Osteoporosis, Activities of Daily Living Skills, Quality of Life, and Dietary Adequacy of Congregate Meal Participants
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design, Ethics, and Population
2.2. Study Variables
- Level of dietary adequacy was considered as servings per day: under, at, or over the dietary guidelines’ recommendations for older adults for meat/protein-group (eggs, tofu, beans, seeds, fish, and other meats), grains, dairy, total fruit and vegetable intake, and dessert. Dessert is not considered a major food group; albeit, it is considered as discretionary calories along with added sugars, solid fats, and alcohol. For persons eating from 1000 to 1600 calories, only 100 to 170 calories per day remain for discretionary calories [15]. This would be approximately a half-portion of dessert a day, not considering other discretionary calories.
- Dietary recommendations for adults >50 years of age from each food group are as follows: 3.5 and 4.0 servings of fruits and vegetables; eight and nine servings of grain; five and 5.5 servings from the protein group; for women and men, respectively; and, three servings of dairy for both sexes [11].
- Dietary information was collected by interviewers who were trained in interpreting participants’ responses to type and amount of food consumed by probing interview questions sufficient to collect these details. They were asked to consider the foods they usually eat in a day. They could answer independently or with the help of their caretaker. The specific food group was presented. The following is an example of the script: “Considering all the food {you eat/s/he eats} in a day, how many servings of fruit {do you/does NAME OF PARTICIPANT} usually eat? One serving of fruit is one piece of fruit; one-half cup chopped, cooked, or canned fruit; or three-fourths cup of juice”.
- Difficulty with activities of daily living (ADL) skills were assessed by an affirmative response to questions concerning dressing, shopping, cooking, cleaning, and other physical activities.
- Physical health interfering with physical function was assessed by the question: “during the past four weeks, how much of the time have you accomplished less than you would like as a result of your physical health?”. The categories were collapsed into: all or most of the time, some of the time, and little or none of the time. This question is part of the Medical Outcome Study, RAND 36-item Short Form Survey Instrument [16].
- Self-rated health (SRH) was assessed based on the question: “in the past 12 months how would you rate your health?” Responses were collapsed from five categories (excellent, very good, good, fair, or poor) to three (fair/poor, good, or very good/excellent). SRH has been validated against actual health in older adults, and it is an independent predictor of mortality [17,18,19]. This question is also part of the Medical Outcome Study, RAND 36-itm Short Form Survey Instrument [16].
- Race/ethnicity was constructed by coding the responses for Hispanic and subtracting Hispanics from other categories to create non-Hispanic Whites, non-Hispanic Blacks, Hispanics, and Others (including Asians, American Indians, and Pacific Islanders).
- Other variables included activities at the site (attending nutrition education, exercising at the site, and receiving a health screenings); self-reported diabetes; education level; sex; marital status; food security (having or not having enough money to buy food), and low income (income < $20,000 per year).
