Dietary Diversity and Healthy Aging: A Prospective Study

Association between 29 food groups of diet quality questionnaire and perceived stress in Chinese adults: a prospective study from China health and nutrition survey

PURPOSE

Diet plays a fundamental role in promoting resilience against stress-related disorders. We aimed to examine the overall and sex-specific association between food groups and perceived stress in adults.

METHODS

We analyzed the prospective data of 7,434 adults who completed both the 2011 and 2015 surveys of the China Health and Nutrition Survey (CHNS). The Diet Quality Questionnaire (DQQ) was used to code all the food items of 2011 dietary intake into 29 food groups, and perceived stress in 2015 was measured using a 14-item perceived stress scale (PSS-14). Univariate analysis and logistic regression models were used to examine the relationship between food groups and perceived stress.

RESULTS

People who perceived a higher level of stress (PSS-14 total score > 25) made up 41.5% and 45.1% of the male and female groups, respectively (χ2 = 9.605, p = 0.002). Individuals with increased intake of food groups such as legumes, other vegetables, other fruits, yogurt, poultry, fish & seafood, fluid milk, and fruit juice were less likely to experience a higher level of psychological stress (OR range: 0.544-0.892, p < 0.05). Additionally, we found sex-specific associations between food groups and perceived stress. The difference in the proportion of food groups, such as fluid milk and fish & seafood, between the two stress groups in men was statistically significant (p < 0.025). In the female group, the distribution of eight food groups, like legumes and nuts & seeds, between the two stress groups was statistically significant (p < 0.025).

CONCLUSION

This study indicated that food groups were differentially associated with perceived stress.

Dietary diversity score and the acceleration of biological aging: a population-based study of 88,039 participants

OBJECTIVES

Our study aimed to investigate the association of dietary diversity score (DDS), as reflected by five dietary categories, with biological age acceleration.

DESIGN

A cross-sectional study.

SETTING AND PARTICIPANTS

This study included 88,039 individuals from the UK Biobank.

METHODS

Biological age (BA) was assessed using Klemerae-Doubal (KDM) and PhenoAge methods. The difference between BA and chronological age represents the age acceleration (AgeAccel), termed as "KDMAccel" and "PhenoAgeAccel". AgeAccel > 0 indicates faster aging. Generalized linear regression models were performed to assess the associations of DDS with AgeAccel. Similar analyses were performed for the five dietary categories.

RESULTS

After adjusting for multiple variables, DDS was inversely associated with KDMAccel (βHigh vs Low= -0.403, 95%CI: -0.492 to -0.314, P < 0.001) and PhenoAgeAccel (βHigh vs Low= -0.545, 95%CI: -0.641 to -0.450, P < 0.001). Each 1-point increment in the DDS was associated with a 4.4% lower risk of KDMAccel and a 5.6% lower risk of PhenoAgeAccel. The restricted cubic spline plots demonstrated a non-linear dose-response association between DDS and the risk of AgeAccel. The consumption of grains (βKDMAccel = -0.252, βPhenoAgeAccel = -0.197), vegetables (βKDMAccel = -0.044, βPhenoAgeAccel = -0.077) and fruits (βKDMAccel = -0.179, βPhenoAgeAccel = -0.219) was inversely associated with the two AgeAccel, while meat and protein alternatives (βKDMAccel = 0.091, βPhenoAgeAccel = 0.054) had a positive association (All P < 0.001). Stratified analysis revealed stronger accelerated aging effects in males, smokers, and drinkers. A strengthening trend in the association between DDS and AgeAccel as TDI quartiles increased was noted.

CONCLUSIONS

This study suggested that food consumption plays a role in aging process, and adherence to a higher diversity dietary is associated with the slowing down of the aging process.

Developing a Personalized Meal Recommendation System for Chinese Older Adults: Observational Cohort Study

BACKGROUND

China's older population is facing serious health challenges, including malnutrition and multiple chronic conditions. There is a critical need for tailored food recommendation systems. Knowledge graph-based food recommendations offer considerable promise in delivering personalized nutritional support. However, the integration of disease-based nutritional principles and preference-related requirements needs to be optimized in current recommendation processes.

