Dietary Patterns and Diet Quality Among Diverse Older Adults: The University of Alabama at Birmingham Study of Aging.

Dietary Patterns and Diet Quality among Diverse Older Adults: The University of Alabama at Birmingham Study of Aging.

Filed under: Eating Disorders

J Nutr Health Aging. 2013; 17(1): 19-25
Hsiao PY, Mitchell DC, Coffman DL, Allman RM, Locher JL, Sawyer P, Jensen GL, Hartman TJ

Objectives: To characterize dietary patterns among a diverse sample of older adults (? 65 years). Design: Cross-sectional. Setting: Five counties in west central Alabama. Participants: Community-dwelling Medicare beneficiaries (N=416; 76.8 ± 5.2 years, 56% female, 39% African American) in the University of Alabama at Birmingham (UAB) Study of Aging. Measurements: Dietary data collected via three, unannounced 24-hour dietary recalls was used to identify dietary patterns. Foods were aggregated into 13 groups. Finite mixture modeling (FMM) was used to classify individuals into three dietary patterns. Differences across dietary patterns for nutrient intakes, sociodemographic, and anthropometric measurements were examined using chi-square and general linear models. Results: Three dietary patterns were derived. A “More healthful” dietary pattern, with relatively higher intakes of fruit, vegetables, whole grains, eggs, nuts, legumes and dairy, was associated with lower energy density, higher quality diets as determined by Healthy Eating Index (HEI)-2005 scores and higher intakes of fiber, folate, vitamins C and B6, calcium, iron, magnesium, and zinc. The “Western-like” pattern was defined by an intake of starchy vegetables, refined grains, meats, fried poultry and fish, oils and fats and was associated with lower HEI-2005 scores. The “Low produce, high sweets” pattern was characterized by high saturated fat, and low dietary fiber and vitamin C intakes. The strongest predictors of better diet quality were female gender and non-Hispanic white race. Conclusion: The dietary patterns identified may provide a useful basis on which to base dietary interventions targeted at older adults. Examination of nutrient intakes regardless of the dietary pattern suggests that older adults are not meeting nutrient recommendations and should continue to be encouraged to choose high quality diets.
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Family Functioning: Associations With Weight Status, Eating Behaviors, and Physical Activity in Adolescents.

Filed under: Eating Disorders

J Adolesc Health. 2012 Aug 29;
Berge JM, Wall M, Larson N, Loth KA, Neumark-Sztainer D

PURPOSE: This article examines the relationship between family functioning (e.g., communication, closeness, problem solving, behavioral control) and adolescent weight status and relevant eating and physical activity behaviors. METHODS: Data are from EAT 2010 (Eating and Activity in Teens), a population-based study that assessed eating and activity among socioeconomically and racially/ethnically diverse youths (n = 2,793). Adolescents (46.8% boys, 53.2% girls) completed anthropometric assessments and surveys at school between 2009 and 2010. Multiple linear regression was used to test the relationship between family functioning and adolescent weight, dietary intake, family meal patterns, and physical activity. Additional regression models were fit to test for interactions by race/ethnicity. RESULTS: For adolescent girls, higher family functioning was associated with lower body mass index z score and percent overweight, less sedentary behavior, higher intake of fruits and vegetables, and more frequent family meals and breakfast consumption. For adolescent boys, higher family functioning was associated with more physical activity, less sedentary behavior, less fast-food consumption, and more frequent family meals and breakfast consumption. There was one significant interaction by race/ethnicity for family meals; the association between higher family functioning and more frequent family meals was stronger for nonwhite boys compared with white boys. Overall, strengths of associations tended to be small, with effect sizes ranging from -.07 to .31 for statistically significant associations. CONCLUSIONS: Findings suggest that family functioning may be protective for adolescent weight and weight-related health behaviors across all race/ethnicities, although assumptions regarding family functioning in the homes of overweight children should be avoided, given small effect sizes.
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An Internet Obesity Prevention Program for Adolescents.

