Dietary Patterns and Quality of Life in Older Adults: A Systematic Review
Abstract
:1. Introduction
2. Methods
2.1. Search Strategy
2.2. Inclusion and Exclusion Criteria
2.3. Data Extraction
2.4. Overall Quality of Studies
3. Results
4. Discussion
Strengths and Limitations of This Study
5. Recommendations
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Study and Setting | Study Design | Sample Size | Mean Age 1 | (A)Dietary Intake Assessment (B) Pattern Analysis Method (C) Adjustment Variables | QoL Measure | Results | Study Quality 2 |
---|---|---|---|---|---|---|---|
Woo, J. et al. [66] Hong Kong | Cross sectional | 3378 | 72.5 ± 5.2 | (A):FFQ (B): DQI-I with 4 aspects—variety, adequacy, moderation and overall balance: Range 0–94, high scores better quality (C): Age, sex, socioeconomic status and districts | SF-12 | Better dietary quality is associated with better self-rated physical and mental health. PCS: β = 0.0689 (p < 0.0001) MCS: β = 0.0693 (p < 0.0001) | moderate |
Haveman-Nies et al., SENECA [67] Europe (Belgium, Denmark, Italy, The Netherlands, Portugal, Spain and Switzerland) | Longitudinal | 480 | 72.6 ± 1.6 | (A) Diet history (B) Modified Mediterranean score: Range 0–7, high scores indicate better quality. (C): Age, country | Self-rated health status | No association observed between diet quality and risk of deterioration of health status. Risk of deterioration in health status resulting from low dietary quality: OR (95% CI): Men 1.1 (0.5, 2.3); women 1.4 (0.7, 2.7) | weak |
Schlesinger et al. [68] Northern Germany | Cross sectional | 1389 | 69 (64–73) | (A): 112 item web-based FFQ/ (B): Dietary Index: Two indices namely ’favorable‘ and ’unfavorable‘ were generated (C): Age sex and SES | EORTC QLQ-C30 | Those with a favorable’ diet had a reduced odds of having a low gHRQoL; OR (95% CI): 0.79 (0.63–0.99) | moderate |
Perez-Tasigchana et al., UAM-cohort, & Seniors-ENRICA [22] Spain | Longitudinal | 2376 | ≥60 | (A):14 item paper-based FFQ (B): Mediterranean dietary pattern index (UAM-MDP): Range −2 to 6, low score indicates less healthy diet. (C): Age, sex, level of education, smoking, BMI, physical activity, comorbidities | SF-36 (Spanish version) | No significant association between UAM-MDP and PCS and MCS. | strong |
1911 | ≥60 | (A): Dietary history-Enrica (B): PREDIMED score: Range 0–14 high scores better adherence MDS :Range 0–9 high scores better adherence (C): Age, sex, level of education, smoking, BMI, physical activity, comorbidities | SF-12 | Higher PREDIMED score was associated with slightly better PCS score. Compared to those in the lowest tertile, PCS: b = 0.55 (−0.48 to 1.59) for tertile 2, 1.34 (0.21 to 2.47) for tertile 3PREDIMED score not significantly associated with a better MCS score. [/MCS: tertile 2, b = −0.25 (−1.31 to 0.80) and tertile 3, b = 0.56 (−0.58 to 1.71)] | |||
MDS not associated with PCS or MCS | |||||||
Gopinath et al., BMES [69] Australia | Longitudinal | 895 | 67.1 ± 7.4 | (A): 145 item FFQ (B): Total Diet Score to assess adherence to dietary guidelines for Australian adults: Range 0–20, higher scores better adherence (C): Age, sex, receipt of pension payment, home ownership, admission to hospitals, walking disability, living alone, 5 or more co morbidities, cognitive and visual impairment | SF-36 and FACT-C | Adherence to dietary guidelines at baseline was associated with significantly better QoL in four domains after 5 years. Participants in the highest vs. lowest quartile of baseline total diet scores had adjusted mean scores 5.6, 4.0, 5.3, and 2.6 units higher in these SF36 domains 5 years later | moderate |