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Acknowledgments
Conflicts of Interest
References
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Variable | Percent (95th CI) | Unweighted Numbers | p | p * |
---|---|---|---|---|
Sociodemographic Factors | ||||
Age category (years) | <0.001 | <0.001 | ||
60–64 | 5.4 (3.7, 7.8) | 64 | ||
65–74 | 40.2 (36.6, 44.1) | 318 | ||
75–84 | 35.5 (30.9, 40.3) | 326 | ||
85 and older | 18.9 (15.6, 22.7) | 180 | ||
Sex | <0.001 | <0.001 | ||
Male | 34.3 (29.9, 39.0) | 282 | ||
Female | 65.7 (62.0, 70.1) | 606 | ||
Race | <0.001 | <0.001 | ||
Black | 10.7 (7.6, 14.8) | 138 | ||
Asian/Am Indian/Pacific Islander | 3.3 (1.8, 6.0) | 31 | ||
Hispanic | 12.3 (8.5, 17.5) | 41 | ||
Non-Hispanic White | 73.7 (67.9, 78.8) | 669 | ||
Education | 0.002 | 0.002 | ||
Less than High School | 16.8 (11.6, 23.7) | 147 | ||
HS or GED | 33.1 (26.9, 40.0) | 310 | ||
Some College/Associate Degree | 31.9 (26.7, 37.6) | 271 | ||
College degree or greater | 18.1 (13.4, 24.1) | 159 | ||
Marital Status | 0.007 | ns | ||
Currently married (yes) | 39.8 (32.9, 47.1) | 349 | ||
Single, divorced, or widowed | 60.2 (52.9, 67.1) | 535 | ||
Food Security | <0.001 | <0.001 | ||
Enough money to buy food | 84.6 (78.3, 89.3) | 723 | ||
Not enough money | 15.4 (10.7, 21.7) | 150 | ||
Income level | 0.138 | ns | ||
Below 20,000/year | 45.1 (38.7, 51.6) | 349 | ||
at or above 20,000/year | 54.9 (48.4, 61.3) | 405 | ||
Health | ||||
Diabetes | <0.001 | <0.001 | ||
yes | 31.6 (27.1, 36.5) | 277 | ||
no | 68.4 (63.5, 72.9) | |||
Physical health interferes with accomplishments | <0.001 | <0.001 | ||
Rarely or not at all | 25.0 (18.8, 32.4) | 241 | ||
Some of the time | 27.8 (22.5, 33.9) | 262 | ||
All or most of the time | 47.2 (41.9, 52.7) | 374 | ||
Osteoporosis | <0.001 | <0.001 | ||
yes | 20.1 (15.4, 25.7) | 187 | ||
no | 79.9 (74.3, 84.6) | 701 | ||
Osteoporosis * sex | 0.020 | ns | ||
Males (yes) | 17.2 (8.7, 31.3) | 20 | ||
Females (yes) | 82.8 (68.7, 91.3) | 167 | ||
Services Attended | ||||
Nutrition education at site (yes) | 11.7 (7.5,17.8) | 102 | <0.001 | <0.001 |
Exercise at site (yes) | 36.0 (30.1, 42.4) | 315 | <0.001 | <0.001 |
Health screening at site (yes) | 36.9 (29.6, 44.9) | 339 | <0.001 | <0.001 |
Parameter | Osteoporosis | No Osteoporosis | Total | p | p * |
---|---|---|---|---|---|
Physical health interferes little or none with my accomplishments | 31.9 (20.3, 46.2) | 51.1 (45.7, 56.4) | 47.2 (41.9, 52.7) | 0.004 | 0.004 |
Health limits moderate activities a lot | 31.5 (22.1, 42.7) | 18.9 (14.2, 24.7) | 21.3 (17.3, 26.0) | 0.026 | ns |
Health limits climbing stairs a lot | 32.2 (20.3, 46.9) | 22.8 (17.1, 29.7.2) | 24.7 (19.8, 30.2) | 0.037 | ns |
Difficulty shopping or visiting doctors | 27.4 (19.1, 37.7) | 15.3 (10.8, 21.3) | 17.7 (13.5, 23.0) | 0.018 | ns |
Difficulty with light housework | 17.8 (10.0, 29.7) | 9.8 (6.8, 14.0) | 11.4 (8.1, 16.0) | 0.048 | ns |
Male | 17.2 (8.7, 31.3) | 38.6 (32.1, 45.5) | 34.3 (29.9, 39.0) | 0.020 | ns |
Female | 82.8 (68.7, 91.3) | 61.4 (54.5, 67.9) | 65.7 (62.0, 70.1) | - | |
100% within sex | 100% within osteoporosis | 100% within osteoporosis |
Parameter | Males % (95th CI) | Females % (95th CI) | Total % (95th CI) | p | p * |
---|---|---|---|---|---|
Estimated 1/3 to 1/2 calories/day from Congregate Meals | 51.5 (42.9, 59.9) | 32.3 (24.0,41.9) | 38.9 (33.2, 45.0) | 0.001 | 0.001 |
Dairy | 0.502 | ns | |||
3 or more servings/day (recommended) | 14.0 (8.2, 22.9) | 9.9 (6.9, 13.8) | 11.3 (6.9, 13.8) | ||