OBJECTIVE

This study aims to develop a knowledge graph-based personalized meal recommendation system for community-dwelling older adults and to conduct preliminary effectiveness testing.

METHODS

We developed ElCombo, a personalized meal recommendation system driven by user profiles and food knowledge graphs. User profiles were established from a survey of 96 community-dwelling older adults. Food knowledge graphs were supported by data from websites of Chinese cuisine recipes and eating history, consisting of 5 entity classes: dishes, ingredients, category of ingredients, nutrients, and diseases, along with their attributes and interrelations. A personalized meal recommendation algorithm was then developed to synthesize this information to generate packaged meals as outputs, considering disease-related nutritional constraints and personal dietary preferences. Furthermore, a validation study using a real-world data set collected from 96 community-dwelling older adults was conducted to assess ElCombo's effectiveness in modifying their dietary habits over a 1-month intervention, using simulated data for impact analysis.

RESULTS

Our recommendation system, ElCombo, was evaluated by comparing the dietary diversity and diet quality of its recommended meals with those of the autonomous choices of 96 eligible community-dwelling older adults. Participants were grouped based on whether they had a recorded eating history, with 34 (35%) having and 62 (65%) lacking such data. Simulation experiments based on retrospective data over a 30-day evaluation revealed that ElCombo's meal recommendations consistently had significantly higher diet quality and dietary diversity compared to the older adults' own selections (P<.001). In addition, case studies of 2 older adults, 1 with and 1 without prior eating records, showcased ElCombo's ability to fulfill complex nutritional requirements associated with multiple morbidities, personalized to each individual's health profile and dietary requirements.

CONCLUSIONS

ElCombo has shown enhanced potential for improving dietary quality and diversity among community-dwelling older adults in simulation tests. The evaluation metrics suggest that the food choices supported by the personalized meal recommendation system surpass autonomous selections. Future research will focus on validating and refining ElCombo's performance in real-world settings, emphasizing the robust management of complex health data. The system's scalability and adaptability pinpoint its potential for making a meaningful impact on the nutritional health of older adults.

Effectiveness of personalized meal recommendation in improving dietary behaviors of Chinese community-dwelling elders: study protocol for a cluster randomized controlled trial

BACKGROUND

Inappropriate eating behaviors, particularly a lack of food diversity and poor diet quality, have a significant impact on the prognosis of certain chronic conditions and exacerbate these conditions in the community-dwelling elderly population. Current dietary interventions for the elderly have not adequately considered the nutritional needs associated with multiple chronic conditions and personal dietary preferences of elderly individuals. A personalized recommendation system has been recognized as a promising approach to address this gap. However, its effectiveness as a component of an elderly-targeted dietary intervention in real-world settings remains unknown. Additionally, it is unclear whether this intervention approach will be user-friendly for the elderly. Therefore, this study aims to examine the effectiveness of a personalized meal recommendation system designed to improve dietary behavior in community-dwelling elders. The implementation process in terms of System usability and satisfaction will also be assessed.

METHODS

The trial has been designed as a 6-month, non-blinded, parallel two-arm trial. One hundred fifty community-dwelling elders who meet the eligibility criteria will be enrolled. Subjects will be allocated to either the intervention group, receiving personalized meal recommendations and access to corresponding food provided as one component of the intervention, as well as health education on elder nutrition topics, or the control group, which will receive nutritional health education lectures. Outcomes will be measured at three time points: baseline at 0 months, 3 months, and 6 months. The primary outcomes will include dietary diversity (DDS) and diet quality (CDGI-E) of enrolled community-dwelling elders, representing their dietary behavior improvement, along with dietary behavior adherence to recommended meals. Secondary outcomes will measure the perceived acceptability and usability of the personalized meal recommendation system for the intervention group. Exploratory outcomes will include changes in the nutritional status and anthropometric measurements of the community-dwelling elders.

