Association between dietary quality of rural older adults and self-reported food avoidance and food modification due to oral health problems.
OBJECTIVE
To quantify the association between food avoidance and modification due to oral health problems, to examine the association between food practices and dietary quality, and to determine foods associated with these self-management behaviors.


METHODS
Cross-sectional.


METHODS
Rural North Carolina.


METHODS
Six hundred thirty-five community-dwelling adults aged 60 and older.


METHODS
Demographic and food frequency data and oral health assessments were obtained during home visits. Avoidance (0, 1-2 foods, 3-14 foods) and modification (0-3 foods, 4-5 foods) due to oral health problems were assessed for foods representing oral health challenges. Food frequency data were converted into Healthy Eating Index-2005 (HEI-2005) scores. Linear regression models tested the significance of associations between HEI-2005 measures and food avoidance and modification.


RESULTS
Thirty-five percent of participants avoided three to 14 foods, and 28% modified four to five foods. After adjusting for age, sex, ethnicity, poverty, education, and tooth loss, total HEI-2005 score was lower (P<.001) for persons avoiding more foods and higher for persons modifying more foods (P<.001). Those avoiding three to 14 foods consumed more saturated fat and energy from solid fat and added sugar and less nonhydrogenated fat than those avoiding fewer than three foods. Those who modified four to five foods consumed less saturated fat and solid fat and added sugar but more total grains than those modifying fewer than four foods.


CONCLUSIONS
Food avoidance and modification due to oral health problems are associated with significant differences in dietary quality. Approaches to minimize food avoidance and promote food modification by persons having eating difficulties due to oral health conditions are needed.
Department of Nutrition, University of North Carolina at Greensboro, Greensboro, NC 27402, USA. mrsavoca@uncg.edu
Margaret R
MR
Savoca
Thomas A
TA
Arcury
Xiaoyan
X
Leng
Haiying
H
Chen
Ronny A
RA
Bell
Andrea M
AM
Anderson
Teresa
T
Kohrman
Gregg H
GH
Gilbert
Sara A
SA
Quandt
D000368:Aged; D003430:Cross-Sectional Studies; D004032:Diet; D004034:Diet Surveys; D005247:Feeding Behavior; D005260:Female; D005518:Food Preferences; D015577:Geriatric Assessment; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D009909:Oral Health; D012423:Rural Health; D012959:Socioeconomic Factors; D009057:Stomatognathic Diseases / Q000150:complications* / Q000523:psychology* / Q000628:therapy