Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
J Am Geriatr Soc. 2021 Apr;69(4):964-971. doi: 10.1111/jgs.16971. Epub 2021 Jan 5.
BACKGROUND/OBJECTIVES: Food insecurity has emerged as a critical health issue for older adults. Food insecurity has been shown to disrupt healthy eating patterns, but these associations have not been widely studied among older adults. The objectives of the present study were to: (1) examine national trends in food insecurity across a 10-year period, and (2) evaluate the associations between food insecurity and multiple diet quality indices in a recent and nationally representative sample of adults aged 60 or older.
Cross-sectional analysis of the 2007-2016 National Health and Nutrition Examination Surveys.
Nationally representative sample of the United States.
The analytic sample was comprised of 5,097 adults aged 60 or older, with household incomes at or below 300% of the federal poverty level.
Household food security was measured using the 18-item US Household Food Security Survey Module. Diet was assessed using two 24-hour dietary recalls. Multivariate linear and logistic regression models examined the associations between household food security and three evidence-based diet quality indices, adjusting for sociodemographic and health characteristics.
Across the 10-year period, food insecurity increased significantly from 5.5% to 12.4% among older adults; this increase was more pronounced among lower-income older adults. From the linear regression models, food insecurity was associated with lower scores on the Healthy Eating Index (β = -1.90, 95% confidence interval (CI) = -3.70, -0.09), the Alternate Healthy Eating Index-2010 (β = -1.47, 95% CI = -2.51, -0.44), and the Mediterranean Diet Score (β = -0.54, 95% CI = -1.06, -0.01) after multivariate adjustment. Further adjustment for the presence of chronic medical conditions did not attenuate these results.
Food insecurity is associated with lower overall diet quality among older adults, supporting the need for clinical efforts to identify those at risk of food insecurity and public health efforts to alleviate food insecurity and promote healthy eating behaviors among older adults.
背景/目的：食物不安全已成为老年人的一个关键健康问题。食物不安全已被证明会扰乱健康的饮食习惯，但这些关联在老年人中尚未得到广泛研究。本研究的目的是：（1）在 10 年期间检查食物不安全的全国趋势，以及（2）在最近和全国代表性的 60 岁或以上成年人样本中评估食物不安全与多种饮食质量指数之间的关联。
2007-2016 年全国健康与营养调查的横断面分析。
美国全国代表性样本。
分析样本由 5097 名年龄在 60 岁或以上、家庭收入在联邦贫困线的 300%或以下的成年人组成。
家庭食物安全使用 18 项美国家庭食物安全调查模块进行测量。饮食通过两次 24 小时饮食回忆进行评估。多变量线性和逻辑回归模型检查了家庭食物安全与三个基于证据的饮食质量指数之间的关联，同时调整了社会人口统计学和健康特征。
在 10 年期间，老年人的食物不安全率从 5.5%显著上升到 12.4%；这一增长在低收入老年人中更为明显。从线性回归模型来看，食物不安全与健康饮食指数（β=-1.90，95%置信区间（CI）=-3.70，-0.09）、替代健康饮食指数-2010（β=-1.47，95%CI=-2.51，-0.44）和地中海饮食评分（β=-0.54，95%CI=-1.06，-0.01）的得分较低有关，经多变量调整后。进一步调整慢性疾病的存在并没有减弱这些结果。
食物不安全与老年人整体饮食质量较低有关，这支持了临床努力识别那些有食物不安全风险的人和公共卫生努力缓解食物不安全和促进老年人健康饮食行为的必要性。
