Diabetes nutrition education programs should increase awareness of eating history, spousal support, and time management practices. Future research should include the refinement and validation of a nutritional management model of diabetes.

No abstract

Objective: Poor oral health influences the dietary quality of older individuals. The objective of the present study was to relate the number of teeth to adherence to the 2005 Dietary Guidelines for Americans among an ethnically diverse sample of older adults. Design: A block cluster design was used to obtain a sample of older adults. Data were weighted to census data for ethnicity and gender. Dietary intakes were assessed using an FFQ and converted into Healthy Eating Index-2005 (HEI-2005) scores. Setting: Two counties in North Carolina, USA, with large African-American and American Indian populations. Subjects: Community-dwelling older adults (N 635). Results: Three hundred and twenty-six participants had severe tooth loss (0-10 teeth remaining), compared with 305 participants with 111 teeth. After controlling for socio-economic factors, those with 0-10 teeth had lower total HEI-2005 scores and consumed less Total Fruit, Meat and Beans, and Oils, and more energy from Solid Fat, Alcohol and Added Sugar, compared with those with 111 teeth. Less than 1 % of those with 0-10 teeth and 4 % of those with 111 teeth met overall HEI-2005 recommendations. Those with 0-10 teeth were less likely to eat recommended amounts of Total Vegetables, Dark Green and Orange Vegetables, and energy from Solid Fat, Alcohol and Added Sugar. Conclusions: Older adults with severe tooth loss are less likely than those with moderate to low tooth loss to meet current dietary recommendations. Nutrition interventions for older adults should take oral health status into consideration and include strategies that specifically address this as a barrier to healthful eating.

Food services for older adults should consider their oral health status. Policy changes are needed to provide oral health care in benefits for older adults.

OBJECTIVES 1) quantify the association between food avoidance and modification due to oral health problems; 2) quantify the relationship between these nutritional self-management strategies and dietary quality; and 3) determine foods associated with these self-management strategies. DESIGN Cross-sectional SETTING Rural North Carolina PARTICIPANTS Six hundred thirty-five community-dwelling adults aged 60 years and older. MEASUREMENTS Demographic and food frequency data and oral health assessments were obtained during home visits. Avoidance (none, 1–2 foods, 3–14 foods) and modification (0–3 foods, 4–5 foods) was assessed for foods representing oral health challenges. Food frequency data were converted into Healthy Eating Index-2005 (HEI-2005) scores. Linear regression models tested the significance of associations between HEI-2005 measures and food avoidance and modification. RESULTS Thirty-five percent of the sample avoided 3–14 foods and 28% modified 4–5 foods. After adjusting for age, sex, ethnicity, poverty, education, and tooth loss, the total HEI-2005 score was lower (P<0.001) for persons avoiding more foods and higher for persons modifying more foods (P<0.001). Those avoiding 3–14 foods consumed more saturated fat and energy from solid fat and added sugar and lower intake of non-hydrogenated fats than those avoiding <3 foods. Those who modified 4–5 foods consumed less saturated fat and solid fat and added sugar but more total grains than those modifying <4 foods. CONCLUSION Food avoidance and modification due to oral health problems are associated with significant differences in dietary quality. Approaches to minimize food avoidance and promote food modification by persons having eating difficulties due to oral health conditions are needed.