 1,020 valid matched daily responses. Adherence to the CDG was assessed by the China Prime Diet Quality Score (CPDQS), SWB was measured by the Index of Well-being (IWB) and the Affect Valuation Index (AVI). Correlation analysis, multiple regression analyses, and hierarchical regression were conducted to examine the associations of adherence to the CDG with its components, and SWB.

RESULTS

The cross-sectional survey revealed significant predictors of SWB, including adherence to the CDG (β = 0.24, p<0.001) and its components: cereals and tubers (β = 0.07, p = 0.024), vegetables and fruits (β = 0.11, p<0.001), dairy/soy/nuts (β = 0.11, p = 0.002), and condiments and alcoholic beverages (β = 0.08, p = 0.002). The daily diary investigation showed positive associations between adherence to the CDG (β = 0.19, p<0.001), and its components: vegetables and fruits (β = 0.11, p = 0.001), dairy/soy/nuts (β = 0.06, p = 0.009), animal source food (β = 0.06, p = 0.026), and condiments and alcoholic beverages (β = 0.07, p = 0.026), with higher levels of daily SWB.

CONCLUSIONS

Adherence to healthy dietary patterns such as the CDG, rather than focusing on individual components in isolation, is associated with better SWB. Furthermore, the consumption of CDG components had an impact on SWB, although the specific effects varied between the two studies. This study offers modest evidence supporting the role of the CDG in promoting positive mental health.

Relationship between occlusal force and psychological frailty in Japanese community-dwelling older adults: The Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians study

BACKGROUND

Frailty increases the risk of negative health-related events, such as falls, disability, hospitalizations, and death. Although the association between oral health and physical frailty is well established, the relationship between oral health and psychological frailty has not yet been investigated. Therefore, we conducted a cross-sectional study to examine the association between maximal occlusal force and psychological frailty in Japanese community-dwelling older adults.

METHODS

Psychological frailty was defined as a World Health Organization-5 scale (WHO-5) score of <13, cognitive and functional status was defined as a Japanese version of the Montreal Cognitive Assessment (MoCA-J) score of <23, and psychological robustness was defined as a WHO-5 score of ≥13 and a MoCA-J score of ≥23. We used a cross-sectional study design to measure maximal occlusal force in 1810 participants, and examined the following factors relevant to psychological frailty: educational level, financial status, living situation, history of chronic diseases, handgrip strength, and instrumental activities of daily living. We used propensity score matching to match the psychological frailty and psychological robustness groups according to demographic and confounding factors. This process, resulted in 344 participants, of whom 172 were in the psychological frailty group and 172 were in the psychological robustness group. In the matched cohort, differences between groups with and without psychological frailty were compared using generalized estimating equations for maximal occlusal force after adjusting for the number of teeth.

RESULTS

After controlling for potential confounding factors of frailty, the psychological frailty group showed lower maximal occlusal force compared with the psychological robustness group (unstandardized regression coefficients = -72.7, 95% confidence interval: -126.3 to -19.1).

CONCLUSIONS

Maximal occlusal force was associated with a reduced prevalence of psychological frailty among Japanese community-dwelling older adults participating in our study.

Determinants of Changes in the Diet Quality of Japanese Adults during the Coronavirus Disease 2019 Pandemic

This study evaluated changes in diet quality during the coronavirus disease 2019 (COVID-19) pandemic and its association with variations in attitudes or behavior, as well as health status changes. Participants were Japanese adults aged 20-69 years who resided in 13 prefectures where specific cautions were announced to prevent the spread of the virus. An online survey was conducted in September 2021, and participants were those who shopped for food or prepared meals more than twice a week during the survey. Overall, 2101 participants were analyzed. An improved or worsened diet quality was determined based on changes in food consumption patterns, and participants were categorized into three groups (improved diet quality (IDQ), worsened diet quality (WDQ), and others). The IDQ group participants (10.2%) improved their dietary consciousness during COVID-19, cooked almost everything from ingredients, and increased their balanced meal eating frequency. However, the WDQ participants (11.1%) had worsened dietary consciousness and increased consumption of takeaway meals and alcohol but decreased balanced meal consumption. Cooking frequency changes were not independent determinants of variations in diet quality. Our results show that the diet quality changes during COVID-19 were possibly caused by changes in dietary consciousness or different levels of meal preparation practices.

The relationship between individual and environmental factors related to health, nutritional status, and diet in elderly people living alone in Japan

Aging is an essential milestone that governments worldwide must plan for. At a global level, Japan currently has the highest share of population older than 65 years. Thus, the Japanese experience may be a useful guide to other countries as they consider their policies. Elderly individuals living alone encounter many challenges typically not faced by those living in a multiperson household. Nutrition status and diet are 2 such challenges, both of which are crucial determinants of health and well-being. The health and nutrition statuses as well as some other factors in elderly individuals living alone in Japan were investigated. The identification of the factors relating to food diversity, social relationships, and physical ability, among others, indicates, as hypothesized, that the relationship between individual and environmental factors is associated with the health, nutritional statuses, and diets of elderly people living alone. The findings and approach may be useful to scholars and policy makers in significantly aging societies like Japan as well as other societies experiencing population aging.

Association between meal frequency with others and psychological distress during the COVID-19 pandemic: A cross-sectional study

Aim

Previous studies evaluated the association between eating alone and mental health mainly in older people and adolescents. This study aimed to evaluate the association between dinner frequency with others and psychological distress during the COVID-19 outbreak among the Japanese working population.

