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Shea MK, Korat AVA, Jacques PF, Sebastiani P, Cohen R, LaVertu AE, Booth SL. Leveraging Observational Cohorts to Study Diet and Nutrition in Older Adults: Opportunities and Obstacles. Adv Nutr 2022; 13:1652-1668. [PMID: 35362509 PMCID: PMC9526832 DOI: 10.1093/advances/nmac031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 01/14/2022] [Accepted: 03/25/2022] [Indexed: 01/28/2023] Open
Abstract
By 2060, the number of adults aged ≥65 y is expected to double, and the ≥85 y segment of the population is expected to triple in the United States. US federal nutrition guidance is based on the premise that healthy diets contribute to delaying the onset and progression of many age-related diseases and disability. Yet, little is known about the dietary intakes or nutritional needs across the older adulthood age span. This review aims to identify community-based cohorts that collected information on dietary intake of adults ≥65 y in the United States. Thirty-two cohorts met all inclusion criteria. We summarized information on the cohorts' design, demographics, and diet assessment. We also identified key gaps in the existing databases that, if filled, could enhance their utility to address certain research questions. This review serves as a valuable inventory of cohorts that can be leveraged to answer key questions about the diet and nutritional needs of the oldest old, who represent the fastest growing segment of the population in the United States.
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Affiliation(s)
| | | | - Paul F Jacques
- USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Paola Sebastiani
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - Rebecca Cohen
- USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Amy E LaVertu
- Hirsh Health Sciences Library, Tufts University, Boston, MA, USA
| | - Sarah L Booth
- USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
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Gu Q, Sable CM, Brooks-Wilson A, Murphy RA. Dietary patterns in the healthy oldest old in the healthy aging study and the Canadian longitudinal study of aging: a cohort study. BMC Geriatr 2020; 20:106. [PMID: 32178631 PMCID: PMC7077120 DOI: 10.1186/s12877-020-01507-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 03/06/2020] [Indexed: 11/14/2022] Open
Abstract
Background Very few people live to eighty-five years and older (the ‘oldest old’), and even fewer live to this age without developing chronic diseases. It is important to understand the relationship, if any, of modifiable factors such as diet on healthy aging. However, there are few studies of diet among healthy oldest old, especially in North American populations. We aimed to characterize dietary patterns among ‘super-seniors’ (SS) within the Canadian Healthy Aging Study. Methods 122 SS aged 85 years or older and free of cancer, cardiovascular or pulmonary disease, dementia and diabetes were recruited. Comparisons were made to 12,626 participants aged 65–86 in the Canadian Longitudinal Study of Aging who completed the same 36-item food frequency questionnaire that queried consumption over the prior 12 months of nutrients and foods thought to be important for aging. Dietary patterns were identified with principal component analysis. The odds of being a SS were determined for quartiles of each dietary pattern with logistic regression. Results Two dietary patterns were identified; a western diet characterized by french fries, red meat, processed meat and a nutrient-rich diet which included fruits, vegetables, whole grains, nuts and seeds among other healthy food choices. Higher scores for both dietary patterns were associated with increased odds of being a SS, however, only the western dietary pattern remained associated with adjustment for covariates (Quartile 4: OR = 3.21, 95% CI 1.91–5.51). Conclusions Our finding adds to the limited evidence on dietary intake among the healthiest oldest old but it is unclear whether assocations reflect generational differences between groups or possible contributions to longevity.
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Affiliation(s)
- Qianqian Gu
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Carly M Sable
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Angela Brooks-Wilson
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, BC, Canada.,Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Rachel A Murphy
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada. .,Cancer Control Research, BC Cancer, Vancouver, BC, Canada.
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Hausman DB, Fischer JG, Johnson MA. Nutrition in centenarians. Maturitas 2011; 68:203-9. [PMID: 21276673 DOI: 10.1016/j.maturitas.2011.01.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Accepted: 01/05/2011] [Indexed: 11/25/2022]
Abstract
The oldest old are among the fastest growing segment of the population and it is important to understand not only the influence of modifiable lifestyle factors such as diet and nutrition on the achievement of exceptional longevity but also the role, if any, of these factors on maintaining optimal cognitive, mental and physical health into advanced age. This review summarizes studies of dietary intake and patterns of long-lived peoples and presents current knowledge of nutritional status of centenarians as determined with nutritionally relevant biomarkers, providing information on comparative levels of the various biomarkers between centenarians and older adult controls and on the prevalence and predictors of nutritional deficiencies in centenarians. The studies indicate that BMI and nutritional status as indicated by circulating levels of antioxidant vitamins, vitamin B12, folate, homocysteine and 25(OH) vitamin D of centenarians are quite heterogeneous and influenced by region of residency and many of the demographic, dietary and lifestyle factors that influence nutritional status in other older adults. While many of the studies have been small, convenience samples of relatively healthy community-dwelling centenarians, a few have population-based or included participants of varying cognitive functioning. These and future studies examining associations between nutritional status and cognitive, mental and physical function should be instrumental in determining the role of nutrition in promoting longevity and improving the quality of life in these exceptional survivors.