DISCUSSION

This study aims to examine the effectiveness, acceptability, and usability of a personalized meal recommendation system as a data-driven dietary intervention to benefit community-dwelling elders. The successful implementation will inform the future development and integration of digital health strategies in daily nutrition support for the elderly.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2300074912. Registered on August 20, 2023, https://www.chictr.org.cn/showproj.html?proj=127583.

Correlation of lifestyle behaviors during pregnancy with postpartum depression status of puerpera in the rural areas of South China

Background

Postpartum depression (PPD) is among the most common postpartum complications. Its prevalence is associated with strong regional variability. Women in rural areas of China have a high risk of PPD. The aim of this study was to investigate the PPD status of women in rural South China and explore the effects of modifiable lifestyle behaviors during pregnancy on their PPD status, thereby providing a scientific basis for the prevention and intervention of PPD in rural China.

Methods

A cohort study was conducted on 261 women from four maternal health institutions situated in rural areas of Guangdong Province and the Guangxi Zhuang Autonomous Region from October 2021 to December 2022. The questionnaires were administered to these women to obtain data about sociodemographic characteristics, health literacy, physical activity during pregnancy, and sleep and dietary status during pregnancy, as well as depression status on the 42nd day after delivery. The lifestyle behaviors during pregnancy and the PPD status of the study population were analyzed. Multiple linear regression models were used to determine the correlation between lifestyle behaviors and PPD status. Path analysis was performed to explore the interaction between various lifestyle behaviors.

Results

A total of 14.6% of women had a PPD status. Women who continued to work during pregnancy had an Edinburgh Postpartum Depression Scale (EPDS) score of 1.386 points higher than that of women who did not (В = 1.386, β = 0.141, p = 0.029). For every 1-point increase in the infant feeding-related knowledge score and pregnancy diet diversity score, the EPDS score decreased by 0.188 and 0.484 points, respectively, and for every 1-point increase in the Pittsburgh sleep quality index score, the EPDS score increased by 0.288 points. Age was related to infant feeding-related knowledge (indirect path coefficient = 0.023). During pregnancy, sedentary time was correlated with sleep quality (indirect path coefficient = 0.031) and employment status (indirect path coefficient = 0.043).

Conclusion

Employment status, infant feeding-related knowledge, sleep quality, and diet diversity during pregnancy directly influenced the PPD status, while age and sedentary time during pregnancy indirectly influenced the PPD status. Promoting healthy lifestyle behaviors, including reducing sedentary time, improving sleep quality, and increasing dietary diversity, may be effective in reducing PPD occurrence.

Relationship between three dietary indices and health-related quality of life among rural elderly in China: a cross-sectional study

Purpose

This study aimed to explore the association between health-related quality of life (HRQOL) and diet quality using three evidence-based dietary indices among older people in rural China.

Methods

This cross-sectional study included 1,258 rural older people (mean age 72.32 years; 55.6% female). HRQOL was assessed using the European Five Dimension Health Scale (EQ-5D), and dietary intake was assessed using a Food Frequency Questionnaire. Three dietary scoring indices, including the Alternate Healthy Eating Index, Dietary Approaches to Stop Hypertension, and Dietary Diversity Score (DDS), were calculated to assess and analyze the relationship between these dietary indices and quality of life.

Results

The EQ-5D score was 0.95 ± 0.10, and the EQ-Visual Analog Scale (VAS) score was 76.76 ± 14.44. All three groups with higher dietary indices had higher quality of life scores. After controlling for covariates in multivariate adjusted binary logistic regression analyzes, participants in the top tertile of DDS had higher quality of life scores than those in the bottom tertile. DDS was consistently associated with EQ-5D (Model 2: OR = 1.567, p = 0.001; Model3: OR = 1.351, p = 0.044) and EQ-VAS (Model 2: OR = 1.830, p < 0.001; Model 3: OR = 1.383, p = 0.047), significantly different from the other groups.

