The Diet Quality of Rural Older Adults in the South as Measured by Healthy Eating Index-2005 Varies by Ethnicity

doi:10.1016/j.jada.2009.09.005

Journal of the American Dietetic Association

Volume 109, Issue 12, December 2009, Pages 2063-2067

https://doi.org/10.1016/j.jada.2009.09.005 Get rights and content

Abstract

The 2005 Dietary Guidelines for Americans publication placed increased emphasis on the importance of consuming a wide range of healthful foods and further reducing the consumption of less healthful ones. These recommendations are challenging for rural elders whose functional limitations, fewer resources, and limited access to foods negatively affect the quality of their diets. The purpose of this study was to characterize the diet quality of a multiethnic population-based sample of older adults (N=635) in the southern United States. Data were collected via home visit; dietary intakes were assessed using a food frequency questionnaire and converted into Healthy Eating Index-2005 (HEI-2005) scores used to monitor adherence to dietary guidelines. The mean total HEI-2005 score was 61.9/100 with fewer than 2% meeting the recommended score of 80/100. After controlling for age, sex, marital status, poverty status, and education, African Americans (n=136) had higher total HEI-2005 scores compared to American Indians (n=195) and non-Hispanic whites (n=304) (64.5 vs 60.1 and 61.1 respectively, P=0.001). Certain HEI-2005 foods were consumed in greater amounts by particular groups, such as total fruit and meat and beans (African Americans), whole fruit and grains (African Americans and American Indians), milk (non-Hispanic whites), and energy from solid fat, alcohol, and added sugars (American Indians). The overall diet quality of these rural elders was not adequate as determined by the HEI-2005; however, intakes of dark green and orange vegetables were adequate, and many participants were in compliance with the added fat and sugar guidelines. Determination of factors that promote or prevent the consumption of healthful foods among rural elders may help tailor nutrition education programs for these vulnerable communities.

Section snippets

Sampling Plan and Recruitment

Between January 2006 and March 2008, the Rural Nutrition and Oral Health Study conducted a cross-sectional survey of the dietary intake of an ethnically diverse (African American, American Indian, and non-Hispanic white) population of older adults in two rural North Carolina counties. Details of sampling and recruitment are presented elsewhere (18).

Individuals were considered eligible if they were aged 60 years or older, spoke English, were able to give informed consent, and were physically

Results and Discussion

The total sample of 635 participants had a mean age of 71.5±0.4 years. Women comprised 54.1% of the sample. More women than men had incomes below the poverty level (36.4% vs 23.2%, P=0.04). Educational attainment did not differ between men and women with 55.7% of the sample having less and 19.8% having more than high school education.

The mean total HEI-2005 score was 61.87±0.72. African Americans had higher total HEI-2005 scores than other groups (Table 2). African Americans consumed more total

Conclusions

Although 98% of these older adults did not meet overall recommendations for a healthful diet, certain populations met recommended guidelines for individual HEI-2005 components. Approximately half of participants did not exceed recommended amounts of solid fats and sugar. Many African Americans reported consuming sufficient whole fruits and many American Indians consumed recommended amounts of whole-grain foods. However, all groups need to increase consumption of non-hydrogenated oils and dairy

M. R. Savoca is an assistant professor, Department of Nutrition, University of North Carolina Greensboro, NC.

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M. R. Savoca is an assistant professor, Department of Nutrition, University of North Carolina Greensboro, NC.

T. A. Arcury is a professor, Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, NC.

R. A. Bell and S. A. Quandt are professors, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC.

X. Leng and H. chen are is assistant professors, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC.

A. Anderson is a biostatistician IV, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC.

T. Kohrman is an associate project manager, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC.

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ResearchResearch and Professional BriefThe Diet Quality of Rural Older Adults in the South as Measured by Healthy Eating Index-2005 Varies by Ethnicity

Abstract

Section snippets

Sampling Plan and Recruitment

Results and Discussion

Conclusions

Am J Prev Med.

Appetite

Am J Clin Nutr.

J Am Diet Assoc.

Addict Behav.

J Am Diet Assoc.

J Aging Studies

Rural healthy people 2010: Identifying rural health priorities and models for practice

J Rural Health

Nutrition and overweight concerns in rural areas

Geriatric Nutrition: The Health Professional's Handbook