Associations between transition to retirement and changes in dietary intakes in French adults (NutriNet-Santé cohort study)

Dietary concepts in the dyad: Results from a qualitative study of middle-aged and older couples

BACKGROUND

The positive effects of a healthy diet on older adults' health status are well established. Yet, inadequate health outcomes prevail. Insufficient healthy dietary styles may be related to the complexity of lay concepts regarding what constitutes a healthy diet. It is hence of importance to disentangle and understand such concepts in depth. The aim of this qualitative study was to explore diet-related intra-couple dynamics and to reconstruct dietary concepts and associated influencing factors among older couples METHODS: The qualitative sample consisted of 15 German couples with at least one partner aged between 50 and 70 years. Study participants were recruited using theoretical sampling. Dyadic guideline-based interviews were conducted from 2016 to 2017. The transcripts were analyzed by means of the Grounded Theory Method RESULTS: Diverse Dyadic dietary concepts emerged from the data material and were shown to be dynamically influenced - among others - within the context of the couple relationship. Three major components showed to be integral to Dyadic dietary concepts: Ideas of healthy diet, Taste and Body images. Moreover, in all of the couples interviewed, one of the partners developed the role of a "Health Expert", who was consensually considered to have more solid health expertise. Different expressions of the HE with corresponding couple dynamics were identified DISCUSSION: This study demonstrates the relevance of diet-related intra-couple dynamics in shaping Dyadic dietary concepts. Particularly, the role of the "Health Expert" within couples showed to decisively influence such concepts. Future research is needed to gain a greater in-depth knowledge on the related influencing factors and couple dynamics. Public health (nutrition) strategies targeting older couples should address such intra-couple dynamics such as the role the partners play for shaping Dyadic dietary concepts.

Changes in Secondary Healthcare Use Over Retirement Transition: Examining Social Differences With Swedish Register Data

BACKGROUND

Despite its relevance for healthcare expenditures and public health, few studies have examined how secondary healthcare use changes during the retirement transition. We therefore use Swedish register data to examine whether retirement is associated with intensified secondary healthcare use overall and for specific subgroups based on gender and education.

METHODS

The sample was all individuals registered in Sweden who retired from paid work in 2010. We used Generalised Estimating Equations models to analyse changes in two indicators of secondary healthcare use, namely specialist visits and hospitalisation, from 3 years prior to 5 years after retirement.

RESULTS

Retirement is not associated with changes in specialist visits or hospitalisation per se. Three years before retirement, women were more likely to visit a specialist but less likely to be hospitalised than men; these gender differences disappeared approximately 1 year before retirement. Women with high education were more likely to visit a specialist than women with low education across the entire retirement transition, particularly post-retirement. Significant differences with regard to specialist visits between male educational groups only emerged 12 months after retirement. There were no educational differences with regard to hospitalisation.

CONCLUSIONS

We conclude that secondary healthcare use in Sweden does not generally change with retirement. However, over the course of retirement gender differences in secondary healthcare use tend to decrease and within-gender educational differences tend to increase. We interpret the results as reflecting the role of labour market institutions in contributing to gender differences but repressing educational differences in secondary healthcare use.

The Associations between Dietary Supplement Use, Diet Quality, and Health-Related Quality of Life among Older Female Cancer Survivors

Evidence-based guidelines for cancer survivorship do not recommend dietary supplementation, yet older cancer survivors report high prevalence of dietary supplement use, specifically multivitamin (MVM), calcium, and vitamin D. Female cancer survivors (≥65 years) who were ≤5 years post-cancer diagnosis completed questionnaires assessing health-related quality of life (HRQoL), diet quality, and supplement intake. Intakes of MVM, calcium, and vitamin D supplementation were 61.4%, 76.9%, and 35.3%, respectively. Women who used MVM supplements had significantly higher dietary quality mean scores for total vegetables (4.5 ± 0.9 to 4.1 ± 1.1), greens and beans (4.1 ± 1.3 to 3.6 ± 1.6), whole fruit (4.7 ± 0.8 to 4.3 ± 1.3), and whole grains (2.9 ± 1.8 to 2.3 ± 1.6) than those who did not use these supplements. After controlling for demographic and clinical variables, the odds of MVM use was 1.07 times greater among those women who had higher total HEI scores. Participants with lower HRQoL were 4% more likely to take an MVM. Understanding the prevalence of supplementation, associations with diet quality, and perceived benefits of supplementation may help healthcare providers in educating survivors and promoting adherence to the evidence-based guidelines.

Retirement is associated with a decrease in dietary quality

BACKGROUND AND AIM

Retirement has been associated with changes in dietary intake. We evaluated dietary intake and compliance to dietary guidelines after retirement in a population-based survey.

METHODS

Data from a prospective study conducted in Lausanne, Switzerland. Dietary intake was assessed using a validated food frequency questionnaire in 2009-2012 (first survey) and 2014-2017 (second survey). Total energy intake (TEI), macro and micronutrients, foods, dietary scores and compliance to dietary guidelines were assessed. Three approaches were used comparing changes in dietary intake: 1) before and after retiring (paired analysis); 2) in participants who retired with gender- and age-matched participants who did not retire (two-group comparison), and 3) in participants who retired, who did not retire or who were retired at both surveys (analysis of variance).