Conclusion

Older people in rural China who adhere to various foods experience a better quality of healthy life.

Association between life's essential 8 and biological ageing among US adults

BACKGROUND

Biological ageing is tightly linked to cardiovascular disease (CVD). We aimed to investigate the relationship between Life's Essential 8 (LE8), a currently updated measure of cardiovascular health (CVH), and biological ageing.

METHODS

This cross-sectional study selected adults ≥ 20 years of age from the 2005-2010 National Health and Nutrition Examination Survey. LE8 scores (range 0-100) were obtained from measurements based on American Heart Association definitions, divided into health behavior and health factor scores. Biological ageing was assessed by different methods including phenotypic age, phenotypic age acceleration (PhenoAgeAccel), biological age and biological age acceleration (BioAgeAccel). Correlations were analyzed by weighted linear regression and restricted cubic spline models.

RESULTS

Of the 11,729 participants included, the mean age was 47.41 ± 0.36 years and 5983 (51.01%) were female. The mean phenotypic and biological ages were 42.96 ± 0.41 and 46.75 ± 0.39 years, respectively, and the mean LE8 score was 67.71 ± 0.35. After adjusting for potential confounders, higher LE8 scores were associated with lower phenotypic age, biological age, PhenoAgeAccel, and BioAgeAccel, with nonlinear dose-response relationships. Negative associations were also found between health behavior and health factor scores and biological ageing, and were stronger for health factors. In health factor-specific analyses, the β negativity was greater for blood glucose and blood pressure. The inverse correlations of LE8 scores with phenotypic age and biological age in the stratified analyses remained solid across strata.

CONCLUSIONS

LE8 and its subscale scores were strongly negatively related to biological ageing. Encouraging optimal CVH levels may be advantageous in preventing and slowing down ageing.

Nutrition and Healthy Ageing in Asia: A Systematic Review

BACKGROUND

Nutrition plays a key role in modulating the likelihood of healthy ageing. In the present study, we aimed to conduct a systematic review to assess the impact of nutrition on healthy ageing in Asia.

METHODS

The systematic review was registered in the International Prospective Register of Systematic Reviews database (CRD42023408936) and conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, Web of Science, and Embase databases were searched up to February 2023 without language restrictions. We included prospective cohort studies that evaluated the associations of intake of a single food or consumption of a single nutrient at midlife; adherence to various dietary patterns at midlife; and improved adherence to dietary patterns from mid- to late life with the likelihood of healthy ageing and its components.

RESULTS

Out of 16,373 records, we included 71 papers comprising 24 cohorts from Singapore, China, Japan, and Thailand. The healthy ageing components included cognitive function, physical function, and depression. The majority of studies supported the observation that the likelihood of healthy ageing and its components in late life was positively increased by a higher consumption of healthy foods, such as vegetables, fruits, fish, nuts, legumes, tea, milk, and dairy, at midlife, and also by greater adherence to dietary patterns with high diversity scores or high total antioxidant capacities. Furthermore, improved adherence to healthy dietary patterns from mid- to late life also increased the likelihood of healthy ageing in late life.

CONCLUSION

Consuming healthy foods and adhering to healthy dietary patterns at midlife can promote the likelihood of healthy ageing. Moreover, improving diet quality from mid- to late life can still be beneficial.

