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Dietary Intakes of Women’s Health Initiative Long Life Study Participants Falls Short of the Dietary Reference Intakes

      Abstract

      Background

      Understanding how nutrient intake in older women compares with recommendations is important. The Academy of Nutrition and Dietetics position statement summarizes the nutrient needs of older adults (aged ≥60 years) based on a systematic review.

      Objective

      The objective of this study was to compare nutrient intake of Women's Health Initiative Long Life Study participants to the Dietary Reference Intakes for nutrients reviewed in the Academy of Nutrition and Dietetics position statement.

      Design

      The study is a cross-sectional analysis.

      Participants/setting

      Participants (n=7,875) were mailed the General Nutrition Assessment Food Frequency Questionnaire during 2012-2013, of whom 77% (n=6,095) completed it, and 5,732 were included in the analytic sample after exclusion for implausible energy intakes.

      Main outcome measures

      Mean intake of energy and protein, calcium, fiber, folate, potassium, sodium, vitamins B-12, D, E, and K were described overall and compared with recommendations.

      Statistical analyses performed

      Demographic and lifestyle characteristics were summarized using descriptive statistics. The proportion of participants meeting recommendations was computed.

      Results

      Mean age of completers was 79±7 years and 53.5% were non-Hispanic white, 30% were non-Hispanic black, and 16.5% were Hispanic/Latina. Only one-third of women consumed ≥21 g/day fiber, whereas fewer met the Recommended Dietary Allowance for calcium (18.6%), vitamin E (16.9%), and vitamin D (1.7%). Just more than half (56%) of participants met the Recommended Dietary Allowance for protein of 0.8 g/kg body weight/day, and just less than half (47.0%) met potassium guidelines.

      Conclusions

      These findings suggest older women within the Women’s Health Initiative were generally not achieving recommended intake for several key nutrients highlighted by the Academy of Nutrition and Dietetics position statement. These findings underscore the need to identify effective approaches for improving the nutrient density of dietary intake in older women.

      Keywords

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      References

        • Hiza H.A.
        • Casavale K.O.
        • Guenther P.M.
        • Davis C.A.
        Diet quality of Americans differs by age, sex, race/ethnicity, income, and education level.
        J Acad Nutr Diet. 2013; 113: 297-306
        • Hsiao P.Y.
        • Mitchell D.C.
        • Coffman D.L.
        • et al.
        Dietary patterns and diet quality among diverse older adults: The University of Alabama at Birmingham Study of Aging.
        J Nutr Health Aging. 2013; 17: 19-25
        • Bernstein M.
        • Munoz N.
        Position of the Academy of Nutrition and Dietetics: Food and nutrition for older adults: Promoting health and wellness.
        J Nutr Acad Nutr Diet. 2012; 112: 1255-1277
        • Lichtenstein A.H.
        • Rasmussen H.
        • Yu W.W.
        • Epstein S.R.
        • Russell R.M.
        Modified MyPyramid for older adults.
        J Nutr. 2008; 138: 5-11
        • Institute of Medicine, Food and Nutrition Board
        Dietary Reference Intakes for Sodium and Potassium.
        The National Academies Press, Washington, DC2019
        • Institute of Medicine, Food and Nutrition Board
        Dietary Reference Intakes: The Essential Guide to Nutrient Requirements.
        The National Academies Press, Washington, DC2006
        • Institute of Medicine, Food and Nutrition Borard
        Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients).
        National Academies Press, Washington, DC2005
        • Women's Health Initiative Study Group
        Long Life Study.
        • Fred Hutchinson Cancer Research Center
        Food frequency questionnaires 2014.
        • Patterson R.E.
        • Kristal A.R.
        • Tinker L.F.
        • Carter R.A.
        • Bolton M.P.
        • Agurs-Collins T.
        Measurement characteristics of the Women's Health Initiative food frequency questionnaire.
        Ann Epidemiol. 1999; 9: 178-187
      1. Nutrition Data System for Research (NDSR) [computer program]. Version June 2012. University of Minnesota Nutrition Coordinating Center, Minneapolis, MN2012
        • Women's Health Initiative Study Group
        Welcome to the Women's Health Initiative.
      2. National Heart, Lung, and Blood Institute. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. National Institutes of Health; 1998. NIH Publication No. 98-4083.

