Hays Judith C, Keller Heather H, Ostbye Truls
School of Nursing, Duke University, Durham, NC, 27710, USA.
J Nutr Elder. 2005;25(2):41-67. doi: 10.1300/j052v25n02_04.
The purpose of this epidemiological study was to estimate mortality risk associated with poor diet quality (consumption of five food groups), extremes of body mass index (BMI), waist circumference, and impaired food-related activities of daily living among community-dwelling older Black and White men and women. The design of the current study was a retrospective-prospective cohort study. The sample included residents (n = 1920) of five North Carolina Piedmont counties. The dependent variable was four-year all-cause mortality. Analyses were stratified by gender and race, and controlled covariates included: age, living with others, income, smoking and alcohol use, cognitive status, and overall self-rated health. Data were self-reported to interviewers, except BMI and waist, which were measured by trained interviewers. Difficulty in fixing meals elevated the risk of mortality between 2.7 and 6.5 times across the four gender-race groups. Among older adults, inability to fix a meal conferred more risk of mortality than did lack of financial means. Adequate servings of vegetables were uniformly protective, although significant only among Black males. Neither BMI nor waist circumference conferred significant mortality risk. These population-based findings suggest relationships between nutrition risk factors and mortality that are unique and require further focused studies.
这项流行病学研究的目的是评估社区居住的老年黑人和白人男性及女性中,与饮食质量差(五类食物的摄入量)、体重指数(BMI)极端值、腰围以及与食物相关的日常生活活动受损相关的死亡风险。本研究的设计为回顾性-前瞻性队列研究。样本包括北卡罗来纳州皮埃蒙特五个县的居民(n = 1920)。因变量是四年全因死亡率。分析按性别和种族分层,控制的协变量包括:年龄、与他人同住、收入、吸烟和饮酒情况、认知状态以及总体自我健康评分。数据由受访者自行报告,但BMI和腰围由经过培训的访谈员测量。在四个性别-种族组中,做饭困难使死亡风险增加了2.7至6.5倍。在老年人中,无法做饭比经济困难带来的死亡风险更高。充足的蔬菜摄入量具有一致的保护作用,尽管仅在黑人男性中显著。BMI和腰围均未带来显著的死亡风险。这些基于人群的研究结果表明,营养风险因素与死亡之间的关系具有独特性,需要进一步开展针对性研究。