Novel Healthy Eating Index to Examine Daily Food Guides Adherence and Frailty in Older Taiwanese (original) (raw)
Related papers
Nutrients, 2015
Dietary pattern analysis is an emerging approach to investigate the association between diet and frailty. This study examined the association of dietary patterns with frailty in 2724 Chinese community-dwelling men and women aged ě 65 years. Baseline dietary data were collected using a food frequency questionnaire between 2001 and 2003. Adherence to a priori dietary patterns, including the Diet Quality Index-International (DQI-I) and the Mediterranean Diet Score (MDS) was assessed. Factor analysis identified three a posteriori dietary patterns, namely "vegetables-fruits", "snacks-drinks-milk products", and "meat-fish". Incident frailty was defined using the FRAIL scale. Binary logistic regression was applied to examine the associations between dietary patterns and four-year incident frailty. There were 31 (1.1%) incident frailty cases at four years. Every 10-unit increase in DQI-I was associated with 41% reduced risk of frailty in the sex-and age-adjusted model (odds ratio (OR) (95% confidence interval (CI)): 0.59 (0.42-0.85), p = 0.004). The association attenuated in the multivariate adjusted model (0.69 (0.47-1.02), p = 0.056). No association between other dietary patterns and incident frailty was observed. Our study showed that a better diet quality as characterized by higher DQI-I was associated with lower odds of developing frailty. The contribution of MDS or a posteriori dietary patterns to the development of frailty in Chinese older people remains to be explored.
2015
Dietary pattern analysis is an emerging approach to investigate the association between diet and frailty. This study examined the association of dietary patterns with frailty in 2724 Chinese community-dwelling men and women aged ě 65 years. Baseline dietary data were collected using a food frequency questionnaire between 2001 and 2003. Adherence to a priori dietary patterns, including the Diet Quality Index-International (DQI-I) and the Mediterranean Diet Score (MDS) was assessed. Factor analysis identified three a posteriori dietary patterns, namely "vegetables-fruits", "snacks-drinks-milk products", and "meat-fish". Incident frailty was defined using the FRAIL scale. Binary logistic regression was applied to examine the associations between dietary patterns and four-year incident frailty. There were 31 (1.1%) incident frailty cases at four years. Every 10-unit increase in DQI-I was associated with 41% reduced risk of frailty in the sex-and age-adjusted model (odds ratio (OR) (95% confidence interval (CI)): 0.59 (0.42-0.85), p = 0.004). The association attenuated in the multivariate adjusted model (0.69 (0.47-1.02), p = 0.056). No association between other dietary patterns and incident frailty was observed. Our study showed that a better diet quality as characterized by higher DQI-I was associated with lower odds of developing frailty. The contribution of MDS or a posteriori dietary patterns to the development of frailty in Chinese older people remains to be explored.
Ranking: http://links. …, 2011
A 28-item simplified food frequency questionnaire (SFFQ) combined with 9 open questions about staples was designed for the Elderly Nutrient and Health Survey in Taiwan (NAHSIT) to collect information on participants' usual food intake of the previous month. We have examined the validity of this SFFQ via comparison with data on multiple 24-hour dietary recall (n=81) and biomarkers (n=1473). All questionnaires were completed by faceto-face interview and fasting blood samples were taken. Thirty seven males and 44 females were randomly selected from NAHSIT participants. Of these, 31 and 50 subjects completed 2 or 3 24-hour dietary recalls within one month, respectively. Mean daily intake frequencies for each food group were calculated from the SFFQ and 24-hr recalls, respectively. Spearman rank correlation coefficients between frequencies of food group obtained from the FFQ and from dietary recalls ranged from 0.132 to 0.678 for men; 0.052 to 0.759 for women. Correlation coefficients between frequency and food weight were similar. When validated by nutrient status, the most correlated was dairy intake frequency judged by 24-hour vitamin B-2 and calcium intakes and by erythrocyte glutathione reductase (EGRAC) for B-2 functionality, where the correlation coefficients were, respectively, 0.533, 0.518 and-0.205 for men; 0.494, 0.475 and-0.174 for women; fish and fruit frequency followed in overall validity. The SFFQ measured the food patterns of NAHSIT elders with validity high for dairy and good for fish and fruit intakes in both genders.
