Socio-demographic characteristics associated with the dietary diversity of Thai community-dwelling older people: results from the national health examination survey

Adherence to planetary health diet index in relation to dietary diversity score and anthropometric indices among Iranian older adults

BACKGROUND

Ensuring a nutritious and sustainable diet for an expanding population presents a formidable challenge. In response to this pressing issue, the EAT-Lancet Commission has proposed a sustainable diet framework. This study aimed to investigate the relationship between Planetary Health Diet (PHDI), Dietary Diversity Score (DDS), and anthropometric indices among Iranian elders.

METHODS

In this cross-sectional study, 398 participants aged ≥ 60 y were included. Dietary data was collected using a validated 168-item food frequency questionnaire and the DDS was computed based on five distinct food groups. Anthropometric measurements were conducted by standard protocol to derive relevant indices. Binary logistic and linear regression models, adjusted for potential confounders, were employed to analyze the association between adherence to PHDI and outcomes of interest using SPSS version 26.

RESULT

Subjects had a mean age of 63.28 years (SD = 3.58), ranging from 60 to 84 years, of whom 50% were females. PHDI was categorized into tertiles, with 34.7% of individuals in the highest tertile. Highest adherence to PHDI, compared to the lowest, was found to be inversely associated with a lower probability of high BMI (OR: 0.31, 95% CI: 0.17, 0.56), WC (OR: 0.53, 95% CI: 0.32, 0.90), and BRI (OR: 0.43, 95% CI: 0.25, 0.75) in fully adjusted models. Additionally, every 10-point increase in PHDI was linked to a 38%, 25%, and 28% decrease in odds of high BMI, WC, and BRI, respectively, after adjustments for potential confounders. Notably, no significant associations were observed between PHDI and other anthropometric indices or DDS in the fully adjusted model.

CONCLUSION

In conclusion, this study reveals a negative association between adherence to EAT-Lancet recommendations (PHDI) and unfavorable anthropometric measures in Iranian older adults. These findings suggest that promoting diets aligned with the EAT-Lancet guidelines may support healthier aging and help prevent obesity-related health risks. Further, prospective studies are needed to confirm these results and inform public health strategies.

Public assistance program and food diversity among older people: a cross-sectional study using the Japan Gerontological Evaluation Study data : Public assistance program and food diversity

BACKGROUND

Food diversity plays an important role in people's healthy and affluent lives. However, poverty and eating alone can create multi-dimensional barriers to food diversity. Although public assistance programs guarantee a minimum income to people in need, financial support alone may not be sufficient to support the health of people in poverty. This study aimed to identify the differences in food diversity intake between older recipients of public assistance and non-recipients.

METHODS

This cross-sectional study utilized data from the Japanese Gerontological Evaluation Study (2022), involving 14,467 participants aged 65 years and older. The Dietary Variety Score (DVS), ranging from 0 to 10 (higher scores indicate higher dietary variety), assessed dietary diversity based on the regular consumption of ten food groups. Receiving public assistance was categorized as "yes" or "no." Eating together was defined as eating with others every day. To assess the relationship between receiving public assistance and the DVS, we calculated the unstandardized coefficient (β) and p values using a general linear model. Additionally, the interaction between public assistance and eating together was examined. As covariates, we adjusted for sociodemographic factors such as age, disease, marital status, and living alone.

RESULTS

Men recipients of public assistance had a lower DVS, even after adjusting for sociodemographic factors (adjusted β: -0.72, p = 0.04). For women, no association was seen between receiving public assistance and a lower DVS (adjusted β: -0.19, p = 0.66). An interaction between public assistance and eating together was observed among men (p = 0.07).

CONCLUSIONS

Even after adjusting for sociodemographic factors, men recipients of public assistance have less food diversity than non-recipient men. Men recipients were more likely to increase their food diversity by eating together. To ensure recipients' rights to food security, the public assistance program should provide additional support to integrate recipients into communities that enable them to eat together in addition to providing financial support.

Household structure and dietary diversity among older adults in rural and urban China: a cross-sectional study

BACKGROUND

Household structure can significantly affect older adults' eating behaviours and diet quality. However, the difference in dietary diversity in various household structures in urban and rural has rarely been investigated. This study aimed to investigate the association between household structure and dietary diversity among older Chinese adults and examine whether the association differed by urban and rural.

