Dietary intakes of community-dwelling adults in the United States across older adulthood: NHANES 2015-March 2020

Authors: SHEA, KYLA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; BARGER, KATHRYN - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; ROGERS, GAIL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; TALEGAWKAR, SAMEERA - George Washington University; EICHER-MILLER, HEATHER - Purdue University; BOOTH, SARAH - Jean Mayer Human Nutrition Research Center On Aging At Tufts University

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/11/2023
Publication Date: 2/15/2024
Citation: Shea, K., Barger, K., Rogers, G., Talegawkar, S., Eicher-Miller, H., Booth, S.L. 2024. Dietary intakes of community-dwelling adults in the United States across older adulthood: NHANES 2015-March 2020. Journal of Nutrition. https://doi.org/10.1016/j.tjnut.2023.12.014.
DOI: https://doi.org/10.1016/j.tjnut.2023.12.014

Interpretive Summary: Dietary guidance is set based on age and life stage and defines older adults as 60 years or older. Yet, little is known about if and/or how diet quality differs beyond age 60. To address this gap, we compared diet quality and dietary intakes of older adults by decade of life. Compared to the 60-69-year-olds, men and women in their eighties reported eating less calories. Overall diet quality was similar across the age groups. However, some components of diet quality, such as greens and beans, were lower in the 80+ year olds compared to the 60-69-year-olds. Future research is needed to determine if or how dietary changes across older adulthood are related to development or progression of age-related health outcomes and ascertain relevance to federal nutrition assistance programs for older adults.

Technical Abstract: Background: Dietary guidance is set based on age and life stage and defines older adults as = 60 years. Yet, little is known about if and/or how diet quality differs beyond age 60. Objective: To compare the dietary intakes of 60-69 (n=2079), 70-79 (n=1181), and 80+ year-old (n=644) non-institutionalized men and women in the United States using the Healthy Eating Index 2015 (HEI) and the What We Eat in America food categories. Methods: Data were obtained from NHANES 2015-2016 and 2017-March 2020. HEI and component scores were calculated using the population ratio method. Population estimates for dietary intake were calculated as the average reported over two separate non-consecutive 24-hour dietary recalls. Results: In men and women, the reported energy intake was lower among the 80+ year olds (kilocalories/day men: 80+: 1884 +/- 30, 70-79: 2022 +/- 33, 60-69: 2142 +/- 39; women 80+: 1523 +/- 36; 70-79: 1525 +/- 33, 60-69: 1650 +/- 25; p-trend<0.001). Total HEI scores did not differ significantly across the three age categories, but the 80+ year-olds had significantly lower scores for the green vegetables and beans component than the 60-69-year-olds [men: mean(95%CI) 2.0(1.5, 2.5) vs 3.4(2.6, 4.1); women: 2.3(1.8, 2.8) vs 4.4(3.7, 5.0)]. In women, the % of daily calories from protein was significantly lower in the 80+ year olds than in the 60-69 and 70-79-year-olds (12.9 +/- 0.6%, vs 17.0 +/- 0.9% and 15.6 +/- 0.6%, respectively). Protein intake did not differ significantly among the three age groups in men. The 80+ year old men and women reported consuming a significantly higher % of calories from snacks & sweets compared to the 60-69-year-olds (men: 80+: 18.1 +/- 0.8%, 60-69: 15.4 +/- 0.7%; women: 80+: 19.6 +/- 0.8%, 60-69: 15.5 +/- 0.7%).Conclusion: The diet of 80+ year-olds differed from that of 60-69-year-olds in some key components- including energy, snacks and sweets, protein, and green vegetables. