Unidad de Investigación de Atención Primaria-OSIs Gipuzkoa, Osakidetza, 20014 San Sebastián, Spain.
Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), 48902 Barakaldo, Spain.
Nutrients. 2018 Mar 24;10(4):406. doi: 10.3390/nu10040406.
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 ( = 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 ( = 392). Three groups of individuals are identified: cluster one ( = 285), cluster two ( = 194) and cluster three ( = 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.
越来越多的人认识到，饮食模式而非单一食物或营养素对健康结果的影响。本横断面研究调查了来自西班牙吉普斯夸省（Gipuzkoa）的 527 名非住院、功能独立的 70 岁以上老年人的饮食模式。收集了社会人口统计学特征、健康状况、人体测量学指标和饮食数据。采用多元对应分析（MCA）和聚类分析来确定饮食模式和个体群体。MCA 中包括了选定食物的频率和对食物建议的遵守情况。该样本人群中相当大比例的人超重或肥胖，而只有 3.3%有营养不良的风险（用 Mini Nutritional Assessment 确定）。虚弱个体（n=130），用计时起立行走测试（Timed-Up and Go test）测量，他们更年长、教育程度较低、更肥胖、健康状况较差（有更多的抑郁症状、多种药物治疗和跌倒等），对食物建议的遵守情况也较差，比强壮个体（n=392）更差。确定了三个个体群体：群体一（n=285）、群体二（n=194）和群体三（n=48）。从群体一到群体三，观察到虚弱程度和健康状况恶化的梯度增加。后者还表现出最糟糕的饮食模式，就饮食建议而言。使用易于使用的工具来评估饮食可以检测到三个群体之间的差异。需要提高对初级保健环境中营养筛查和随后的饮食评估的认识，为老年人，特别是虚弱个体提供营养护理。