METHODS

The study used data from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The participants were individuals aged 60 and over with available dietary and household structure data. Dietary diversity was defined as 'high' if respondents had a dietary diversity score (DDS) above the mean value. Household structures were classified into four mutually exclusive categories: (1) living alone; (2) spouse only; (3) at least with a great/grandchild(ren); (4) non-empty-nested. Binary logistic regression was applied to investigate the association between household structures and dietary diversity.

RESULTS

Non-empty-nested older adults had the highest probability (OR = 1.64, 95% CI = 1.44-1.87) of having high dietary diversity. People who only lived with their spouse and at least lived with a great/grandchild(ren) were 1.45 (OR = 1.45, 95% CI = 1.23-1.71) and 1.23 (OR = 1.23, 95% CI = 1.08-1.41) times as likely to have diverse diets than older adults who lived alone. The difference in dietary diversity among various household structures is more evident in urban than rural areas. Solo-living older adults were the most disadvantaged regarding dietary diversity in urban and rural areas.

CONCLUSIONS

Household structures are significantly associated with dietary diversity among older Chinese adults aged 60 years and over. The findings emphasise the need to reduce nutritional inequality, encourage dietary diversity, and consider both the household structures and residences when providing health intervention programs to the older population.

Factors Associated with Dietary Diversity in Community-Dwelling Brazilian Older Adults

BACKGROUND

Older populations are at high risk of nutritional inadequacy and monotonous diets, and assessing dietary diversity can be a practical measure to indicate groups at nutritional risk. We aimed to explore the dietary diversity of older adults enrolled in primary health care services in Brazil and to evaluate its associated factors.

METHODOLOGY

In this cross-sectional study, we evaluated the dietary diversity score (DDS) of 581 participants (≥60 years) registered in primary care services. All foods mentioned in a 24 h food recall were classified into 10 groups, and factors associated with the DDS were analyzed using hierarchical linear regression models in two blocks: (1) sociodemographic and (2) health conditions and lifestyle.

RESULTS

The mean DDS was 5.07 (±1.34), and 67.5% of the sample reached the minimum dietary diversity (≥5 groups). In the final model, income, previous diagnosis of cancer, and sporadic intake of alcohol were positively associated with DDS. In contrast, cognitive decline, sedentary lifestyle, and anorexia of aging were negatively associated with DDS.

CONCLUSIONS

These findings show that the entire structural, economic, and social system needs to facilitate access to quality food, adequate places and conditions for the practice of physical activity, and policies regarding tobacco and alcohol abuse, in addition to nutritional guidance.

Dietary diversity and its association with changes in anthropometric indices of community-dwelling older adults in Tehran, Iran: a longitudinal study (2017-2021)

BACKGROUND

Dietary diversity refers to the consumption of a variety of foods or food groups over a given reference period, which is crucial for improving nutrition and overall health. This longitudinal study aimed to investigate the association between dietary diversity and anthropometric indices in community-dwelling older adults living in Tehran in 2017 and 2021.

METHODS

The current study was conducted on 368 older adults [204 (55.4%) women and 164 (44.6%) men] over 60 years of age living in Tehran, who were selected by a systematic cluster sampling method at two-time points, 2017 and 2021. Anthropometric measures (weight, height, hip circumference, and waist circumference) were assessed with standard methods. The participants' dietary intake was assessed by completing two non-consecutive 24-hour recalls, and dietary diversity score (DDS) was calculated based on Kant's method. Statistical analysis was performed using R software by the mixed effect model method.

RESULTS

The mean DDS of the participants in 2017 (5.07 ± 1.20) was higher than that in 2021 (4.94 ± 1.09) (p < 0.05). DDS and dairy diversity score decreased significantly over time. After adjusting for confounders, there was an inverse relationship between the DDS and Body Mass Index (BMI) (B = -0.22; SE = 0.09), but the interaction effect of year × DDS (B = 0.19; SE = 0.10) was not significant (p = 0.06). However, there was a positive relationship between the DDS and A Body Shape Index (ABSI) (B = 0.00; p = 0.022), after adjusting for confounders, this relationship was no longer significant. Additionally, the interaction effect of year and DDS on the ABSI was not significant.