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Affiliation(s)
- Dorothy B Hausman
- Department of Foods and Nutrition, University of Georgia, 280 Dawson Hall, Athens, GA, USA.
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Johnson MA, Davey A, Park S, Hausman DB, Poon LW. Age, race and season predict vitamin D status in African American and white octogenarians and centenarians. J Nutr Health Aging 2008; 12:690-5. [PMID: 19043643 PMCID: PMC2978665 DOI: 10.1007/bf03028616] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Poor vitamin D status has been associated with osteoporosis, falls, cardiovascular diseases, cancer, autoimmune diseases, pain, nursing home placement, and other age-related conditions, but little is known about the prevalence and predictors of vitamin D status in those aged 80 and older. Thus, this study tested the hypothesis that vitamin D status would be 1) poorer in a population-based multi-ethnic sample of centenarians as compared with octogenarians and 2) predicted by specific dietary, demographic or environmental factors. DESIGN Cross-sectional population-based analyses. SETTING Northern Georgia in the United States. PARTICIPANTS Men and women aged 80 to 89 (octogenarians, n=80) and 98 and older (centenarians, n=237). MEASUREMENTS Regression analyses were used to examine the associations of serum 25-hydroxyvitamin D [25(OH)D] with age, gender, race, living arrangements, dairy food intake, supplement intake, and season. RESULTS The prevalence of vitamin D insufficiency [25(OH)D<50 nmol/L] was higher in centenarians than in octogenarians (p<0.02). In logistic regression analyses, the risk of being vitamin D insufficient was significantly increased by being a centenarian vs. octogenarian (p<0.005) and by being African American vs. white (p<0.001) and decreased by taking a supplement with vitamin D (p<0.001) or by having vitamin D status measured in the summer or fall (each p<0.05), compared with spring. CONCLUSIONS Centenarians and octogenarians are at high risk for vitamin D insufficiency for many of the same reasons identified in younger populations. Given the numerous potential adverse consequences of poor vitamin D status, efforts are needed to ensure vitamin D adequacy in these older adults.
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Affiliation(s)
- M A Johnson
- The University of Georgia, Department of Foods and Nutrition, 280 Dawson Hall, Athens, GA 30602, USA.
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Johnson MA, Davey A, Hausman DB, Park S, Poon LW. Dietary differences between centenarians residing in communities and in skilled nursing facilities: the Georgia Centenarian Study. AGE (DORDRECHT, NETHERLANDS) 2006; 28:333-41. [PMID: 22253499 PMCID: PMC3259161 DOI: 10.1007/s11357-006-9021-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2006] [Revised: 10/02/2006] [Accepted: 10/03/2006] [Indexed: 05/31/2023]
Abstract
The purpose of this study was to examine the dietary habits among centenarians residing in community settings (n=105) and in skilled nursing facilities (n=139). The sample was a population-based multi-ethnic sample of adults aged 98 years and older (N=244) from northern Georgia in the US. Compared to centenarians in skilled nursing facilities, those residing in the community were more than twice as likely to be able to eat without help and to receive most of their nourishment from typical foods, but they had a lower frequency of intake of all of the food groups examined, including dairy, meat, poultry and fish, eggs, green vegetables, orange/yellow vegetables, citrus fruit or juice, non-citrus fruit or juice, and oral liquid supplements. A food summary score was created (the sum of the meeting recommendations for five food groups). In multiple regression analyses, the food summary scores were positively associated with residing in a nursing facility and negatively associated with eating without help and receiving most nourishment from typical foods. These data suggest that centenarians residing in communities may have limited access to foods that are known to provide nutrients essential to health and well-being. Also, centenarians who are able to eat without help and/or who eat mainly typical foods may have inadequate intakes of recommended food groups. Given the essential role of foods and nutrition to health and well-being throughout life, these findings require further exploration through the detailed dietary analyses of centenarians living in various settings.
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Affiliation(s)
- Mary Ann Johnson
- University of Georgia, 373 Dawson Hall, Athens, GA 30602-3622 USA
| | | | | | - Sohyun Park
- University of Georgia, 280 Dawson Hall, Athens, GA 30602 USA
| | - Leonard W. Poon
- Institute of Gerontology, University of Georgia, 109 Gerontology Bldg., 255 E. Hancock Ave, Athens, GA 30602 USA
| | - The Georgia Centenarian Study
- University of Georgia, 373 Dawson Hall, Athens, GA 30602-3622 USA
- Temple University, Philadelphia, PA USA
- University of Georgia, 280 Dawson Hall, Athens, GA 30602 USA
- Institute of Gerontology, University of Georgia, 109 Gerontology Bldg., 255 E. Hancock Ave, Athens, GA 30602 USA
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Abstract
The changing demographics of the world population necessitate a review of normative eating behavior in order to better differentiate eating pathologies from age-associated changes. This review examines the psychological, social, and physiological changes in aging as they affect eating behavior. Neurochemical and neurophysiological bases of appetite, psychobehavioral models of eating, and concomitant variables of depression, bereavement, and social interactions are examined. As many sensory systems decline with aging, these declines influence food choice and acceptability and may manifest conditions such as geriatric anorexia. Special circumstances of centenarians are discussed to provide further insights into pathological, normative, and superlative aging.
