Correlates of low dietary energy reporting in free-living elderly: The MEDIS study

Adherence to Mediterranean Diet and Frailty

OBJECTIVE

Το investigate associations between adherence to the Mediterranean diet and frailty in a Greek population of older adults.

DESIGN

Cross-sectional study.

SETTING

Data were drawn from the Hellenic longitudinal Investigation of Aging and Diet (HELIAD), a population-based, multidisciplinary study designed to estimate the prevalence and incidence of dementia in the Greek population.

PARTICIPANTS

Data from 1740 participants aged ≥65 years were included in the present analysis. Participants were selected through random sampling from the records of 2 Greek municipalities.

MEASUREMENTS

Adherence to Mediterranean diet was evaluated through the MedDietScore, calculated from the information participants provided to a validated food frequency questionnaire. Frailty was assessed using 3 different definitions (the phenotypic approach proposed by Fried et al, the Frailty Index, and the Tilburg Frailty Indicator). Unadjusted and adjusted logistic and linear regression models were performed.

RESULTS

Of our participants, 70 (4%), 325 (18.7%), and 442 (25.4%) were identified as frail according to the Fried et al definition, the Frailty Index, and the Tilburg Frailty Indicator, respectively. Adjusting for confounding factors, each additional unit in the MedDietScore was associated with a 5% (P = .09), 4% (P = .005), and 7% (P < .001) decrease in the odds for frailty according to the Fried definition, the Frailty Index, and the Tilburg Frailty Indicator, respectively.

CONCLUSIONS

According to study results, a higher adherence to the Mediterranean diet was associated with lower odds of frailty, irrespective of the definition used. This finding may be of relevance in the setting of population-based prevention efforts as well as in clinical practice.

Dietary Assesment of Free-Living Elderly Spanish People with Disabilities

Nutritional research in elderly disabled is difficult in noninstitutionalized people. The dietary intake of a noninstitutionalized disabled population of the eastern region of Spain was evaluated to detect possible nutritional deviations. A total of 329 participants aged 65 and over were recruited. Most participants were overweight. Carbohydrates did not reach 50% of total Kcal/day. Insufficient micronutrient intakes and high consumption of simple carbohydrates and saturated fats (SFA) were found. A decreasing trend of water intake (p < .05) as well as an increasing trend of alcohol consumption (p < .05) with increasing age was found. The area of residence had a relevant impact on nutritional, dietary, and anthropometric characteristics of our population.

Validation of a Web-based, self-administered, non-consecutive-day dietary record tool against urinary biomarkers

New technologies are promising for the use of short-term instruments for dietary data collection; however, innovative tools should be validated against objective biomarkers. The aim of the present study was to investigate the validity of a Web-based, self-administered dietary record (DR) tool using protein, K and Na intakes against 24 h urinary biomarkers (24 h U). Of the total participants, 199 adult volunteers (104 men and 95 women, mean age 50·5 (23–83 years)) of the NutriNet-Santé Study were included in the protocol. They completed three non-consecutive-day DR and two 24 h U on the first and third DR days. Relative differences between reported (DR) and measured (24 h U) intakes were calculated from the log ratio (DR/24 h U) for protein, K and Na intakes: − 14·4,+2·6 and − 2·1 % for men; and − 13·9, − 3·7 and − 8·3 % for women, respectively. The correlations between reported and true intakes were 0·61, 0·78 and 0·47 for men and 0·64, 0·42 and 0·37 for women for protein, K and Na, respectively. Attenuation factors, that represent attenuation of the true diet–disease relationship due to measurement error (a value closer to 1 indicating lower attenuation), ranged from 0·23 (Na, women) to 0·60 (K, men). We showed that the Web-based DR tool used in the NutriNet-Santé cohort study performs well in estimating protein and K intakes and fairly well in estimating Na intake. Furthermore, three non-consecutive-day DR appear to be valid for estimating usual intakes of protein and K, although caution is advised regarding the generalisability of these findings to other nutrients and general population.

Severity of depressive symptoms and accuracy of dietary reporting among obese women with major depressive disorder seeking weight loss treatment

An elevation in symptoms of depression has previously been associated with greater accuracy of reported dietary intake, however this association has not been investigated among individuals with a diagnosis of major depressive disorder. The purpose of this study was to investigate reporting accuracy of dietary intake among a group of women with major depressive disorder in order to determine if reporting accuracy is similarly associated with depressive symptoms among depressed women. Reporting accuracy of dietary intake was calculated based on three 24-hour phone-delivered dietary recalls from the baseline phase of a randomized trial of weight loss treatment for 161 obese women with major depressive disorder. Regression models indicated that higher severity of depressive symptoms was associated with greater reporting accuracy, even when controlling for other factors traditionally associated with reporting accuracy (coefficient  =  0.01 95% CI = 0.01 - 0.02). Seventeen percent of the sample was classified as low energy reporters. Reporting accuracy of dietary intake increases along with depressive symptoms, even among individuals with major depressive disorder. These results suggest that any study investigating associations between diet quality and depression should also include an index of reporting accuracy of dietary intake as accuracy varies with the severity of depressive symptoms.

Dietary assessment methods for older persons: what is the best approach?

PURPOSE OF REVIEW

Due to the present worldwide demographic change and the close relation between nutrition and health up to old age, accurate dietary assessment in older persons gains in interest and importance. The purpose of this article is to give an overview of dietary assessment methods for this growing population group, with emphasis on recent findings, and to highlight future research needs.

RECENT FINDINGS

Knowledge on dietary assessment in older and especially in very old persons is limited and specific aspects were selectively examined in recent times. For use in epidemiological studies, short food frequency questionnaires were developed and validated, which seem to be promising to reduce the burden for respondents and interviewers. In the clinical setting estimation of dietary intake by plate diagrams was shown to be valid, and in different populations anorexia emerged as an important prognostic parameter.

SUMMARY

The best approach for dietary assessment in older persons depends on the purpose of the assessment and the specific abilities and impairments of the sample or person under study. Research is needed to further develop existing methods in order to meet the needs of old and very old persons and to identify major modifiable prognostic nutritional characteristics.