CONCLUSION

The dietary intake and dietary diversity of older adult residents of Tehran declined dramatically with age, and a higher DDS was associated with improved anthropometric indices. DDS had an inverse relationship with general obesity in the studied participants, and the passage of time did not affect this relationship. The DDS can be used as a predictive index and is a powerful tool for investigating changes in nutritional status in longitudinal studies of old age. However, longer-duration studies are needed to obtain more conclusive results.

Nutritional Health Risk (Food Security) in Thai Older Adults and Related Factors

The older adult population in Thailand has been steadily increasing in recent years, and urbanization has resulted in many older adults living independently, leaving many at nutritional risk. The purpose of this research is to explore food security among Thai older adults using a simple screening tool, the DETERMINE tool, as well as from three surveys which reflect seniors' health and ultimately food security including the mini-mental state examination (MMSE), the self-efficacy for physical activity scale (SEPAS), and the health literacy questionnaire. The DETERMINE tool was used in Thailand for the first time in this study. The findings revealed a moderate risk of food insecurity amongst participants, as most of them claimed to have underlying diseases, eat alone, eat a few nutrient-rich foods, and take medication. The MMSE, SEPAS, and health literacy questionnaire results suggested that food security was found to be negatively correlated with higher cognitive ability, higher physical activity, self-efficacy, and higher health literacy. In conclusion, there appears to be a high risk for malnutrition among older adults in Thailand, particularly in those with low income and underlying diseases.

Health Information Source Patterns and Dietary Variety among Older Adults Living in Rural Japan

Dietary variety is associated with some health outcomes among older adults. Rural areas, however, often have difficulty accessing health information that influences dietary variety. This study aimed to identify patterns of health information sources by using latent class analysis and assess their association with dietary variety among older adults aged ≥ 75 in rural Japan (n = 411). Three patterns of health information sources were identified: multi-sources (29.7%), television-only (53.5%), and non-sources (16.8%). In the multi-sources pattern, more people used television, radio, and newspapers. The television-only pattern had mostly television users, with fewer other sources. The non-sources pattern had many reporting "none." Logistic regression analysis revealed that the multi-sources pattern has a significant positive effect on dietary variety compared with the non-sources pattern (odds ratio: 5.434, 95% confidence interval: 1.792-16.472), even after adjusting for socioeconomic factors and physical health status. These findings underscore the positive impact of broad access to health information on the dietary habits of older individuals. The study highlights the importance of promoting access to diverse health information sources to enhance dietary variety and overall well-being among rural older adults.

Prevalence and factors associated with malnutrition on patients with cancer in Bangladesh: a cross-sectional study

Introduction

Malnutrition is related to the development of chronic diseases, including cancer and is a major cause of mortality in patients with cancer. The study aimed to understand the prevalence and factors associated with malnutrition among patients with cancer.

Methods

This cross-sectional study investigated the prevalence of malnutrition among patients with cancer and its relationship with sociodemographic status and treatments. Patients' nutritional diagnosis was performed using the Patient-Generated Subjective Global Assessment (PG-SGA) tool. The performance status (PS) was obtained from the scale developed by the Eastern Cooperative Oncology Group (ECOG). Data were collected from two hospitals from January to March 2023. A χ2 test and multinominal regression analysis were performed by SPSS V.25.

Results

Out of 275 patients, 164 (60%) were male, with the mean age of 49.54 years (SD 15.61). Of these, 184 patients (67%) were malnourished of whom 149 patients (54%) had moderate and 35 patients (13%) had severe malnutrition. Patients' age, sex, PS, cancer site, treatment modalities, duration and hospitalisation were significantly associated with nutritional status (p<0.05). Patients between the ages of 40 and 60 were 2.96 times more likely to be malnourished compared with those younger than 40 (adjusted odd ratio (AOR) 2.96; 95% CI 1.40 to 6.24). Female patients had 7.74 times higher risk of malnutrition compared with male patients (AOR 7.74; 95% CI 2.03 to 19.80). Malnutrition was 2.6 times higher for surgical patients compared with nonsurgical ones (AOR 2.60; 95% CI 1.29 to 5.26). The risk of malnutrition was 4.06 times greater in patients treated longer than 12 months compared with those treated less than 6 months (AOR 4.06; 95% CI 1.82 to 9.08).

