Division of Cancer Control and Population Sciences, Epidemiology and Genomics Research Program, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892, USA.
Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, 20892, USA.
Int J Behav Nutr Phys Act. 2021 May 20;18(1):67. doi: 10.1186/s12966-021-01122-x.
Though a healthy diet is widely associated with reduced risks for chronic disease and mortality, older adults in the U.S. on average do not meet dietary recommendations. Given that few studies have examined the association between meal context on older adult diet quality, the aims of this study were (1) to compare the dietary quality of foods consumed in different meal contexts, as measured by the Healthy Eating Index 2015 (HEI-2015): meal location, the presence of others, and the use of electronic screens; and (2) to examine which components of the HEI-2015 drove differences in HEI-2015 total scores by meal context.
Interactive Diet and Activity Tracking in AARP study participants (50-74 years) completed the Automated Self-Administered 24-h Dietary Assessment tool (ASA24, version 2011) that included foods and beverages consumed and three meal contexts: "at home" versus "away from home," "alone" versus "with company," and "with screen time" versus "without screen time." A population ratio approach was used to estimate HEI-2015 total and component scores for all food items consumed by meal context. Mean HEI-2015 scores (range: 0-100) for the three meal context variables were compared using t-tests. Where there were significant differences in total scores, additional t-tests were used to explore which HEI-2015 components were the primary drivers. All tests were stratified by sex and adjusted for multiple comparisons.
HEI-2015 scores were lower for meals consumed away vs. at home (mean difference (SE), males: - 8.23 (1.02); females: - 7.29 (0.93); both p < 0.0001) and for meals eaten with vs. without company (mean difference (SE), males: - 6.61 (1.06); females: - 7.34 (1.18); both p < 0.0001). There was no difference comparing with vs. without screen time. When HEI-2015 component scores were examined, fewer total fruits, whole grains, and dairy were consumed away from home or with company; more total vegetables and greens and beans, and less added sugars were consumed with company.
Our findings suggest an association between the behavior cues of meal location and companions and dietary choices among older adults. Future studies can explore the individual and interactive effects of meal context on diet quality and subsequent health outcomes.
尽管健康饮食与降低慢性病和死亡率风险广泛相关，但美国的老年人平均无法达到饮食建议。鉴于很少有研究调查用餐环境对老年人饮食质量的影响，本研究的目的是：（1）比较通过 2015 年健康饮食指数（HEI-2015）衡量的不同用餐环境下所摄入食物的饮食质量：用餐地点、是否有他人在场和使用电子屏幕；（2）研究 HEI-2015 总分因用餐环境而产生差异的原因。
参加 AARP 互动式饮食和活动追踪研究的参与者（50-74 岁）完成了自动自我管理的 24 小时饮食评估工具（ASA24，版本 2011），其中包括所摄入的食物和饮料以及三种用餐环境：“在家”与“不在家”、“独自”与“有同伴”和“有屏幕时间”与“无屏幕时间”。采用人口比例法估算了根据用餐环境摄入的所有食物的 HEI-2015 总分和各个组成部分的分数。使用 t 检验比较了三种用餐环境变量的平均 HEI-2015 分数（范围：0-100）。在总分存在显著差异的情况下，进一步使用 t 检验探讨了哪些 HEI-2015 组成部分是主要驱动因素。所有检验均按性别分层，并对多次比较进行了调整。
与在家用餐相比，在外（男性：-8.23（1.02）；女性：-7.29（0.93）；均 p<0.0001）和与同伴一起用餐（男性：-6.61（1.06）；女性：-7.34（1.18）；均 p<0.0001）时的 HEI-2015 评分较低。与有无屏幕时间相比，并无差异。当检查 HEI-2015 成分分数时，在家或与同伴一起用餐时摄入的总水果、全谷物和乳制品较少；与同伴一起用餐时摄入的总蔬菜和绿叶蔬菜及豆类较多，添加糖较少。
我们的研究结果表明，老年人的用餐地点和同伴的行为线索与饮食选择之间存在关联。未来的研究可以探索用餐环境对饮食质量和随后健康结果的个体和交互影响。
