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

Savoca, Margaret R.; Arcury, Thomas A.; Leng, Xiaoyan; Bell, Ronny A.; Chen, Haiying; Anderson, Andrea; Kohrman, Teresa; Quandt, Sara A.

doi:10.1016/j.jada.2009.09.005

Cited by 60 publications

(79 citation statements)

References 24 publications

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“…Differences may be related to access, familiarity, and preference. Rural, low-income residents’ limited access to healthy foods has been documented throughout North America (Gittelsohn and Sharma 2009; Larson, Story, and Nelson 2009; Savoca et al 2009; Sharkey, Johnson, and Dean 2010). Gittelsohn and Sharma (2009) and Dillinger et al (1999) documented the food environments in rural American Indian reservation communities as dependent on small convenience type stores and gas stations that sell canned and packaged food and fast food, and as having moderate availability of fresh produce.…”

Section: Discussionmentioning

confidence: 99%

Demographic characteristics and food choices of participants in the Special Diabetes Program for American Indians Diabetes Prevention Demonstration Project

et al. 2014

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Objective American Indians and Alaska Natives (AI/ANs) suffer a disproportionate burden of diabetes. Identifying food choices of AI/ANs at risk of type 2 diabetes, living in both rural and urban settings, is critical to the development of culturally relevant, evidence-based education strategies designed to reduce morbidity and mortality in this population. Design At baseline, 3135 AI/AN adults participating in the Special Diabetes Program for American Indians Diabetes Prevention Demonstration Project (SDPI-DP) completed a socio-demographic survey and a 27-item food frequency questionnaire (FFQ). The primary dietary behavior goal of SDPI-DP education sessions and lifestyle coaching is changes in food choices, i.e., increased fruits, vegetables and whole grains, decreased high sugar beverages, red meat, and processed foods. Subsequently, program assessment focuses on changes in food types. Foods were delineated using a ‘healthy’ and ‘unhealthy’ classification as defined by the educators advising participants. Urban and rural differences were examined using χ2 tests and two sample t-tests. Multiple linear regressions and linear mixed models were used to assess the association between socio-demographic factors and food choice. Results Retired participants, those living in urban areas and with high income and education selected healthy foods most frequently. Young males, those with low income and education consumed unhealthy foods most frequently. Selection of unhealthy foods did not differ by urban and rural setting. Conclusions The ubiquitous nature of unhealthy food choices makes them hard to avoid. Food choice differences by gender, age, income, and setting suggest that nutrition education should more effectively target and meets the needs of young AI/AN males.

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Section: Discussionmentioning

confidence: 99%

Demographic characteristics and food choices of participants in the Special Diabetes Program for American Indians Diabetes Prevention Demonstration Project

et al. 2014

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“…However, older Americans increasingly have a poor diet. 8,9 Compared to older White women, older Black women carry a disproportionally higher burden of cardiometabolic diseases 10 and related risk factors. 11,12 To formulate effective interventions, a thorough understanding of the racial differences in determinants of dietary behaviors is fundamental.…”

Section: Introductionmentioning

confidence: 99%

Racial differences in eating patterns and food purchasing behaviors among urban older women

Youssef

Procter-Gray

et al. 2017

The Journal of nutrition, health and aging

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Objectives To examine differences in diet and food purchasing behaviors between Black and White older women living in urban neighborhoods. Design Cross-sectional observational study. Setting Urban neighborhoods in Washington, DC, USA. Participants Community-dwelling White and Black women of age 65 and older. Measurements Participants were queried on diet via 24-hour recalls, food purchasing habits, their use of neighborhood resources and local travel patterns. Frequency and location of self-reported food purchasing and consumption were compared by race. Results In 2014 and 2015, 49 White and 44 Black older women were enrolled in the study. Compared to Whites, Blacks reported lower daily caloric intake (mean (SD) 1314 (404) vs. 1529 (448), p=0.02), with a higher percent of calories from protein and fat 1.8 (7.0), p=0.03), and a slightly higher polyunsaturated to saturated fat ratio (p=0.05). Blacks had substantially lower healthy eating index (HEI) (33.5 (10.2) vs. 43.9 (10.8) of 80 possible points, p<0.001), daily intake (grams) of total fiber (15.3 (8.1) vs. 22.9 (8.5), p<0.001), insoluble fiber (10.8 (6.9) vs. 15.9 (6.5), p<0.001), and soluble fiber (4.5 (2.0) vs. 6.9 (2.8), p<0.001). Blacks had lower intake of micronutrients, alcohol and caffeine. Blacks shopped for groceries less often (4.4 (3.0) vs. 6.2 (3.0) monthly; p=0.006) and spent a longer time traveling to stores (15.8 (9.1) vs. 11.5 (7.2) minutes per trip, p=0.02). A lower percent of Blacks walked to stores (14% vs. 40%, p=0.003) and a higher percent of Blacks rode in a car with someone else (33% vs. 6%, p<0.001). Conclusions In an urban setting, food consumption and purchasing behaviors differed substantially between older Black and White women, which should be further investigated and considered to promote healthy eating in older populations.