Conclusion

There is a high prevalence of malnutrition among patients with cancer, and it is essential to include regular nutritional assessment in the treatment process for better outcomes.

Nutritional Profiles and Their Links to Insulin Resistance and Anthropometric Variables in a Female Cohort

This study investigates the relationship between dietary habits and metabolic health among women, emphasizing the role of anthropometric parameters as proxies for insulin resistance. We analyzed data from 443 women categorized into two groups based on the presence or absence of clinically diagnosed insulin resistance. Our assessments included dietary quality, socio-demographic characteristics, and a series of anthropometric measurements such as body weight, Body Mass Index (BMI), Waist-Hip Ratio (WHR), Abdominal Volume Index (AVI), and Body Adiposity Index (BAI). The results indicated significant disparities in these parameters, with the insulin-resistant group exhibiting higher average body weight (78.92 kg vs. 65.04 kg, p < 0.001), BMI (28.45 kg/m2 vs. 23.17 kg/m2, p < 0.001), and other related measures, suggesting a strong influence of dietary patterns on body composition and metabolic risk. The study underscores the importance of dietary management in addressing insulin resistance, advocating for personalized dietary strategies to improve metabolic health outcomes in women. This approach highlights the need for integrating dietary changes with lifestyle modifications and socio-demographic considerations to combat metabolic risks effectively.

Impact of age on the prevalence of poor-quality dietary variety, associated lifestyle factors, and body composition profile (low body muscle mass and high body fat mass) in older people residing in Colombo district, Sri Lanka

Aims

To assess the impact of age on the prevalence of poor-quality dietary variety, associated lifestyle factors, and body composition profile (low body muscle mass and high-fat mass) in older Sri Lankans.

Methods

In this population-based cross-sectional study, older people of 60 years or above were selected using a multistage cluster sampling technique probability proportionate to the size. They were classified into 3 groups; 60-64, 65-69 and > 70-years. The poor-quality dietary variety was defined based on food variety, dietary diversity and dietary serving scores assessed using 24-h dietary recall. Body composition was measured using bio-electrical impedance. The impact of age on determinants of poor-quality dietary variety and being at risk of low muscle mass and high-fat mass were assessed by using multivariable logistic regression models.

Results

Eight hundred older participants with a mean (SD) 68.1(5.8) years were included. There were 28.4%(n = 227), 36.2%(n = 290) and 35.4%(n = 283) in the 60-64, 65-69 and ≥ 70-year age groups, respectively. The prevalence of poor-quality dietary variety was similar across age groups. The urban living environment, and getting nutritional advice from the GP/hospital were found to have a significant negative association only in the 60-64 age group. A poor-quality dietary variety was significantly associated with no education or up to the primary level in the 65-69 age group and having diabetes or hypertension in the ≥70-year group. Odds of low muscle mass and high-fat mass were 2.43(1.46-4.03) and 2.17(1.30-3.63) respectively among the≥70-year age group compared to the 60-64-year group, after controlling for confounders.

Conclusions

The prevalence of poor-quality dietary variety was similarly high in all age groups. Increasing age was associated with higher odds of low body muscle and high body fat mass despite similar dietary variety, indicating the need for special dietary attention.

Exploring Differences in Dietary Diversity and Micronutrient Adequacy between Costa Rican and Mexican Adolescents

Diet diversity becomes especially relevant during adolescence to satisfy the adequate micronutrient intake. Diet diversity (DD) and micronutrient probability of adequacy (PA) were studied in 818 Costa Rican (CR) and 1202 Mexican (MX) adolescents aged 13-18 years. DD was compared using the Minimum Dietary Diversity (MDD) score. Receiver-operating characteristic (ROC) curves were employed to identify the optimal MDD for each sample from the respective countries. The mean MDD for the overall CR sample was 4.17 ± 1.43 points, and for the MX sample, the mean MDD was 4.68 ± 1.48 points. The proportion of adolescents with a DD was significantly higher in Costa Rica than in Mexico (66.5% vs. 55.6%; p < 0.0001). Also, DD was higher in rural Costa Rican adolescents, while no difference was found in the MX adolescents by area of residence. CR adolescents reported significantly higher PA than MX participants for 6 of the 11 micronutrients assessed. The calcium PA in MX adolescents was significantly higher than in the CR sample (MX: 0.84 vs. CR: 0.03; p < 0.0001), while low PA was obtained for iron in both countries (CR: 0.01 vs. MX: 0.07; p < 0.0001). In Costa Rica and Mexico, nutritional interventions and assessing the compliance of food-fortifying programs are needed to improve the PA of diverse micronutrients.

