Disparities in dietary quantity and quality between the two different types of Korean family of older adults living with spouses and living alone: using data from the 6th Korea National Health and Nutrition Examination Survey

Association Between Nutrition Literacy and Quality of Life in Adults With Chronic Diseases in Bengbu China

CONTEXT

Nutrition literacy (NL) reflects an individual's ability to make correct nutritional decisions, and nutrition is a factor influencing patients' quality of life (QOL).

OBJECTIVES

To assess the association between NL and QOL in adults with chronic diseases.

DESIGN

A cross-sectional survey was conducted among Chinese residents beginning in May 2023. Investigators, who were trained to follow standardized procedures, conducted individual, face-to-face interviews.

SETTING

Bengbu City, Anhui Province, China.

PARTICIPANTS

A total of 1607 Chinese residents aged 18 and over.

MAIN OUTCOME AND MEASURES

A 12-Item Short-Form Health Survey was used to assess QOL and the short-form NL measurement tool to measure the NL. Ordinal logistic regression models were used to investigate the association between NL and QOL.

RESULTS

Of the 1607 participants, compared to those in the first quartile of NL, individuals in the 4th quartile, characterized by higher NL, reported a significantly higher QOL, including physical component summary and mental component summary. For dimensions, nutrition knowledge, understanding, interactive, and critical skills were associated with QOL. Upon stratification, this association was evident exclusively in individuals with low monthly incomes, moderate to high physical activity levels, those living with others and 1 to 3 diseases. Additionally, there's synergistic association between NL and the number of diseases with QOL.

CONCLUSIONS

Our findings underscore that adequate NL is positively associated with better QOL in populations with chronic diseases, and the relationship varied by income, physical activity, living arrangements, and the number of diseases. Focusing on the NL of populations with chronic diseases might help provide a basis for dietary nutrition management and intervention to improve QOL in patients with chronic diseases.

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.

Six-year mortality associated with living alone and loneliness in Swedish men and women born in 1930

BACKGROUND

This study examined how living alone and loneliness associate with all-cause mortality in older men and women.

METHODS

Baseline data from the Gothenburg H70 Birth Cohort Studies, including 70-year-olds interviewed in 2000 and 75-year-olds (new recruits) interviewed in 2005 were used for analyses (N = 778, 353 men, 425 women). Six-year mortality was based on national register data.

RESULTS

At baseline, 36.6% lived alone and 31.9% reported feelings of loneliness. A total of 72 (9.3%) participants died during the 6-year follow-up period. Cumulative mortality rates per 1000 person-years were 23.9 for men and 9.6 for women. Mortality was increased more than twofold among men who lived alone compared to men living with someone (HR 2.40, 95% CI 1.34-4.30). Elevated risk remained after multivariable adjustment including loneliness and depression (HR 2.56, 95% CI 1.27-5.16). Stratification revealed that mortality risk in the group of men who lived alone and felt lonely was twice that of their peers who lived with someone and did not experience loneliness (HR 2.52, 95% CI 1.26-5.05). In women, a more than fourfold increased risk of mortality was observed in those who experienced loneliness despite living with others (HR 4.52, 95% CI 1.43-14.23).

CONCLUSIONS

Living alone was an independent risk factor for death in men but not in women. Mortality was doubled in men who lived alone and felt lonely. In contrast, mortality was particularly elevated in women who felt lonely despite living with others. In the multivariable adjusted models these associations were attenuated and were no longer significant after adjusting for mainly depression in men and physical inactivity in women. Gender needs to be taken into account when considering the health consequences of living situation and loneliness.

Evaluation on the Nutrition Quotient Scores of Elderly People Living Alone in Korea

As the Korean society is aging rapidly, the issues on physical, social, economic, and mental disabilities of single-person households aged 65 years or older has also increased. This study aimed to investigate the nutrition-related dietary conditions of elderly people living alone and determine their dietary behavior by calculating the nutrition quotient for elderly (NQ-E). One hundred and three elderly people living alone who were basic living recipients were recruited from six senior welfare centers in Seoul, and the data were collected using a questionnaire from 19 July 2016 to 17 August 2016, with a 1:1 in-depth interview using the modified version of the NQ-E questionnaire. The data were analyzed using SPSS 27.0 for Mac (IBM Corp., Armonk, NY, USA); a p value of <0.05 was considered significant. The nutrition-related dietary conditions of the elderly living alone were limited, and many of them received support from the government, which helped improve their diet. The nutrition quotient score of the elderly living alone was 50.14, which was lower than the NQ-E mean score (57.6) of the Korean elderly and the NQ-E (62 points), which is the top 25% of the national survey subjects according to the criteria value presented by the Korean Nutrition Society. Elderly people living alone often have poor dietary habits and nutritional status. The NQ-E presented in this study can be used to evaluate the dietary conditions of the elderly and is expected to be used as an indicator for developing community programs for health promotion and evaluating their effectiveness.

The Relationship between Living Arrangements and Sleep Quality in Older Adults: Gender Differences

(1) Background: This study examined the effects of living arrangements on the quality of sleep among older adults and analyzed related gender differences; (2) Methods: A total of 4756 older adults in Seoul were included. After adjusting for socio-demographic factors, older adults living alone showed a poorer sleep quality compared with those living with others; (3) Results: When we analyzed the effects of living arrangements on sleep quality by gender, there was no difference in the risk of poor sleep quality between male older adults living alone and those living with others (OR = 1.089, 95% CI = 0.729–1.628), whereas the risk of poor sleep quality was higher for female older adults living alone than those living with others (OR = 1.359, 95% CI = 1.088–1.696); (4) Conclusions: In this study, we have confirmed that older women living alone had poor sleep quality compared to older men. Hence, gender-based approaches will be helpful when providing social support resources to older adults living alone.

Association of the Healthy Eating Index with Metabolic Abnormalities among Middle-Aged Adults Living in Single-Person Households in Korea

This study aimed to analyze the association between the dietary lifestyles and health outcomes among middle-aged (40-64 years old) and elderly (65 years old and older) individuals living alone using the Korean Healthy Eating Index (KHEI). The study was conducted with 1442 participants (475 men and 967 women) aged 40 years and older living in single-person households using the Korea National Health and Nutrition Examination Survey from 2016 to 2018. The KHEI scores were calculated based on the 24-h recall data of dietary intake. Among women living alone, the total KHEI score of the participants aged 40-64 years was 65.92, which was significantly lower than the 70.66 of those aged 65 years and older (p = 0.0152). In addition, the total score in the adequacy domain was significantly lower among the 40~64-year-old group than those aged 65 years and older (p = 0.0011). Among the elderly in single-person households, the odds of diabetes in the T1 group were 2.08 times higher than those in the T3 group according to the KHEI (95% confidence interval: 1.36-3.17). The results of this study are expected to be used as baseline data to establish nutrition, home meal replacement utilization, and health policies for the elderly living alone.