Anti-Inflammatory Effects of Nutritionally Relevant Concentrations of Oleuropein and Hydroxytyrosol on Peripheral Blood Mononuclear Cells: An Age-Related Analysis

Immunosenescence and inflammaging facilitate the insurgence of chronic diseases. The Mediterranean diet is a non-invasive intervention to improve the chronic low-grade inflammatory status associated with aging. Olive oil oleuropein (OLE) and hydroxytyrosol (HT) demonstrated a controversial modulatory action on inflammation in vitro when tested at concentrations exceeding those detectable in human plasma. We studied the potential anti-inflammatory effects of OLE and HT at nutritionally relevant concentrations on peripheral blood mononuclear cells (PBMCs) as regards cell viability, frequency of leukocyte subsets, and cytokine release, performing an age-focused analysis on two groups of subjects: Adult (age 18-64 years) and Senior (age ≥ 65 years). OLE and HT were used alone or as a pre-treatment before challenging PBMCs with lipopolysaccharide (LPS). Both polyphenols had no effect on cell viability irrespective of LPS, but 5 µM HT had an LPS-like effect on monocytes, reducing the intermediate subset in Adult subjects. OLE and HT had no effect on LPS-triggered release of TNF-α, IL-6 and IL-8, but 5 µM HT reduced IL-10 secretion by PBMCs from Adult vs. Senior group. In summary, nutritionally relevant concentrations of OLE and HT elicit no anti-inflammatory effect and influence the frequency of immune cell subsets with age-related different outcomes.

Dietary diversity and possible sarcopenia among older people in China: a nationwide population-based study

Background

Sarcopenia is a common geriatric disease. Many dietary factors may contribute to the development of sarcopenia. Few studies have been conducted on dietary diversity and sarcopenia in Chinese older adults. Among a nationwide sample, the objective of this study is to assess the association between the dietary diversity score (DDS) and the prevalence of possible sarcopenia. We considered the different patterns of dietary diversity in relation to possible sarcopenia.

Methods

We conducted this analysis utilizing the cross-sectional data from the 2012, 2014, and 2018 waves of the Chinese longitudinal healthy longevity survey (CLHLS). A standard developed by the Asian Working Group for Sarcopenia 2019 (AWGS2019) was used to assess the possibility of sarcopenia. On the basis of the DDS generated by previous studies, we have constructed four new indicators as follows: total diet, animal-based diet, plant-based diet, and plant-based diet without the consumption of legume products and nuts. We used the generalized estimation equation (GEE) model to evaluate the associations between the DDS of the total diet, animal-based diet, plant-based diet, and plant-based diet without the intake of legume products and nuts and possible sarcopenia. These associations were statistically adjusted for a variety of potential confounders. Sensitivity analysis was performed by excluding some participants who were long-term bedridden, had Alzheimer's disease, or were terminally ill.

Results

The analysis included 6,624 participants (mean age 83.4 years at baseline). In our study, we found that participants with a higher DDS of the total diet (OR = 0.62; 95% CI: 0.51-0.77), animal-based diet (OR = 0.62; 95% CI: 0.49-0.79), and plant-based diet (OR = 0.64;95% CI: 0.51-0.80) were at a lower risk of developing sarcopenia. In sensitivity analyses, the associations remained unchanged.

Conclusion

Taking a diversified diet, including animal foods, may reduce the risk of developing sarcopenia. According to the findings of this study, adopting a diversified diet might reduce the risk of sarcopenia for older adults.

Effects of dietary diversity on frailty in Chinese older adults: a 3-year cohort study

BACKGROUND

Frailty has emerged as a global health burden with increased population aging. A diverse diet is essential for an adequate and balanced supply of nutrients. However, limited evidence supports the relationship between dietary diversity and frailty. We therefore assessed the associations of dietary diversity with the risk of frailty.

METHODS

We used the Chinese Longitudinal Healthy Longevity Survey to analyze a prospective cohort of Chinese older adults. A total of 1948 non-frail older adults were included in the final sample. Participants were categorized into groups with high or low dietary diversity scores (DDSs) using a food frequency questionnaire. A Generalized Estimating Equation were used to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for determining frailty incidence.