Milte et al., WELL [70] Australia | Longitudinal | 2457 | 59.9 (65–55) | (A): 111 item FFQ (B): DGI: Range 0–130 higher scores reflect greater compliance with dietary guidelines RFS: Range 0–49, with higher scores associated with greater diet quality MDS: Range 0–8, higher scores reflecting greater adherence to Mediterranean diet. (C): Model 1: adjusted for age, sex, education and urban/rural location. Model 2: additionally adjusted for smoking and total physical activity. Model 3: additionally adjusted for BMI | RAND 36 | Older adults with better quality diets report better health-related QoL, with additional associations with emotional wellbeing observed in women. Better diet quality by DGI was associated with better self-reported HRQoL on the physical function (OR = 1.56, 95% confidence intervals (CI): 1.22–1.99), bodily pain (OR = 1.29, CI: 1.01, 1.63), general health (OR = 1.72, CI: 1.36, 2.19), energy (OR = 1.51, CI: 1.19, 1.92), emotional wellbeing (OR = 1.36, CI: 1.08, 1.72) and PCS (OR = 1.46, CI: 1.15, 1.86). | strong |
A higher RFS was associated with better HRQoL on the physical function (OR = 1.43, CI: 1.13–1.82), general health (OR = 1.41, CI: 1.12, 1.78), energy (OR = 1.55, CI: 1.22, 1.96) and emotional wellbeing (OR = 1.41, CI: 1.12, 1.77) | |||||||
MDS score in the top quartile was associated with a better score on the energy scale (OR = 1.53, CI: 1.11, 2.10). An association between MDS and general health was also observed after adjustment for smoking and physical activity (OR = 1.52, CI: 1.11, 2.08) | |||||||
Zaragoza-marti et al. [71] Spain | Cross sectional | 351 | 71.06 | (A): MEDIS-FFQ (B): MDS: Range 0–9, higher the score higher the adherence (C): Age, hours of physical activity, educational level, BMI, blood cholesterol, blood glucose levels and blood pressure | SF 12 | Adherence to MD is positively related to both PCS and MCS of SF12 for both sexes. Regression coefficients for the relationship between Mediterranean diet score with women (MCS (0.07, CI:(−0.96–0.23, p < 0.001) and PCS (0.19, CI (0.04–0.34, p = 0.020)) and men (MCS (0.01, CI: −0.12–0.29, p = 0.004 and PCS (0.05, CI: 0.17–0.20, p = 0.060)) | moderate |
Veronese et al., Osteoarthritis Initiative [21] United States | Cross sectional (sub study of a large longitudinal study) | 4470 | 61.3 ± 9.2 | (A): 77 item Block brief 2000 FFQ (B): Modified MDS: Range: 0–55 high scores better adherence (C): Age, sex, race, BMI, education, smoking status, total energy intake, Charlson co morbidity index, use of analgesic drugs, annual income | SF-12 | Higher adherence to med diet is associated with better QOL. Those with higher aMED showed significantly higher PCS (quintile 5: 50 ± 8.5 compared to quintile 1: 47.2 ± 9.8; p < 0.0001) and MCS (quintile 5: 54.5 ± 7.6 compared to quintile 1: 53.2 ± 8.8; p < 0.0001) | moderate |
Lewis et al. [72] United States | Longitudinal | 265 | 64.5 ± 10.3 (Caucasians)/60.7 ± 10.2 (African American) | (A): 44 item Diet history questionnaire (B): Dietary index scored from −30 to 30 Higher scores better adherence. (C): Age, sex, follow up time, education, Socio economic factors, BMI, alcohol consumption, smoking and physical activity | SF-12 | Subjects who improved dietary quality exhibited positive changes in QOL-significant changes observed in functional wellbeing (0.14, CI: 0.05–0.07, p ≤ 0.01), functional assessment of cancer therapy-general total score (0.19, CI: 0.01, 0.37, p = 0.04) and Physical composite score of SF12 (0.23,CI: 0.05–0.41, p = 0.01) | strong |
Alcubierre et al. [73] Spain | Cross sectional | 294 (146 DR and 148 NDR) | No Diabetic retinopathy: 57.9 ± 10.3 | (A) Semi quantitative FFQ 101 items (B): rMED: Range, 0–18 Adherence was rated as low (0–6), medium (7–10) and high (11–18) (C):Adjustments varied for different components of the QoL domain and included age, ethnicity, insulin treatment, retinopathy, diabetes duration another diabetes related factors | ADDQOL-19 | rMED was significantly associated with HRQOL dimensions of travels, self-confidence, freedom to eat and freedom to drink. rMED > 8, positively associated with self confidence (p = 0.015), freedom to eat 0.839 (p = 0.037) and freedom to drink 1.150 (p = 0.015) | moderate |
Diabetic retinopathy: 60.5 ± 8.8 | |||||||