A Prospective Investigation of Dietary Intake and Functional Impairments among the Elderly
American journal of epidemiology, 2018
Limited information is available in Asian populations regarding the association of dietary intake and patterns with age-related functional impairments. Using data from two population-based cohort studies, the Shanghai Women's Health Study (1996-2015) and Shanghai Men's Health Study (2002-2015), we prospectively examined adherence to dietary guidelines, including the Chinese Food Pagoda, the Dietary Approaches to Stop Hypertension and the Alternative Healthy Eating Index, as well as specific food consumption, for their associations with impairment in function, both physical (walking, hearing/vision) and mental (memory, decision-making). Included in the analyses were 30,484 participants who had been followed up for an average of 14.4 years and were between the ages of 70 and 86 at the functional status assessment. Higher dietary recommendation adherence scores were associated with a lower likelihood of developing functional impairments. The odds ratios ranged from 0.61 (95% co...
Journal of Nutritional Science
Disease-related malnutrition is prevalent among older adults; therefore, identifying the modifiable risk factors in the diet is essential for the prevention and management of disease-related malnutrition. The present study examined the cross-sectional association between dietary patterns and malnutrition in Chinese community-dwelling older adults aged ≥65 years in Hong Kong. Dietary patterns, including Diet Quality Index International (DQI-I), Dietary Approaches to Stop Hypertension (DASH), the Mediterranean Diet Score, ‘vegetable–fruit’ pattern, ‘snack–drink–milk product’ pattern and ‘meat–fish’ pattern, were estimated and generated from a validated food frequency questionnaire. Malnutrition was classified according to the modified Global Leadership Initiative on Malnutrition (GLIM) criteria based on two phenotypic components (low body mass index and reduced muscle mass) and one aetiologic component (inflammation/disease burden). The association between the tertile or level of adhe...
Nutrients
This study aims to investigate whether frailty severity in conjunction with cognitive function, termed as” cognitive frailty”, is associated with dietary diversity in older adults. This cross-sectional study used the data from the 2014–2016 Nutrition and Health Survey in Taiwan (N = 1115; age ≥ 65 years). Dietary intake was assessed using a 24 h dietary recall and food-frequency questionnaire, and dietary diversity score (DDS; range, 0–6) and food intake frequency were calculated. The presence of frailty phenotypes was determined using the FRAIL scale, which was proposed by the International Association of Nutrition and Aging, and cognitive function was assessed using the Mini–Mental State Examination (MMSE) score. The prevalence of cognitive frailty (FRAIL scale score ≥ 3 and MMSE score ≤ 26) was 4.2%. A higher consumption frequency of dairy products, whole grains, vegetables, fruit, fish and seafood, nuts, tea, and coffee, as well as lower pickled vegetable, was inversely associat...
Scientific Reports
Nutritional factors contributing to disability and mortality are modifiable in later life. Indices would add utility. We developed a gender-specific Healthy Ageing Nutrition Index (HANI) for all-cause mortality in free-living elderly. We stratified 1898 participants aged ≥65 y from the 1999-2000 Nutrition and Health Survey in Taiwan by region and randomly allocated them into development and validation sets. Linkage to the National Death Registry database until December 31, 2008 enabled mortality prediction using Cox proportional-hazards models. Four factors (appetite, eating with others, dietary diversity score, and BMI) with best total of 25 HANI points for men; and 3 factors (cooking frequency, dietary diversity score, and BMI) with best total of 27 HANI points for women, were developed. In the validation set, the highest HANI group exhibited a greater intake of plant-derived food and associated nutrients, a favourable quality of life, and more muscle mass, compared with the lowest group. The highest HANI group predicts mortality risk lower by 44 percent in men and 61 percent in women. Adjusted mortality HRs were comparable between sets. HANI is a simple, non-invasive, inexpensive, and potentially modifiable tool for nutrition monitoring and survival prediction for older adults, superior to its individual components. Population Ageing is a critical concern for global public health, because of its varied rates of increase and quality 1. Quality of life (QOL) and disability compromise the value and extent of longevity and the majority of health expenditure is incurred in the last year of life 2. Time trends which demonstrate reductions in age-specific disability provide evidence of avoidability 3. To reduce the burden of disease and increase life expectancy in later life, the focus has been on chronic disease with its behavioural, social, and environmental