RESULTS

Among 1,948 participants, 381 had frailty with the prevalence of 19.56% during the 3-year follow-up period. Compared with the low DDS group, the high DDS group exhibited a lower risk of frailty (RR, 0.72; 95% CI: 0.57-0.91). Compared with those with a consistently low DDS, the RR of participants with a consistently high DDS for frailty was 0.56 (95% CI: 0.42-0.74). Moreover, meat, beans, fish, nuts, fresh fruits, and fresh vegetables were inversely associated with frailty. In stratified analysis, a consistently high DDS, compared with a consistently low DDS, reduced the risk of frailty for people aged 65-79 years and those living in town and rural areas.

CONCLUSION

This study found a prospective association between dietary diversity and frailty among Chinese older adults. These findings stressed that it is important to improve dietary diversity for older adults to promote healthy ageing, particularly for young older adults and in town and rural areas.

Health-related quality of life and its association with socioeconomic status and diet diversity in Chinese older adults

Objectives

The study aimed at examining the combined association of socioeconomic status (SES) and diet diversity (DD) with health-related quality of life (HRQoL) and exploring whether DD played a mediating role in the relationship between varied SES and HRQoL among Chinese older persons.

Method

A multi-stage random sampling method was conducted in Shanxi Province of China, with 3,250 older adults participating in this cross-sectional survey. SES was divided into groups by quartiles and DD by means, and these variable groups were combined in pairs to generate a total of eight combinations. The PROCESS macro developed by Hayes was employed for the simple mediation analysis.

Results

Compared with the reference group (those with both high SES and high DD), older adults who were classified to have lower SES or DD had elevated odds of having worse HRQoL: low SES/ low DD (OR = 1.65, 95% CI 1.41-2.92); low SES/ high DD (OR = 1.45, 95% CI 1.17-1.80); middle low SES/ low DD (OR = 1.43, 95% CI 1.24-1.65); middle low SES/ high DD (OR = 1.23, 95% CI 1.03-1.47); upper high SES/ low DD (OR = 1.41, 95% CI 1.21-1.65); and high SES/ low DD (OR = 1.30, 95%CI 1.10-1.53). The mediation analysis revealed that DD mediated the relationship between SES and HRQoL (B=0.011, 95% CI 0.008-0.013), with its indirect effects accounting for 39.29% of the total effects.

Conclusions

These findings highlighted the role of DD as a mediator of the relationship between SES and HRQoL. As DD could be protective, modifiable, and easy for older adults to understand and implement, village clinics and community health stations should work collaboratively to design proper DD intervention measures for better HRQoL.

Dietary diversity, diet quality, and oxidative stress in older adults

This cross-sectional study aimed to explore the relationship between diet quality, dietary diversity, and oxidative stress levels in older adults in parts of the Ningxia Hui Autonomous Region in northwestern China. A total of 335 participants voluntarily participated in the study from April to July 2021. Laboratory tests and questionnaires were used to obtain general characteristics, dietary conditions, and indicators of oxidative stress. The dietary diversity scores of the participants were 5.20±1.39, the diet quality indices were 56.91±11.14, and most had poor diet quality. The levels of the oxidative stress markers malondialdehyde, superoxide dismutase, 8-iso-prostaglandin F2α, and total antioxidant capacity were 4.77±1.77, 40.33±9.85, 763.10±245.41, and 1.02±0.14, respectively. The results showed that the diet quality scores of participants were related to dietary diversity and whether the scores passed or not was significantly related to total antioxidant capacity.

Inverse Association between Dietary Diversity Score Calculated from the Diet Quality Questionnaire and Psychological Stress in Chinese Adults: A Prospective Study from China Health and Nutrition Survey