Rifai et al. [65] United States | Randomised controlled trial | 48 | DASH group (60) and comparison group (64) | (A): FFQ/food diaries (B): DASH diet index: Range 0 to 11, with higher scores indicating higher levels of concordance. (C): N/A | MLHF | Adhering to the DASH diet improved QoL scores at 3 months; improved MLHFQ scores at 3-month follow-up (21 vs. 39; p = 0.006) | strong |
Sanchez-Aguadero et al. MARK study [74] Spain | Longitudinal | 314 | 61.1 ± 8.4 (35–74) | (A): FFQ with 18 food groups divided into three categories (B): DQI: Range 18–54, with higher scores associated with better diet quality. aMED: Score ≥ 5 meaning good compliance (C): Age, sex, hypertension, dyslipidaemia and Charlson Comorbidity Index | Spanish version of the SF-12 v.2 | In those at intermediate cardiovascular risk, DQI was directly related to the mental component score (r = 0.127, p < 0.05) and mental health (r = 0.121, p < 0.05), in bivariate analyses | moderate |
Greater adherence to the Mediterranean diet was associated with higher scores on the SF-12 mental component, social functioning and vitality and DQI showed an association with the mental component score. Bivariate correlation: The Mediterranean Diet (total score) was related to the mental component (r = 0.164, p < 0.01) as well as social functioning (r = 0.172, p < 0.01) and vitality (r = 0.122, p < 0.05). Multiple linear regression: 1.177 point increase in the mental component for each increase of 1 point in the Mediterranean diet adherence score (p < 0.01), Vitality (β = 0.958 and 0.990) and Social Functioning (p < 0.05 and p < 0.01) domains maintained association post adjustments. | |||||||
Mosher et al., RENEW [75] United States, UK and Canada | Cross sectional | 641 | 73 ± 5 | (A): 24 h dietary recalls (B): HEI05: Range 0–100 with scores above 80 indicating good diet quality. (C): age, race, level of education, and number of comorbidities | SF-36 | Diet quality was positively associated with physical functioning (β = 0.10, Ps < 0.005) and vitality (β = 0.095, Ps = 0.01) | moderate |
Ford et al., GRAS [76] United States | Cross sectional | 4009 | Males: 81.3 ± 4.2, Females: 81.5 ± 4.5 | (A): DST (B): HEI 05: Range :0–100 (<60 considered “unhealthy”, 60–75 “borderline”, and >75 “healthy”) (C): BMI, disease burden, sex, education, age, smoking status, living situation and self-vs. proxy report | HALex | Poor diet quality, as assessed by the DST, is associated with lower HRQoL. HALex scores were significantly lower for participants with dietary intakes categorized as unhealthy (<60) (0.70, 95% CI 0.69, 0.72, p < 0.05) or borderline (60–75) (0.71, 95% CI 0.70, 0.73, p < 0.05) compared to those scoring in the healthy range (>75) (0.75, 95% CI 0.73, 0.77). | moderate |
Sameiri et al., Three City Study [77] France | Cross-sectional | 1724 | 76.0 ± 4.9 | (A): 148 item FFQ (B): Mixed method combining hybrid clusters to derive sex-specific dietary patterns. Five dietary patterns were identified in men and women each. (C): Sociodemographic variables, and comorbidities | Self-rated health status | Men in the “pasta eaters” cluster had greater risk of reporting poor health (odds ratio [OR] 1.91; 95% CI, 1.21–3.01) than the “healthy” cluster. Women in the “biscuits and snacking” cluster (n = 162; 15%) had greater risk of poor perceived health (OR 1.69; 95% CI, 1.15–2.48) compared to “healthy” eaters. | moderate |
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Govindaraju, T.; Sahle, B.W.; McCaffrey, T.A.; McNeil, J.J.; Owen, A.J. Dietary Patterns and Quality of Life in Older Adults: A Systematic Review. Nutrients 2018, 10, 971. https://doi.org/10.3390/nu10080971
Govindaraju T, Sahle BW, McCaffrey TA, McNeil JJ, Owen AJ. Dietary Patterns and Quality of Life in Older Adults: A Systematic Review. Nutrients. 2018; 10(8):971. https://doi.org/10.3390/nu10080971
Chicago/Turabian StyleGovindaraju, Thara, Berhe W. Sahle, Tracy A. McCaffrey, John J. McNeil, and Alice J. Owen. 2018. "Dietary Patterns and Quality of Life in Older Adults: A Systematic Review" Nutrients 10, no. 8: 971. https://doi.org/10.3390/nu10080971