Hata Toshiki, Seino Satoshi, Tomine Yui, Yokoyama Yuri, Nishi Mariko, Narita Miki, Hida Azumi, Shinkai Shoji, Kitamura Akihiko
Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology.
Department of Food and Nutritional Science, Graduate School of Applied Bioscience, Tokyo University of Agriculture.
Nihon Koshu Eisei Zasshi. 2021 Jul 20;68(7):477-492. doi: 10.11236/jph.20-125. Epub 2021 Apr 26.
Objectives This study examined the effects of checking the "Tabepo Check Sheet," which has 10 food groups, on changes in dietary variety among older adults living in Japanese metropolitan areas.Methods We used baseline and two-year follow-up data from a community-wide intervention to prevent frailty in Ota City, Tokyo. A total of 8,635 non-disabled residents (4,145 men and 4,490 women) aged 65-84 years who responded to the self-administered questionnaire surveys in 2016 and 2018, were included in the two analyses. In 2018, we asked about their experience with the "Tabepo Check Sheet," which had been distributed among participating communities from three districts in Ota City since July 2017. The "checked group" consists of those who answered "habitually check" or "have checked." Dietary variety was assessed using the Dietary Variety Score (DVS). We performed propensity score matching with a 1:1 ratio (checked group vs. non-checked group) for the following variables: demographic, socioeconomic, physical, medical, and lifestyle variables, and DVS. After propensity score matching, 876 participants from the checked and non-checked groups were selected. We used a two-way ANOVA to examine the changes in DVS over two years. We also compared the rates of DVS ≤3 and ≥7 points in 2018 using multivariate adjusted logistic regression analysis.Results In 2018, 11.9% of the respondents had checked the "Tabepo Check Sheet." The DVS mean±standard deviation in the checked and non-checked groups were 3.9±2.2 points and 3.9±2.3 points in 2016, respectively, and 4.5±2.4 points and 4.1±2.4 points in 2018, respectively. The DVS showed a significant interaction between checking experience and time (p<0.001). The rates of DVS ≤3 points in 2018 were 35.2% and 43.8% among the checked and non-checked groups, respectively. The multivariate adjusted odds ratio (OR) of DVS ≤3 points was 0.68 (95% confidence interval [95% CI] 0.56-0.83) in the checked group versus the non-checked group. The rates of DVS ≥7 points in 2018 were 21.7% and 16.8% among the checked and non-checked groups, respectively. The multivariate adjusted OR (95% CI) of DVS ≥7 points was 1.40 (1.10-1.78) in the checked versus the non-checked group.Conclusions These results suggest that checking the "Tabepo Check Sheet" may improve dietary variety. However, the effects of dietary variety improvement may be weakened by the incidence of skipped meals, social isolation, frailty, and lack of social participation.
目的 本研究调查了查看包含10个食物类别的“Tabepo检查表”对日本大都市地区老年人饮食多样性变化的影响。
方法 我们使用了东京大田区一项预防身体衰弱的社区干预的基线数据和两年随访数据。共有8635名65 - 84岁的非残疾居民（4145名男性和4490名女性）参与了2016年和2018年的自填式问卷调查，并纳入两项分析。2018年，我们询问了他们使用“Tabepo检查表”的情况，该检查表自2017年7月起在大田区三个地区的参与社区中分发。“检查组”包括回答“经常检查”或“已经检查过”的人。饮食多样性通过饮食多样性得分（DVS）进行评估。我们对以下变量进行了1:1比例的倾向得分匹配（检查组与未检查组）：人口统计学、社会经济、身体、医疗和生活方式变量以及DVS。倾向得分匹配后，从检查组和未检查组中各选取了876名参与者。我们使用双向方差分析来研究两年内DVS的变化。我们还使用多变量调整逻辑回归分析比较了2018年DVS≤3分和≥7分的比例。
结果 2018年，11.9%的受访者查看过“Tabepo检查表”。2016年，检查组和未检查组的DVS均值±标准差分别为3.9±2.2分和3.9±2.3分，2018年分别为4.5±2.4分和4.1±2.4分。DVS在检查经历和时间之间存在显著交互作用（p<0.001）。2018年，检查组和未检查组中DVS≤3分的比例分别为35.2%和43.8%。与未检查组相比，检查组中DVS≤3分的多变量调整优势比（OR）为0.68（95%置信区间[95%CI]0.56 - 0.83）。2018年，检查组和未检查组中DVS≥7分的比例分别为21.7%和16.8%。与未检查组相比，检查组中DVS≥7分的多变量调整OR（95%CI）为（1.10 - 1.78）。
结论 这些结果表明，查看“Tabepo检查表”可能会改善饮食多样性。然而，饮食多样性改善的效果可能会因不规律饮食、社会隔离、身体衰弱和缺乏社会参与而减弱。