Specific nutrients or dietary patterns influence an individual’s psychological stress. As a major aspect of a healthy diet, the influence of dietary diversity on psychological stress remains uncertain. Within these contexts, we aimed to examine the association between the dietary diversity score and psychological stress, using prospective data from the China Health and Nutrition Survey (CHNS). We included 7434 adult participants, with complete dietary information, in the 2011 wave, and followed-up with perceived stress scale (PSS-14) in the 2015 wave. The dietary intake of foods was coded into 29 food groups, using the DQQ for China, and the dietary diversity scores were obtained, using DQQ, by calculating the number of food groups consumed during one 24-h dietary recall. The univariate analysis, and logistic regression model were used to examine the relationship between psychological stress and diet diversity. Approximately half of the participants (4204, 56.55%) perceived a higher level of stress (PSS-14 total score > 25). Dietary diversity was lower in the higher-stress group (p for trend <0.0001). Unconditional multivariate logistic regression demonstrated that participants with higher daily dietary diversity were less likely to experience higher-level psychological stress, compared with participants with lower daily dietary diversity (ORs range: 0.480−0.809). Dietary diversity was found to be inversely associated with psychological stress, in this prospective analysis of a national population. Further studies are required to figure out the mechanism and effectiveness of dietary diversity on psychological stress.

Association of Eating Behavior, Nutritional Risk, and Frailty with Sarcopenia in Taiwanese Rural Community-Dwelling Elders: A Cross-Sectional Study

This cross-sectional study assessed the association of eating behavior, nutritional risk, and frailty with sarcopenia in 208 community-dwelling individuals aged ≥65 years who were recruited from random rural community care centers in Chiayi County, Taiwan. The participants’ eating behavior was categorized into six categories. The gait speed (GS), grip strength, and appendicular skeletal muscle mass (ASM) were assessed based on these three parameters, which revealed that 50.9% of the participants had sarcopenia. In an adjusted model, water intake (odds ratio (OR) = 0.99, p = 0.044), dairy product intake (OR = 0.42, p = 0.049), body mass index (BMI) (OR = 0.77, p = 0.019), and marital status with widowed (OR = 0.31, p = 0.005) were significantly associated with sarcopenia. After eight steps of eliminating the least significant independent variable, age (p = 0.002), sex (p = 0.000), marital status with widowed (p = 0.001), water intake (p < 0.018), dairy product intake (p < 0.019), and BMI (p = 0.005) were found to be indispensable predictors of sarcopenia. The logistic regression model with these six indispensable variables had a predictive value of 75.8%. Longitudinal analyses are warranted to examine whether eating behavior is a risk factor for sarcopenia onset.

Long-Term High Dietary Diversity Maintains Good Physical Function in Chinese Elderly: A Cohort Study Based on CLHLS from 2011 to 2018

(1) Objective: This study aimed to explore the correlation between dietary factors and physical function in Chinese elderly. (2) Methods: A cohort study was conducted on the association of long-term dietary intake status with physical function in older people based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2011 to 2018. The physical function of the subjects was judged according to the scores of basic activities of daily living (BADL) and instrumental activities of daily living (IADL). The dietary diversity score was established according to the intake frequency of the food groups, and the dietary pattern score was obtained by factor analysis. The associations between dietary factors and functional impairment was investigated by logistic regressions. (3) Results: A total of 2282 subjects were included in our cohort study, 458 and 1439 of whom had BADL limitation and IADL limitation, respectively. The risk of functional impairment decreased in the consistent high dietary diversity groups compared with the consistent low dietary diversity group (p < 0.05). The fruit-egg-milk pattern, vegetable-meat-fish pattern, and condiment and tea pattern reduced the risk of functional impairment (p < 0.05). (4) Conclusions: Long-term maintenance of high dietary diversity and increasing total dietary intake can help maintain good physical function of Chinese elderly.

Food for the elderly based on sensory perception: A review

Background

The impairments of physiological functions caused by aging are common problems in the elderly, especially the impairments of sensory perception. Besides, close relationship between food sensory perception and nutritional status also suggests the importance of dietary management for the elderly population. The foods taking sensory perception into account are urgently needed by the elderly.

Scope and approach

This review analyzed sensory perception changes and their effects on food behaviors and nutritional status. Besides, sensory properties essential for aged-foods and acquisition methods, as well as current status of such foods were summarized.

