Vitolins Mara Z, Tooze Janet A, Golden Shannon L, Arcury Thomas A, Bell Ronny A, Davis Cralen, Devellis Robert F, Quandt Sara A
Department of Biostatistical Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
J Am Diet Assoc. 2007 Feb;107(2):265-272. doi: 10.1016/j.jada.2006.11.009.
To evaluate diet quality of rural older adults using national dietary guidelines and the Healthy Eating Index (HEI).
Five to six 24-hour recalls were conducted at monthly intervals over a 6-month period, using the Nutrition Coordinating Center food grouping system to calculate intake.
Included in this cross-sectional study were 63 females and 59 males aged 65 to 93 years residing in two rural North Carolina counties; one third of each sex group was African American, Native American, or white. Inclusion criteria included age>65 years, education<or=12 years, and low income.
HEI scores were computed from the average of the recalls, and compared using one-way analysis of variance. Multiple regression modeling was utilized to evaluate effects of demographic and self-reported health variables on HEI score.
Most study participants did not meet minimum Food Guide Pyramid recommended servings of grains, fruits, vegetables, and dairy. They exceeded recommendations for discretionary calorie servings (median=3.3 and 5.3 for females and males, respectively). Using the HEI, 24% had poor diets, 75% needed improvement, and only 1% had good diets. Of the participants with an eighth-grade education or less, men had a mean HEI score 9.6 units lower than women.
These rural adults are not meeting recommended nutrition guidelines, and most are consuming diets considered poor or needing improvement. Health care providers should recognize barriers that put these older adults at risk for poor nutrition and should be prepared to initiate referrals to community resources. Nutrition counseling should include strategies to increase whole grain, fruit, vegetable, and reduced-fat dairy consumption with the ultimate goal of improving dietary intake to prevent declines in functional status and independence associated with aging.
运用国家膳食指南和健康饮食指数（HEI）评估农村老年人的饮食质量。
在6个月的时间里，每月进行5至6次24小时饮食回顾，使用营养协调中心的食物分类系统计算摄入量。
这项横断面研究纳入了居住在北卡罗来纳州两个农村县的63名女性和59名男性，年龄在65至93岁之间；每个性别组的三分之一为非裔美国人、美洲原住民或白人。纳入标准包括年龄>65岁、教育程度≤12年且收入较低。
根据饮食回顾的平均值计算HEI得分，并使用单因素方差分析进行比较。利用多元回归模型评估人口统计学和自我报告的健康变量对HEI得分的影响。
大多数研究参与者未达到食物指南金字塔推荐的谷物、水果、蔬菜和乳制品摄入量。他们超过了自由支配卡路里摄入量的建议（女性和男性的中位数分别为3.3和5.3）。使用HEI评估，24%的人饮食质量差，75%的人需要改善，只有1%的人饮食质量好。在八年级及以下教育程度的参与者中，男性的平均HEI得分比女性低9.6分。
这些农村成年人未达到推荐的营养指南，大多数人的饮食被认为质量差或需要改善。医疗保健提供者应认识到使这些老年人面临营养不良风险的障碍，并应准备好将他们转介至社区资源。营养咨询应包括增加全谷物、水果、蔬菜和低脂乳制品消费的策略，最终目标是改善饮食摄入量，以防止与衰老相关的功能状态下降和独立性丧失。