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“…Meal staple foods delivered two thirds of mean total fat intake of all participants, mainly from animal foods (meat, poultry, and egg-based dishes as well as milk, yoghurt, cheese and cream-based dishes combined). Other studies have noted similar high intakes of meats and milk in Western populations [28,29]. However, a large proportion (34%) of all dietary fat consumed by the current study participants was from non-core 'extra foods', mainly from high calorie, high fat snack-type foods including biscuits, cake, chocolate, crisps, ice cream.…”

Section: Discussionmentioning

confidence: 39%

Optimizing dietary fat in a weight-loss trial requires advice based on a structured “whole-of-diet” model

2011

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Dietary trials may link macronutrient intakes to health outcomes, but adherence to dietary targets requires advice based on an understanding of food composition and consumption patterns. Using data from a weight loss trial, we hypothesized that structured advice would be required for significant fat modification to occur. We compared participants' food choice patterns in response to advice based on a structured "whole-of-diet" model vs a general approach to healthy eating. Overweight participants (n = 122) were randomized to 2 advice arms (saturated fat [SFA] < 10% energy [E]): (1) general low fat (LF) control-(a) isoenergy, (b) −2000 kJ; and (2) structured LF high polyunsaturated fat (PUFA) (∼10% energy PUFA; PUFA to SFA ratio ≥1) (LF-PUFA)-(a) isoenergy, (b) −2000 kJ. Intakes of E and fat and fat from food groups (percentage of total fat intake) were compared at baseline, 3 months, P < .05. Baseline diets were similar, with most fat from high-SFA foods (59%): meat and milk-based staple meals and high-fat snacks. By 3 months, all groups reduced E and met the SFA target. Polyunsaturated fat targets were met by the LF-PUFA groups only (P < .001), enabling targeted between-group differences. In response to general advice, LF groups simply switched to LF alternatives of the same foods (P < .05). In comparison, LF-PUFA groups shifted fat intake to high-PUFA choices (54%), consuming more fat than controls from nuts (P < .001), whole grains (P < .001), and oils and spreads (P < .05). Significant reductions in E were achieved regardless of advice, but significant shifts in dietary fat profile relied on structured whole-of-diet advice on a range of meal and snack food sources of fat subtypes. KeywordsMacronutrients, fat type, food choice, food patterns, randomized controlled trial This article was originally published as: Ross, L. J., Tapsell, L. C. & Probst, Y. (2011). Optimizing dietary fat in a weight-loss trial requires advice based on a structured "whole-of-diet" model. Nutrition Research, 31 (9), 683-690. between-group differences for comparison. In response to general advice, LF groups simply switched to low fat alternatives of the same foods (p<0.05). In comparison, LF-PUFA groups shifted fat intake to high PUFA choices (54%), consuming more fat than LF controls from nuts (p<0.001), whole grains (p<0.001), oils, spreads (p<0.05).Significant reductions in energy were achieved regardless of advice, but significant shifts within the dietary fat profile relied on structured whole diet advice on a range of meal and snack food sources of fat sub-types.

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

Cited by 60 publications

References 24 publications

Demographic characteristics and food choices of participants in the Special Diabetes Program for American Indians Diabetes Prevention Demonstration Project

Demographic characteristics and food choices of participants in the Special Diabetes Program for American Indians Diabetes Prevention Demonstration Project

Racial differences in eating patterns and food purchasing behaviors among urban older women

Optimizing dietary fat in a weight-loss trial requires advice based on a structured “whole-of-diet” model

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