Nutrition initiatives in the context of population aging: where does the United States stand?

Assessment of dietary patterns, physical activity and obesity from a national survey: Rural-urban health disparities in older adults

BACKGROUND

Obesity is a critical public health issue, affecting over one-third of all Americans, and is an underlying cause of numerous health issues across the lifespan. For older adults, obesity is linked to premature declines in physical and mental health and cognitive functioning. The occurrence of obesity and related health behaviors and chronic diseases are higher in rural areas than in urban areas. Furthermore, rural areas of the United States have a higher proportion of older adults than urban areas. Few studies, to date, have explored rural-urban differences in the relationships between dietary patterns and obesity among older adults. Therefore, the purpose of this study is to assess rural-urban differences in obesity rates in older adults, and the potential for the associations between obesity and physical activity and dietary patterns to vary by rural-urban status.

METHODS

Data were abstracted from respondents aged 65 and above from the 2012 Behavioral Risk Factor Surveillance System (BRFSS) database linked to Census-based county-level information on rural-urban status and socioeconomic status. Generalized linear models were utilized to assess rural-urban disparities in obesity, and the potential for associations between obesity and known risk factors (fruit consumption, green vegetable consumption and physical activity) to vary by rural-urban status, accounting for complex sampling and confounders.

RESULTS

Obesity rates were highest and fruit consumption was lowest in the most rural areas. However, for older adults in the most urban areas, there was a significant negative association between obesity and fruit and green vegetable consumption. This association was not observed in more rural older adults.

CONCLUSION

These findings underscore the need to take into account place-based factors such as rural-urban status, when designing and implementing policies and interventions designed to reduce obesity through risk factor mitigation in older adults. To reduce rural-urban disparities in older adults, all policies, programs, and interventions should address the unique barriers and needs specific to rural and urban older adults.

Senior Centers and Nutritional Outcomes: A Texas Example

Healthy diet and weight control are important for elders and senior centers (SCs). The authors consider effects of SCs on attendee nutrition and health and efforts to improve diets and weight. Data derive from surveys in 2006 (N = 798) and 2007 (N = 742) at 21 multipurpose SCs in Tarrant County, Texas, supplemented with data from 2012 (N = 1,402). Measures included attendee agreement that SC meals improved nutrition, improved health, attempts to improve diets, and success in controlling weight. Cumulative and binary logistic regression methods were employed. SC attendance and social engagement explained agreement that SC meals improved nutrition and health but were not shown to predict changes in diet or weight control. Findings suggest success of SC programs, as well as physician recommendations, in influencing attendee nutritional behavior and perceptions of nutrition and health effects. Practice recommendations include SC collaborations with local health providers to promote attendee nutritional health.