Factors associated with child and maternal dietary diversity in the urban areas of Bangladesh

Dietary diversity is an indicator of nutrition that has been found positively associated with diet quality, micronutrient adequacy, and improved maternal health and child growth. Due to the cultural responsibility of women in providing food at the household level, their status is very important to perform this role. Hence, this study has been conducted on the status of dietary diversity of the mother and child to understand how it relates to various factors of women in urban settings. Data were obtained from 1978 mother-child pairs living in different cities in Bangladesh. The foods taken by the women and children were categorized into 10 and 7 groups to measure women's dietary diversity (WDD) and children's dietary diversity (CDD), respectively. The study found that more than three-fourths of the mothers and half of the children had low dietary diversity. The household wealth holdings and access to resources by the women were found inadequate, while two-thirds of them had the lowest to medium level of nutritional knowledge. The binomial logistic regression model was used to measure the factors influencing WDD and CDD. The findings also indicated that children's dietary diversity was influenced by the mother's age, education, supportive attitude and behavior of husband, and access to and control over resources. While the household wealth index can enhance both child and mother's dietary variety, nutrition knowledge, dietary counseling, and access to and control over resources can improve maternal dietary diversity. This study recommends improving women's socioeconomic status by increasing their wealth and access to resources and enhancing their nutrition knowledge by providing food and nutrition counseling.

Socio-Demographic Factors Associated with Rural Residents' Dietary Diversity and Dietary Pattern: A Cross-Sectional Study in Pingnan, China

There is limited evidence regarding the factors correlated with dietary diversity (DD) and dietary pattern (DP) in rural residents of China. This study aims to identify the DD and DP of rural residents and their association with socio-demographic factors. A cross-sectional survey was conducted in Pingnan, China. The Food Frequency Questionnaire (FFQ) was applied to evaluate dietary intake. Latent class analysis (LCA) was used to identify patterns of six food varieties, including vegetables-fruits, red meat, aquatic products, eggs, milk, and beans-nuts. Generalized linear models and multiple logistic regression models were used to determine factors associated with the DD and DP. Three DPs were detected by LCA, namely "healthy" DP (47.94%), "traditional" DP (33.94%), and "meat/animal protein" DP (18.11%). Females exhibited lower DD (β = -0.23, p = 0.003) and were more likely to adhere to "traditional" DP (OR = 1.46, p = 0.039) and "meat/animal protein" DP (OR = 2.02, p < 0.001). Higher educational levels and annual household income (AHI) were positively associated with higher DD (p < 0.05) and less likely to have "traditional" DP and "meat/animal protein" DP (p < 0.05). Non-obese people exhibited higher DD (β = 0.15, p = 0.020) and were less likely to have "meat/animal protein" DP (OR = 0.59, p = 0.001). Our study reveals that females, those with lower educational levels and AHI, and obese people are more likely to have a lower DD and are more likely to adhere to "traditional" DP and "meat/animal protein" DP. The local, regional, and even national performance of specific diet-related health promotion measures and interventions must target these vulnerable populations to improve a healthier DD and DP.

Dietary diversity predicts the mortality among older people: Data from the fifth Thai national health examination survey

OBJECTIVE

To examine the association between dietary diversity (DD) and mortality among Thai older people and to investigate whether age, sex, and nutritional status modify this association.

METHODS

The national survey conducted from 2013 to 2015 recruited 5631 people aged >60 years. Dietary diversity score (DDS) was assessed for the consumption of eight food groups using food frequency questionnaires. The Vital Statistics System provided the data on mortality in 2021. The association between DDS and mortality was analyzed by Cox proportional hazard model and adjusted for the complex survey design. Interaction terms between DDS and age, sex, and BMI were also tested.

RESULTS

The DDS was inversely associated with mortality (HR_adj 0.98, 95%CI: 0.96-1.00). This association was stronger in people aged >70 years (HR_adj 0.93, 95%CI: 0.90-0.96 for aged 70-79 years, and HR_adj 0.92, 95%CI: 0.88-0.95 for aged >80 years). Inverse association between DDS and mortality was also found in the underweight older population (HR_adj 0.95, 95%CI: 0.90-0.99). A positive association was found between DDS and mortality in the overweight/obese group (HR_adj 1.03, 95%CI: 1.00-1.05). However, the interaction between the DDS with sex to mortality was not statistically significant.

