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Health issues and nutrition in the elderly

The association between dietary patterns and nutritional status in community-dwelling older adults—the PEN-3S study

European Journal of Clinical Nutrition volume 75, pages 521–530 (2021)Cite this article

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Abstract

Background

Diet plays a key role in the ageing process. Despite this, little is known about the effect of dietary patterns on older adults’ nutritional status. The main aim of this study was to analyse the association between a posteriori derived dietary patterns (DPs) and nutritional status among community dwellers aged ≥65.

Methods

Cross-sectional study including a representative sample of the community-dwelling Portuguese population aged ≥65 (n = 849, mean age 74.1 years old). Data were collected through computer-assisted, face-to-face interviews. Dietary patterns were derived a posteriori based on two 24-h recalls by a latent class transition model. Nutritional status was assessed by the Mini Nutritional Assessment (MNA®) and measured body mass index (BMI). Associations were estimated by regression models. MNA score was reversed and log-transformed considering its skewed distribution.

Results

Two DPs were identified: 22.0% of the studied population followed a ‘Protein-based foods’ DP (highest consumption of legumes, meats and sweets), and 59.1% followed a ‘Mediterranean’ DP (highest consumption of vegetables, fruits, dairy, cereals/tubers, bread, fishery and olive oil). Moreover, 18.9% switched between those patterns (‘In-between’ DP). After adjustment, the ‘Protein-based foods’ DP was associated with better MNA score (EXP(β) = 0.716, 95% CI 0.533, 0.962), compared to the ‘Mediterranean’ DP, particularly for total energy intake up to 2200 kcal/day. No significant associations were found between DPs and BMI.

Conclusions

A protein-based pattern is associated with lower malnutrition risk in older adults, when considering an adequate energy intake. This should be taken into account when designing and disseminating food-based guidelines for healthy ageing.

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Acknowledgements

The authors acknowledge the PEN-3S research team, the IAN-AF team, the interviewers who collected the data, the staff from primary healthcare units and all study participants. The authors also acknowledge the staff of Faculdade de Medicina, Universidade de Lisboa and Central Administration of the Health System (ACSS) for the institutional support.

Funding

The project PEN-3S (136SI5) was granted by the Public Health Initiatives Programme (PT06), financed by EEA Grants Financial Mechanism 2009–2014. TM is supported by a PhD Scholarship (SFRH/BD/117884/2016) from Fundação para a Ciência e a Tecnologia (FCT) through national funds (MCTES). AO is supported by a FCT Investigator Grant (IF/01350/2015).

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Authors and Affiliations

  1. Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisbon, Portugal

    Teresa Madeira & João Gorjão Clara

  2. Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisbon, Portugal

    Teresa Madeira & João Gorjão Clara

  3. EPIUnit—Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-600, Porto, Portugal

    Milton Severo, Andreia Oliveira & Carla Lopes

  4. Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal

    Milton Severo, Andreia Oliveira & Carla Lopes

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  1. Teresa Madeira
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Contributions

TM, MS, AO, JGC and CL contributed to the study design. TM, AO and CL coordinated the data collection. MS advised on the statistical analyses. TM wrote the first draft of this manuscript. All authors critically revised the manuscript and approved its final version.

Corresponding author

Correspondence to Teresa Madeira.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was conducted according to the ethical standards laid down in the Declaration of Helsinki. All procedures involving human subjects were approved by the National Data Protection Committee, Academic Medical Centre of Lisbon Ethics committee, and all seven Regional Health Administrations Ethics committees. Data collection was also formally authorised by primary healthcare units. Written informed consent was obtained from all subjects. When risk of malnutrition or malnutrition were identified, participants received an informative form about their status and were advised by interviewers (nutritionists) to contact their medical doctors.

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Madeira, T., Severo, M., Oliveira, A. et al. The association between dietary patterns and nutritional status in community-dwelling older adults—the PEN-3S study. Eur J Clin Nutr 75, 521–530 (2021). https://doi.org/10.1038/s41430-020-00745-w

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