RESULTS

Using the first approach, newly retired participants (n = 215) increased their intake of total (median and [interquartile range]: 15.2 [13.7-17.5] vs. 14.9 [13.3-17.1] % of TEI) and animal (11.1 [9.1-13.0] vs. 10.0 [8.5-12.6] %TEI) protein; total (35.8 [32.1-40.7] vs. 34.6 [30.0-39.1] %TEI), saturated and monounsaturated fat; alcohol; cholesterol; vitamin D and fish, and decreased their intake of vegetable protein; total carbohydrates and monosaccharides, and of the Mediterranean diet score. Those findings were confirmed for total and saturated fat, alcohol, total carbohydrates and monosaccharides; vitamin D and fish intake, and of the Mediterranean diet score in the other two approaches.

CONCLUSION

Retirement was associated with an unhealthier dietary intake.

The Impact of Retirement on Cardiovascular Disease and Its Risk Factors: A Systematic Review of Longitudinal Studies

Background and Objectives

People are now spending longer in retirement than ever before and retirement has been found to influence health. This study systematically reviewed the impact of retirement on cardiovascular disease (CVD) and its risk factors (metabolic risk factors, blood biomarkers, physical activity, smoking, drinking, and diet).

Research Design and Methods

Longitudinal studies published in Medline, Embase, Social Science Citation Index, PsycINFO, and Social Policy and Practice were searched. No language restrictions were applied if there was an English abstract. Eighty-two longitudinal studies were included after critical appraisals.

Results

Studies in the United States often found no significant effect of retirement on CVD, while studies in European countries, except France, showed a detrimental effect of retirement on CVD. Results from the United States and several European countries consistently show that retirement increase adiposity measures among those retired from physically demanding jobs. For diabetes and hypertension, five out of nine studies suggest no effect of retirement. Retirement has been repeatedly linked to increasing leisure-time physical activity but may reduce work- and transport-related physical activity in turn. Most studies showed that retirement either decreased smoking or had no effect on smoking. The evidence did not show a clear conclusion on drinking. Only a few studies have assessed the impact on diet and blood biomarkers.

Discussion and Implications

Effect of retirement varies according to the health outcomes studied and country of the study population. Policy concerning extending the retirement age needs to focus on ensuring they are suited to the individual.

Changes in fruit, vegetable and fish consumption after statutory retirement: a prospective cohort study

Retirement is a major life transition affecting health and health behaviour, but evidence on how this transition contributes to changes in healthy food habits is scarce. We examined whether the consumption of fruit and vegetables as well as fish changes after transition into statutory retirement. The data were derived from the prospective Helsinki Health Study. At phase 1 in 2000-2002, all participants were 40- to 60-year-old employees of the City of Helsinki, Finland (n 8960, response rate 67 %). Follow-up surveys were conducted in 2007, 2012 and 2017 (response rates 79-83 %). Using the four phases, we formed three nested cohorts in which the participants either continued working or moved to statutory retirement. The final analytical sample consisted of 6887 participants (14 357 observations). Frequency of fruit, vegetable and fish consumption was calculated from a twenty-two-item FFQ. Analyses of repeated measures of food consumption before and after retirement transition were conducted with a negative binomial mixed model, adjusting for age, marital status, limiting long-standing illness and household income. During the follow-up, altogether 3526 participants retired. Transition to retirement was associated with a decrease in vegetable consumption among women and, contrarily, with an increase in fruit consumption among men (P < 0·05 for interaction between time and employment status). Fish consumption did not differ by the change in employment status. Statutory retirement can have mixed effects on healthy food habits, and these can differ between food groups and sex. Healthy food habits should be promoted among employees transitioning to retirement.

Potential for, and readiness to, dietary-style changes during the retirement status passage: a systematic mixed-studies review

Context

Unfavorable diets contribute to the global burden of disease and particularly affect individuals’ health in old age. To promote healthy aging, it is vital to understand the biographical circumstances under which diets manifest and change.

Objective

This systematic mixed-studies review explored changes in dietary styles of people facing retirement.

Data Sources

Seven electronic databases were searched systematically, along with reference lists.

Data Extraction

Five qualitative and five quantitative studies were identified out of n = 974 records screened. Relevant study characteristics were extracted with a piloted form.

Data Synthesis

A qualitative convergent synthesis design was conducted.

Results

Study results were inconsistent. The majority of studies identified various dietary-style changes after retirement – some in favorable ways (eg, increased vegetable consumption [n = 4]) and some in rather unfavorable ways (eg, increased snacking [n = 2]). Influencing factors were changes in mealtime structures, available time, and financial situations accompanying retirement.

Conclusion

More high-quality, longitudinal research is needed to build a sound basis for interventions by utilizing the retirement transition as a window of opportunity for dietary changes.

Systematic Review Registration

PROSPERO registration no. CRD42018074049.