        • Zaslavsky O.
        • LaCroix A.Z.
        • Hale L.
        • Tindle H.
        • Shochat T.
        Longitudinal changes in insomnia status and incidence of physical, emotional, or mixed impairment in postmenopausal women participating in the Women's Health Initiative (WHI) study.
        Sleep Med. 2015; 16: 364-371
        • Levine D.W.
        • Kripke D.F.
        • Kaplan R.M.
        • et al.
        Reliability and validity of the Women's Health Initiative Insomnia Rating Scale.
        Psychol Assess. 2003; 15: 137-148
        • Burnam M.A.
        • Wells K.B.
        • Leake B.
        • Landsverk J.
        Development of a brief screening instrument for detecting depressive disorders.
        Med Care. 1988; 26: 775-789
        • Willett W.
        Nutritional Epidemiology.
        Oxford University Press, New York, NY1998
        • Beasley J.M.
        • Deierlein A.L.
        • Morland K.B.
        • Granieri E.C.
        • Spark A.
        Is meeting the Recommended Dietary Allowance (RDA) for protein related to body composition among older adults?: Results from the Cardiovascular Health of Seniors and Built Environment Study.
        J Nutr Health Aging. 2016; 20: 790-796
        • Berner L.A.
        • Becker G.
        • Wise M.
        • Doi J.
        Characterization of dietary protein among older adults in the United States: Amount, animal sources, and meal patterns.
        J Acad Nutr Diet. 2013; 113: 809-815
        • Fulgoni 3rd, V.L.
        Current protein intake in America: Analysis of the National Health and Nutrition Examination Survey, 2003-2004.
        Am J Clin Nutr. 2008; 87: 1554S-1557S
        • Russell R.M.
        • Suter P.M.
        Vitamin requirements of elderly people: An update.
        Am J Clin Nutr. 1993; 58: 4-14
        • Chernoff R.
        Micronutrient requirements in older women.
        Am J Clin Nutr. 2005; 81: 1240s-1245s
        • Barkoukis H.
        Nutrition recommendations in elderly and aging.
        Med Clin North Am. 2016; 100: 1237-1250
        • Clegg M.E.
        • Williams E.A.
        Optimizing nutrition in older people.
        Maturitas. 2018; 112: 34-38
        • Shlisky J.
        • Bloom D.E.
        • Beaudreault A.R.
        • et al.
        Nutritional considerations for healthy aging and reduction in age-related chronic disease.
        Adv Nutr. 2017; 8: 17-26
        • Tittikpina N.K.
        • Issa A.-R.
        • Yerima M.
        • et al.
        Aging and nutrition: Theories, consequences, and impact of nutrients.
        Curr Pharmacol Rep. 2019; 5: 232-243
        • Deierlein A.L.
        • Morland K.B.
        • Scanlin K.
        • Wong S.
        • Spark A.
        Diet quality of urban older adults age 60 to 99 years: The Cardiovascular Health of Seniors and Built Environment Study.
        J Acad Nutr Diet. 2014; 114: 279-287
        • Ryan A.S.
        • Craig L.D.
        • Finn S.C.
        Nutrient intakes and dietary patterns of older Americans: A national study.
        J Gerontol. 1992; 47: M145-M150
        • Foote J.A.
        • Giuliano A.R.
        • Harris R.B.
        Older adults need guidance to meet nutritional recommendations.
        J Am Coll Nutr. 2000; 19: 628-640
        • US Dept of Agriculture
        Usual nutrient intake from food and beverages, by gender and age, What We Eat in America, NHANES 2013-2016.
        www.ars.usda.gov/nea/bhnrc/fsrg
        Date accessed: December 30, 2019
        • Gahche J.J.
        • Bailey R.L.
        • Potischman N.
        • Dwyer J.T.
        Dietary supplement use was very high among older adults in the United States in 2011-2014.
        J Nutr. 2017; 147: 1968-1976
        • Bailey R.L.
        • Akabas S.R.
        • Paxson E.E.
        • Thuppal S.V.
        • Saklani S.
        • Tucker K.L.
        Total usual intake of shortfall nutrients varies with poverty among US adults.
        J Nutr Educ Behav. 2017; 49: 639-646.e633
        • Neuhouser M.L.
        • Tinker L.
        • Shaw P.A.
        • et al.
        Use of recovery biomarkers to calibrate nutrient consumption self-reports in the Women's Health Initiative.
        Am J Epidemiol. 2008; 167: 1247-1259
        • Prentice R.L.
        • Mossavar-Rahmani Y.
        • Huang Y.
        • et al.
        Evaluation and comparison of food records, recalls, and frequencies for energy and protein assessment by using recovery biomarkers.
        Am J Epidemiol. 2011; 174: 591-603
        • Institute of Medicine, Food and Nutrition Board
        Dietary Reference Intakes: Applications in Dietary Assessment.
        National Academies Press, Washington, DC2000

      Biography

      J. M. Beasley is an assistant professor, Division of General Internal Medicine and Clinical Innovation, New York University School of Medicine, New York City, NY.

      Biography

      E. Rillamas-Sun is a staff scientist, Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.

      Biography

      L. Tinker is a senior staff scientist, Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.

      Biography

      J. Wylie-Rosett is a professor and division head, Health Behavior Research and Implementation Science, Albert Einstein College of Medicine, Bronx, NY.

      Biography

      Y. Mossavar-Rahmani is a certified dietitian-nutritionist and an associate professor, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.

      Biography

      M. Datta is a clinical assistant professor, Department of Food Science and Human Nutrition, Iowa State University, Ames.

      Biography

      B. J. Caan is a senior research scientist, Division of Research, Kaiser Permanente, Oakland, CA.

      Biography

      A. Z. LaCroix is a distinguished professor and chief of Epidemiology, Family Medicine and Public Health, University of California, San Diego, La Jolla, CA.