Key findings and conclusions

Soft, smooth and moisty foods were more suitable for the elderly with chewing and swallowing dysfunction, which can be prepared by gelation, enzyme treatment, blade tenderization and other non-thermal technologies. Flavor enhancement/enrichment, irritant addition and packet sauces were recommended to compensate the impairment of chemical sensory. Molds, piping bag and 3D printing were suggested for refining appearance of pureed foods, and improving appetite of the elderly.

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Sensory perception changes of the elderly affect food behaviors and health.

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Soft, smooth, and moisty foods are more suitable for the elderly.

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Gelation and enzyme treatment are applied to modify the texture of aged food.

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Packet sauces may meet the heterogenetic flavor requirements of the elderly.

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Visually attractive food made by 3D printing can increase the appetite of elderly.

Socioeconomic, Eating- and Health-Related Limitations of Food Consumption among Polish Women 60+ Years: The 'ABC of Healthy Eating' Project

The study aimed at identifying the socioeconomic, eating- and health-related limitations and their associations with food consumption among Polish women 60+ years old. Data on the frequency of consumption of fruit, vegetables, dairy, meat, poultry, fish, legumes, eggs, water and beverages industrially unsweetened were collected with the Mini Nutritional Assessment (MNA^®) and were expressed in the number of servings consumed per day or week. Three indexes: the Socioeconomic Status Index (SESI), the Eating-related Limitations Score (E-LS) and the Health-related Limitations Score (H-LS) were developed and applied. SESI was created on the base of two variables: place of residence and the self-reported economic situation of household. E-LS included: difficulties with self-feeding, decrease in food intake due to digestive problems, chewing or swallowing difficulties, loss of appetite, decrease in the feeling the taste of food, and feeling satiety, whereas H-LS included: physical function, comorbidity, cognitive function, psychological stress and selected anthropometric measurements. A logistic regression analysis was performed to assess the socioeconomic, eating-, and health-related limitations of food consumption. Lower socioeconomic status (vs. higher) was associated with a lower chance of consuming fruit/vegetables ≥ 2 servings/day (OR = 0.25) or consuming dairy ≥ 1 serving/day (OR = 0.32). The existence of multiple E-LS limitations (vs. few) was associated with a lower chance of consuming fruit/vegetables ≥ 2 servings/day (OR = 0.72), consuming dairy ≥ 1 serving/day (OR = 0.55) or consuming water and beverages industrially unsweetened ≥6 cups/day (OR = 0.56). The existence of multiple H-LS limitations was associated with a lower chance of consuming fruit/vegetables ≥ 2 servings/day (OR = 0.79 per 1 H-LS point increase) or consuming dairy ≥ 1 serving/day (OR = 0.80 per 1 H-LS point increase). Limitations found in the studied women were related to insufficient consumption of selected groups of food, which can lead to malnutrition and dehydration. There is a need for food policy actions, including practical educational activities, to eliminate barriers in food consumption, and in turn to improve the nutritional and health status of older women.

A Review Study of a Green Diet and Healthy Ageing

Nowadays people are living longer, and there has been a substantial growth in the global elderly population in the past decades. While life expectancy is increasing, there are growing concerns towards the heavy financial and social burdens related to chronic diseases among the elderly. These have been critical health care issues, and healthy ageing is considered a top priority in public health. Diet and eating habits are crucial factors contributing to healthy ageing. These important aspects have attracted much attention in health research, particularly in consideration of the causes and management of chronic conditions which affect most elder adults in the world. Recently, a growing number of investigations have reported significant findings on the association of reduction in the risks of chronic non-communicable diseases with plant-based diets. Meanwhile, there have been worldwide initiatives and programmes implemented for reduction of salt intake. A green diet, which emphasises the consumption of a diet rich in plant foods with minimal portions of red or processed meat and reduced salt intake, is advocated with due consideration to the importance of sustainable environment and healthy ageing. This paper highlights a brief review of the recent advance of knowledge in diet and health, its effects on the elderly and the significance of a green diet on healthy ageing. Implications for a green diet and recommendations for future research are also discussed.