CONCLUSION

Increasing DD reduces mortality among Thai older people, especially in those above 70, and underweight. In contrast, an increase in DD also meant an increase in mortality among the overweight/obese group. Focus should be placed on the nutritional interventions aimed to improve DD for those 70 and over and underweight to reduce mortality.

Age and cohort trends of the impact of socioeconomic status on dietary diversity among Chinese older adults from the perspective of urban–rural differences: A prospective cohort study based on CLHLS 2002–2018

The association between socioeconomic status (SES) and dietary diversity score (DDS) has been widely discussed, but little is known about the age and cohort effects on DDS and how the SES effect on DDS varies with age and across successive cohorts among urban and rural older adults in China. Thus, this study aimed to examine the temporal change in DDS among Chinese older adults and SES heterogeneities in such change from the perspective of urban–rural differentiation. Data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) between 2002 and 2018 were used, and a total of 13,728 participants aged between 65 and 105 years were included in this study. A total of eight food groups were used to assess DDS, while education, family income, and perceived income status were used to assess SES. A linear mixed model was used to estimate the age and cohort effects on DDS and their urban–rural and SES disparities. The results show that higher SES, including more education, family income, and perceived income status, was associated with higher DDS (for urban older adults, β = 0.1645, p = 0.0003, β = 0.2638, p < 0.0001, β = 0.2917, p < 0.0001, respectively; for rural older adults, β = 0.0932, p = 0.0080, β = 0.4063, p < 0.0001, β = 0.2921, p < 0.0001, respectively). The DDS of older adults increased with age and across successive cohorts in both urban and rural China. Moreover, we found the three-way interaction effect of SES, age, and cohort was statistically significant in both urban and rural China. Thus, living in an urban area and having higher SES are associated with higher DDS, but these associations change with age and across successive cohorts. The dietary health of earlier cohorts and rural oldest-old in China deserves more attention.

Dietary diversity associated with risk of cardiovascular diseases among community-dwelling older people: A national health examination survey from Thailand

Background

Cardiovascular diseases (CVD) are the common comorbidities in older people. Healthy diet is an essential strategy to alleviate the risk of developing CVD. Dietary diversity (DD) is an indicator of diet quality. Currently, limited research exists regarding DD and CVD in older people in developing countries, such as Thailand, despite rapid growth of older population. Therefore, this study aims to determine associations of DD with the risk of CVD and the cardiometabolic risk factors among Thai older people.

Methods

This cross-sectional study used the sub-sample of the fifth Thai National Health Examination Survey conducted from 2013 to 2015. A total of 6,956 older people aged 60 years and older and no pre-existing CVD were included.Dietary diversity score (DDS) was assessed the consumption of eight food groups using food frequency questionnaires. Each food group was scored from 0 to 4. The DDS was calculated as the sum of the scores (0-32). The risk of CVD was calculated by using a Thai cardiovascular (CV) risk score. The cardiometabolic risk factors included hypertension, diabetes mellitus (DM), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) levels. Data were adjusted for a complex survey design and analysed using linear and logistic regression models.

Results

In the adjusted model, DDS had a significant negative association with log-Thai CV risk score, with adjusted β (95% CI) values of -0.01 (-0.01, -0.01). Regarding the cardiometabolic risk factors, DDS had a significant negative association with hypertension, DM and log-TG levels, with adjusted OR (95% CI) values of 0.97 (95% CI 0.97, 0.98) for hypertension, 0.94 (0.93, 0.95) for DM, and adjusted β (95% CI) values of -0.002 (-0.004, -0.001) for log-TG level. DDS was positively associated with TC and LDL-C, with adjusted β (95% CI) values of 0.59 (0.38, 0.80) for TC and 0.59 (0.38, 0.79) for LDL-C levels, while DDS was not associated with HDL-C level.

Conclusion

Higher DD was associated with a lower risk of CVD among Thai older people. The nutritional policies or interventions should encourage a diverse food intake for the prevention of CVD in this population.

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.