contributors 4-6. Some modifiable contributors include diet, physical activity, and substance abuse affecting well-being, disability, disease and survival 4,7-11. Diet-related factors are a leading cause of death globally 12-14. Ageing is affected by demographic, epidemiologic, and nutritional transitions 15 with nutrition-related factors the most modifiable. Nutritional factors derive from the underlying food system which is reflected in the food supply and shopping 16 , nutritional knowledge 17 , skills such as cooking 18 , along with dietary patterns and quality 9,19. There are age-related nutritional conditions such as the anorexia of ageing 20,21 , chewing disability 22 , cognitive impairment 23 and problems with food and eating 24. The marked differences in health and survival between genders might be partly attributed to nutritional status 25,26. These might be on account of women tending to exhibit more health-seeking behavior 26,27 , higher apparent morbidity, and a higher use of health care services 28 than men. For example, the consumption of fruits and
A simple food quality index predicts mortality in elderly Taiwanese
The journal of nutrition, health & aging, 2011
To assess the relative predictive ability for mortality of the Overall Dietary Index-Revised (ODI-R) and the Dietary Diversity Score (DDS) among representative Taiwanese aged 65 and older. Prospective cohort. The Elderly Nutrition and Health Survey in Taiwan during 1999-2000. One thousand seven hundred forty three (860 men and 883 women). Dietary quality measures, the ODI-R (0-100) and DDS (0-6) were based on 24-hour dietary recall and a food frequency questionnaire at baseline. Death by National Death Registry up to 2008 was the outcome measure. During follow-up, 624 subjects died. The survivors had both significantly higher (P <0.001) ODI-R (66.9 vs. 63.6) and DDS (4.69 vs. 4.30) than the deceased. The two indices were correlated (r=0.46). After adjustment for potential covariates, the hazard ratios (HR) (95% CI) were 0.63 (0.42-0.97), 0.71 (0.49-1.04) and 0.53 (0.37-0.76) for those whose ODI-R scores were 60-65, 65-70, >70, respectively, compared to those whose ODI-R scores...
Dietary Patterns and Their Relationship with Frailty in Functionally Independent Older Adults
Nutrients, 2018
The impact of dietary patterns rather than single foods or nutrients on health outcomes is increasingly recognized. This cross-sectional study examines the dietary patterns of 527 non-institutionalized functionally independent older people aged ≥70 years from Gipuzkoa (Spain). Sociodemographic characteristics, health status, anthropometric measures and dietary data are collected. Multiple correspondence analysis (MCA) and cluster analysis are performed to identify dietary patterns and groups of individuals. Frequency of selected food items and compliance with food recommendations are included in the MCA. A high proportion of the sample population are overweight or obese, whereas only 3.3% are at risk of malnutrition (determined with the Mini Nutritional Assessment). Frail individuals (n = 130), measured with the Timed-Up and Go test are older, have a lower educational level, are more obese, present a poorer health status (more depressive symptoms, polypharmacy and falls, among others) and worse compliance with food recommendations than robust individuals (n = 392). Three groups of individuals are identified: cluster one (n = 285), cluster two (n = 194) and cluster three (n = 48). A gradient of increasing frailty and poorer health status is observed from cluster one to cluster three. The latter also shows the poorest dietary pattern, regarding dietary recommendations. The use of an easy-to-use tool to assess diet allows detection of differences among the three clusters. There is a need to increase awareness on the implementation of nutritional screening and a subsequent dietary assessment in primary care settings to provide nutritional care to elder, and moreover, frail individuals.
International Journal of Environmental Research and Public Health, 2022
Individual factors relating to dietary behaviors are widely explored. However, the effects of social environment on dietary patterns for the older people are less explored. The purpose of this study was to identify dietary patterns among older people in Taiwan and to examine the relationship of dietary patterns with social environment and individual factors. The current study used the 2013–2016 Nutrition and Health Survey in Taiwan. The sample was representative at the national and city levels. Only those who were aged 55 years old and above were included for analysis (n = 2922); the mean age of the participants was 68.62 (SD = 8.76). The city-level data, including population characteristics, food availability, and age-friendly city indicators, were obtained from the open data and survey report of government. Three dietary patterns were identified: high protein-vegetable (41.6%), high sweets and low protein-vegetables (37.9%), and high viscera and fats (20.5%). The results of multil...