title: Physical and social determinants of dietary variety among older adults living alone in Japan.
abstract: OBJECTIVE
  Food security and sufficient nutrient intake are critical to longevity and active aging. The present study aimed to elucidate physical and social factors related to dietary variety among single-living older adults in Japanese communities.
  
  
  METHODS
  The cross-sectional survey with a self-administrated questionnaire was carried out for all older adults living alone aged 65 years and older in three cities of Japan during 2014. Dietary variety score (DVS) was determined by counting the number of 10 food groups consumed at least once in 2 days using a food frequency questionnaire. Using the data of 704 men and 1366 women, the sex-specific association of low DVS (<4) with age, region, frailty, annual income, social support, distance to the nearest supermarket and car ownership was analyzed.
  
  
  RESULTS
  The prevalence of low DVS was 40.9% for men and 18.4% for women. Frailty and low social support were associated with low DVS. A gradient association with income was found for women, whereas men showed a threshold: <1.5 million yen per year was associated with low DVS. The distance to the nearest supermarket was not significantly associated with DVS.
  
  
  CONCLUSIONS
  The findings of the present study imply that as well as frailty, poor social support and economic disadvantage are associated with a decline in dietary variety. In particular, frail men with income <1.5 million yen per year had a high risk of decreased dietary variety. Formal and informal support to secure food accessibility for physically and socially vulnerable older adults should be encouraged. Geriatr Gerontol Int 2017; 17: 2232-2238.
authors.affiliation: Teikyo University, Graduate School of Public Health, Itabashi, Japan.
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Fukuda
authors.affiliation: National Institute of Public Health, Wako, Japan.
authors.forename: Midori
authors.initials: M
authors.lastname: Ishikawa
authors.affiliation: National Institute of Public Health, Wako, Japan.
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Yokoyama
authors.affiliation: Kyushu Nutrition Welfare University, Kitakyushu, Japan.
authors.forename: Tatsumi
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: Ritsumeikan University, Kyoto, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Nakaya
authors.affiliation: Kagawa Nutrition University, Sakado, Japan.
authors.forename: Yukari
authors.initials: Y
authors.lastname: Takemi
authors.affiliation: Aomori University of Health and Welfare, Aomori, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kusama
authors.affiliation: Aomori University of Health and Welfare, Aomori, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Yoshiike
authors.affiliation: National institutes of Biomedical Innovation, Health and Nutrition, Shinjuku, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Nozue
authors.affiliation: Japan Association for Development of Community Medicine, Chiyoda, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Yoshiba
authors.affiliation: University of Niigata prefecture, Niigata, Japan.
authors.forename: Nobuko
authors.initials: N
authors.lastname: Murayama
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D004032:Diet / Q000706:statistics & numerical data*; D004034:Diet Surveys; D005260:Female; D005523:Food Supply; D000073496:Frailty / Q000453:epidemiology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D012944:Social Support; D012959:Socioeconomic Factors
keywords: dietary variety; food desert; food insecurity; socioeconomic factors