Filed under: Eating Disorders

J Adolesc Health. 2012 Sep 26;
Whittemore R, Jeon S, Grey M

PURPOSE: To compare the effectiveness of two school-based internet obesity prevention programs for diverse adolescents on body mass index (BMI), health behaviors, and self-efficacy, and to explore moderators of program efficacy. It was hypothesized that the addition of coping skills training to a health education and behavioral support program would further enhance health outcomes. METHODS: A randomized clinical trial with cluster randomization by class and repeated measures with follow-up at 3 and 6 months was conducted (n = 384). BMI was assessed by use of standard procedures. Sedentary behavior, physical activity, nutrition behavior, self-efficacy, and satisfaction were assessed with self-report measures. Data analysis consisted of mixed model analyses with autoregressive covariance structure for repeated data by use of intent-to-treat procedures. RESULTS: The mean age of students was 15.31 years (±0.69), with a mean BMI of 24.69 (±5.58). The majority were girls (62%) and of diverse race/ethnicity (65% non-white). There were no significant differences between groups on any outcomes and no change in BMI over time. There were significant improvements in health behaviors (sedentary behavior, moderate and vigorous physical activity, healthy eating, fruit and vegetable intake, sugar beverages, and junk food intake) and self-efficacy. Gender and lesson completion moderated select health outcomes. There was excellent participation and high satisfaction with the programs. CONCLUSIONS: School-based internet obesity prevention programs are appealing to adolescents and improve health behaviors. The differential effect of coping skills training may require longer follow-up.
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The cost of diabetes in adults in Australia.

Filed under: Eating Disorders

Diabetes Res Clin Pract. 2013 Jan 5;
Lee CM, Colagiuri R, Magliano DJ, Cameron AJ, Shaw J, Zimmet P, Colagiuri S

AIMS: To assess and compare costs associated with diabetes and lesser degrees of glucose intolerance in Australia. METHODS: The Australian Diabetes, Obesity and Lifestyle study collected data on the use of health services and health related expenditure in 2004-2005. Complications data were collected through physical examination and biochemical tests or questionnaire. Data were available on 6101 participants. Age- and sex-adjusted direct healthcare costs, direct non-healthcare costs and government subsidies were estimated according to glucose tolerance status. RESULTS: Annual direct per person costs were A$ 1898 for those with normal glucose tolerance to A$ 4390 for those with known diabetes. Costs were substantially higher in people with diabetes and both micro- and macrovascular complications. The total annual cost of diabetes in 2005 for Australians aged ?30 years was A$ 10.6 billion (A$ 4.4 billion in direct costs; A$ 6.2 billion in government subsidies) which equates to A$ 14.6 billion in 2010 dollars. Total annual excess cost associated with diabetes in 2005 was A$ 4.5 billion (A$ 2.2 billion in direct costs; A$ 2.3 billion in government subsidies). CONCLUSION: The excess cost of diabetes to individuals and government is substantial and is greater in those with complications. Costs could potentially be reduced by preventing the development of diabetes or its complications.
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Current Evidence on Healthy Eating.

Filed under: Eating Disorders

Annu Rev Public Health. 2013 Jan 7;
Willett WC, Stampfer MJ

Large nutritional epidemiology studies, with long-term follow-up to assess major clinical end points, coupled with advances in basic science and clinical trials, have led to important improvements in our understanding of nutrition in primary prevention of chronic disease. Although much work remains, sufficient evidence has accrued to provide solid advice on healthy eating. Good data now support the benefits of diets that are rich in plant sources of fats and protein, fish, nuts, whole grains, and fruits and vegetables; that avoid partially hydrogenated fats; and that limit red meat and refined carbohydrates. The simplistic advice to reduce all fat, or all carbohydrates, has not stood the test of science; strong evidence supports the need to consider fat and carbohydrate quality and different protein sources. This article briefly summarizes major findings from recent years bearing on these issues. Expected final online publication date for the Annual Review of Public Health Volume 34 is March 17, 2013. Please see http://www.annualreviews.org/catalog/pubdates.aspx for revised estimates.
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