Older adults in the rural South are not meeting healthful eating guidelines.
OBJECTIVE
To evaluate diet quality of rural older adults using national dietary guidelines and the Healthy Eating Index (HEI).


METHODS
Five to six 24-hour recalls were conducted at monthly intervals over a 6-month period, using the Nutrition Coordinating Center food grouping system to calculate intake.


METHODS
Included in this cross-sectional study were 63 females and 59 males aged 65 to 93 years residing in two rural North Carolina counties; one third of each sex group was African American, Native American, or white. Inclusion criteria included age>65 years, education<or=12 years, and low income.


METHODS
HEI scores were computed from the average of the recalls, and compared using one-way analysis of variance. Multiple regression modeling was utilized to evaluate effects of demographic and self-reported health variables on HEI score.


RESULTS
Most study participants did not meet minimum Food Guide Pyramid recommended servings of grains, fruits, vegetables, and dairy. They exceeded recommendations for discretionary calorie servings (median=3.3 and 5.3 for females and males, respectively). Using the HEI, 24% had poor diets, 75% needed improvement, and only 1% had good diets. Of the participants with an eighth-grade education or less, men had a mean HEI score 9.6 units lower than women.


CONCLUSIONS
These rural adults are not meeting recommended nutrition guidelines, and most are consuming diets considered poor or needing improvement. Health care providers should recognize barriers that put these older adults at risk for poor nutrition and should be prepared to initiate referrals to community resources. Nutrition counseling should include strategies to increase whole grain, fruit, vegetable, and reduced-fat dairy consumption with the ultimate goal of improving dietary intake to prevent declines in functional status and independence associated with aging.
Vitolins
Mara Z
MZ
Department of Biostatistical Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. mvitolin@wfubmc.edu
Tooze
Janet A
JA
Golden
Shannon L
SL
Arcury
Thomas A
TA
Bell
Ronny A
RA
Davis
Cralen
C
Devellis
Robert F
RF
Quandt
Sara A
SA
D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D000704:Analysis of Variance; D003071:Cognition / Q000502:physiology; D003430:Cross-Sectional Studies; D004032:Diet / Q000592:standards*; D004034:Diet Surveys; D004522:Educational Status; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D008297:Male; D011939:Mental Recall; D009657:North Carolina; D018673:Nutrition Policy; D009747:Nutritional Physiological Phenomena; D009751:Nutritional Requirements; D011203:Poverty; D012423:Rural Health; D012424:Rural Population / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data