Methods

Data were acquired from a prospective online cohort study (the Employee Cohort Study in the COVID-19 pandemic in Japan) conducted in February 2021 as a cross-sectional design. Dinner frequency with others was categorized into five groups: "almost daily," "4-5 times per week," "2-3 times per week," "once per week," and "less than once per week," setting them as a predictor variable. Modified Poisson regression was performed to calculate the prevalence ratio of psychological distress with multiple imputation for missing data. Global fear and worry about COVID-19 were adjusted as a covariate.

Results

A total of 1171 participants completed the questionnaire. Respondents who ate dinner with others "almost daily" had the least psychological distress than those who ate with others "4-5 times," "2-3 times," and "once per week" in the crude model (prevalence ratio (95% CI): 1 [reference], 1.34 [1.08-1.67], 1.40 [1.15-1.69], 1.44 [1.12-1.85], respectively). The association was comparable after adjusting for global fear and worry about COVID-19.

Conclusions

Among those who ate dinner with others at least once a week, those who ate with others "almost daily" had the least psychological distress. The association was comparable after adjusting for global fear and worry about COVID-19. Further study is needed on why those who eat with others less than once a week may have a lower prevalence ratio of having mental distress.

Psychosocial factors influencing the eating behaviours of older adults: A systematic review

Our understanding of how eating behaviours change in later life have been dominated by the studies of physiological and biological influences on malnutrition. Insights from these studies were consequently used to develop interventions, which are predominantly aimed at rectifying nutritional deficiencies, as opposed to interventions that may enable older adults to eat well and enjoy their food-related life well into older age. The objective of the present review is to summarise the existing knowledge base on psychosocial influences on eating behaviours in later life. Following comprehensive searches, review, and appraisal, 53 articles were included (22 qualitative and 31 quantitative) to provide a greater understanding of the mechanisms underpinning the psychosocial factors influencing eating behaviours. Our analysis identified eight underpinning psychosocial factors that influences eating behaviours in later life; (1) health awareness & attitudes, (2) food decision making, (3) perceived dietary control, (4) mental health & mood, (5) food emotions & enjoyment, (6) eating arrangements, (7) social facilitation, and (8) social support. The importance and lasting influence of early food experiences were also identified as contributing to eating behaviours in later life. The review concludes with the call for further investigation into specific psychosocial factors that influence eating behaviour, calls for improvements in methodologies, and a summary of psychosocial barriers and enablers to eating well in later life.

Difference and Variance in Nutrient Intake by Age for Older Adults Living Alone in Japan: Comparison of Dietary Reference Intakes for the Japanese Population

This study aimed to estimate the distribution of usual intakes in protein, sodium, potassium, and calcium by age group and assessed whether proportions of deficiencies/excesses of each nutrient would occur more in older age via a comparison with the dietary reference intakes for the Japanese population (DRIs_J). A cross-sectional analysis was conducted using a database of the 2-day nutrient intake of 361 Japanese people aged 65-90 years. The AGEVAR MODE was used to estimate usual intake. Percentile curves using estimated distribution by sex and age and usual nutrient intake were compared to those of the DRIs_J. The usual intake of protein (male and female) and potassium and calcium (female) were lower with older age. Within-individual variance of protein in female (p = 0.037) and calcium in male (p = 0.008) subjects were considerably lower with older age. The proportion of deficiencies in protein (male and female), potassium (female), and calcium (female) were higher with older age. However, the proportion of people with excess salt (converted from sodium; male and female) did not differ by age. The variances found herein could be important for enhancing the understanding of differences in dietary intake by age.

Eating Alone or Together among Community-Living Older People-A Scoping Review

Research on healthy aging commonly concerns problems related to loneliness and food intake. These are not independent aspects of health since eating, beyond its biological necessity, is a central part of social life. This scoping review aimed to map scientific articles on eating alone or together among community-living older people, and to identify relevant research gaps. Four databases were searched, 989 articles were identified and 98 fulfilled the inclusion criteria. In the first theme, eating alone or together are treated as central topics of interest, isolated from adjoining, broader concepts such as social participation. In the second, eating alone or together are one aspect of the findings, e.g., one of several risk factors for malnutrition. Findings confirm the significance of commensality in older peoples' life. We recommend future research designs allowing identification of causal relationships, using refined ways of measuring meals alone or together, and qualitative methods adding complexity.

A qualitative study on the reasons for solitary eating habits of older adults living with family

Eating alone while living with family members is a risk factor for mental health decline in old age. However, little is known as to why older adults choose to eat alone, even with family present. This study therefore aimed to explore reasons for older adults eating alone despite living with family members, using a qualitative approach. Fifteen people aged 65 years and older (11 men and 4 women) who were eating alone while living with family members were included in the study. These individuals were selected from the participants of the Kashiwa cohort study conducted in 2016. Individual interviews were conducted using an open-ended format. All interviews were recorded and transcribed. The data were further thematically analyzed using a qualitative software package, NVivo 11. We extracted six themes as reasons for eating alone and hypothesized interactions among these themes. The extracted themes were: “age-related changes,” “solo-friendly environment,” “family structure changes,” “time lag for eating,” “bad relationships with family members” and “routinization.” To assess interactions, the themes were categorized as “background factors,” “triggers,” and “stabilizers.” The aforementioned themes could lead to the development and sustained behavior of eating alone among older adults living with family members. As most themes describe conditions that are likely to remain static, it may not be realistic to encourage such individuals to begin eating with family members. The promotion of meals with neighbors or friends could be effective in alleviating the negative consequences of eating alone.