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Affiliation(s)
- Robert J F Elsner
- Department of Nutrition, Food Choice and Acceptability Unit, University College Cork, Cork, Ireland.
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Bernstein A, Nelson ME, Tucker KL, Layne J, Johnson E, Nuernberger A, Castaneda C, Judge JO, Buchner D, Singh MF. A home-based nutrition intervention to increase consumption of fruits, vegetables, and calcium-rich foods in community dwelling elders. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 2002; 102:1421-7. [PMID: 12396159 DOI: 10.1016/s0002-8223(02)90315-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To increase fruit, vegetable, and calcium-rich food consumption in community-dwelling, functionally impaired elderly. DESIGN Six-month, home-based nutrition intervention study. SUBJECTS Seventy men and women older than age 69 years were randomized to either a nutrition education intervention (n = 38) or a control group that received an exercise intervention (n = 32). INTERVENTION Nutrition education was designed to increase fruit, vegetable, and calcium-rich food consumption. MAIN OUTCOME MEASURES Food intake was assessed by a food frequency questionnaire. Fasting blood measures of nutrients and carotenoids were performed. Statistical Analysis Two-group randomized controlled trial with pre-test and post-test design and intention-to-treat analysis. Analysis of covariance to was used to assess differences between the two groups. Baseline and change partial correlation coefficients were performed between intake and blood nutrient levels. Paired t tests were conducted to test within-group changes. RESULTS Compared with the exercise group, subjects in nutrition group increased their self-reported intake of fruits by 1.1 +/- 0.2 (mean +/- SEM) servings per day (2.8 to 3.9, P = .01), vegetables 1.1 +/- 0.2 servings per day (2.3 to 3.4, P = .001), and milk/dairy 0.9 +/- 0.2 servings per day (3.0 to 3.9, P = .001). There was an increase in the dietary intake of alpha-carotene and beta-carotene in the nutrition group and this correlated with the increase in blood concentrations of alpha-carotene and beta-carotene (P < or = .02; r = 0.33 and r = 0.33, respectively). CONCLUSION The results of this study suggest that it is possible to improve the dietary intake of community dwelling elders to include more fruits, vegetables, and calcium-rich foods. Recommendations for increasing consumption of fruits, vegetables, and calcium-rich foods should be specific and individualized to meet the dietary pattern and lifestyle of the individual. Compliance should be encouraged with record keeping as well as through continuous monitoring and positive reinforcement.
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Affiliation(s)
- A Bernstein
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA
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Wu VT, Brochetti D, Duncan SE. Sensory characteristics and acceptability of lactose-reduced baked custards made with an egg substitute. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 1998; 98:1467-9. [PMID: 9850121 DOI: 10.1016/s0002-8223(98)00334-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- V T Wu
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg 24061-0430, USA
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Abstract
OBJECTIVES The purpose of this study was to identify individual characteristics associated with types and frequency of milk consumption in older American adults. METHODS A national probability-based sample (response rate = 91%) completed a telephone survey. Generalized logit and cumulative logit analyses were used to identify predictors of and barriers to fluid milk consumption in 494 elderly people. RESULTS The likelihood of drinking skim or 1% milk rather than whole milk increased with nutrition knowledge, income, trying to reduce cholesterol intake, and being female (P < .05). Frequency of milk consumption was higher with nutrition knowledge, frequency of milk consumption during adolescence, and following a diabetic diet but was lower with milk intolerance. CONCLUSIONS The present results could be used to develop intervention strategies for improving milk consumption rates among older adults. These strategies might focus on increasing elderly people's awareness of milk intolerance and lactose-reduced milk products and their concern about cholesterol. The relationship between current and adolescent milk consumption suggests that intervention strategies should begin early in life.
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Affiliation(s)
- S M Elbon
- Department of Foods and Nutrition, University of Georgia, Athens 30602, USA
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Elbon SM, Johnson MA, Fischer JG. Developing an instrument to measure the influence of knowledge, behaviors, and attitudes on milk consumption patterns in older participants of a community wellness group: a pilot study. JOURNAL OF NUTRITION FOR THE ELDERLY 1996; 15:21-37. [PMID: 8949017 DOI: 10.1300/j052v15n04_03] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
An instrument was developed to assess the relationship between knowledge of dairy products and milk consumption in participants of a community wellness program (age = 50 to 89; n = 103). Multiple regression analyses indicated that consumption of lower fat milk was predicted by nutrition knowledge and trying to reduce fat intake (R2 = .19, p < or = .0001), whereas, frequency of milk intake was predicted by milk consumption during youth, following a weight loss diet, and attitudes related to spoilage, packaging and expense (R2 = .24, p < or = .0001). Thus, nutrition knowledge about dairy products is a better predictor of the type of milk consumed rather than the frequency of milk consumption.
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