at least 2 servings/day | 25.2 (19.1, 34.1) | 29.6 (21.4, 39.3) | 28.1 (22.4, 34.5) | ||
0–1 servings/day | 60.7 (53.0, 67.9) | 60.6 (52.5, 69.0) | 60.6 (53.5, 67.3) | ||
Total fruits and vegetables * | 0.232 | ns | |||
5 or more servings/day | 31.3 (23.3, 40.7) | 34.6 (27.4, 42.5) | 33.5 (27.7, 39.8) | ||
4 servings/day (recommendation 3.5, women and 4.5, men) | 17.1 (10.6, 26.4) | 24.3 (16.9, 33.5) | 21.8 (16.1, 28.9) | ||
3 or fewer servings/day | 51.6 (40.6, 62.4) | 41.1 (30.3, 52.8) | 44.7 (35.9, 53.9) | ||
Eat fruits and vegetables at site (yes) | 95.7 (86.6, 98.7) | 96.3 (94.2, 97.6) | 96.1 (93.3, 97.7) | 0.821 | ns |
Meat/protein | 0.442 | ns | |||
5 or more servings/day (Recommended) | 6.4 (3.3, 11.9) | 3.8 (2.1, 6.9) | 4.7 (3.0, 7.4) | ||
3-4 servings/day | 28.2 (21.2, 33.2) | 27.3 (21.4, 34.1) | 27.1 (22.4, 32.3) | ||
1–2 servings/day | 66.8 (60.6, 72.5) | 68.9 (60.9, 75.9) | 68.2 (62.3, 73.5) | ||
Grain | 0.006 | 0.006 | |||
5 or more servings/day Recommendation 8 and 9 servings/day (women and men, respectively) | 14.8 (9.3, 22.7) | 9.0 (6.4, 12.4) | 11.0 (8.0, 15.1) | ||
3–4 servings/day | 40.0 (33.1, 47.3) | 31.9 (27.2, 37.0) | 34.7 (30.8, 38.9) | ||
1–2 servings/day | 45.2 (36.8, 53.8) | 59.2 (53.6, 64.5) | 54.3 (48.9, 59.5) | ||
Dessert | 0.018 | ns | |||
none | 17.3 (11.0, 26.2) | 23.7 (18.3, 30.0) | 21.5 (17.8, 25.7) | ||
1 serving/day | 51.3 (39.3, 63.2) | 60.8 (53.8, 67.4) | 57.6 (51.3, 63.6) | ||
2 or more servings/day ** | 31.3 (23.7, 40.2) | 15.5 (11.6, 20.6) | 20.9 (17.2, 25.2) |
Variables | B coefficients (95th CI) | df | OR (95th CI) | p | p * |
---|---|---|---|---|---|
Intercept | −1.30 (−2.27, −0.32) | 1, 64 | 0.27 (0.10, 0.73) | 0.010 | ns |
Sex—female | 1.20 (0.35, 2.05) | 1, 64 | 3.32 (1.42, 7.77) | 0.007 | 0.007 |
Male (reference) | 0 | 1.00 | |||
Age category (years) | 3, 62 | ns | 0.565 | ns | |
60–64 | −0.77 (−1.97, 0.43) | 1, 64 | 0.46 (0.14, 1.54) | 0.205 | |
65–74 | −0.30 (−1.33, 0.74) | 1, 64 | 0.74 (0.26, 2.09) | 0.568 | |
75–84 | −0.45 (−0.13, 0.39) | 1, 64 | 0.63 (0.27, 1.48) | 0.283 | |
85 and above (reference) | 0 | 1.00 | |||
Race/ethnicity | 3, 62 | ns | 0.075 | ns | |
Black | 1.41 (−2.47, −0.34) | 1, 64 | 0.24 (0.08, 0.71) | 0.010 | |
Asian/Pacific Islander | 0.29 (−0.75, 1.35) | 1, 64 | 1.34 (0.47, 3.85) | 0.576 | |
Hispanic | 0.04 (−1.94, 2.01) | 1, 64 | 1.04 (0.14, 7.47 | 0.971 | |
White, non-Hispanic (reference) | 0 | 1.00 | |||
Food Security (Yes—enough to buy food) | 0.44 (−0.29, 1.17) | 1, 64 | 1.56 (0.75, 3.22) | 0.229 | ns |
Self-Rated Health | 2, 63 | 0.030 | ns | ||
Fair to poor | 0.80 (0.15, 1.46) | 2.24 (1.16, 4.30) | 0.017 | ||
Good | 0.10 (−0.54, 0.75) | 1.11 (0.58, 2.11) | 0.750 | ||
very good to excellent (reference) | 0 | 1.00 | - |
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Huffman, F.G.; Vaccaro, J.A.; Zarini, G.G.; Vieira, E.R. Osteoporosis, Activities of Daily Living Skills, Quality of Life, and Dietary Adequacy of Congregate Meal Participants. Geriatrics 2018, 3, 24. https://doi.org/10.3390/geriatrics3020024
Huffman FG, Vaccaro JA, Zarini GG, Vieira ER. Osteoporosis, Activities of Daily Living Skills, Quality of Life, and Dietary Adequacy of Congregate Meal Participants. Geriatrics. 2018; 3(2):24. https://doi.org/10.3390/geriatrics3020024
Chicago/Turabian StyleHuffman, Fatma G., Joan A. Vaccaro, Gustavo G. Zarini, and Edgar R. Vieira. 2018. "Osteoporosis, Activities of Daily Living Skills, Quality of Life, and Dietary Adequacy of Congregate Meal Participants" Geriatrics 3, no. 2: 24. https://doi.org/10.3390/geriatrics3020024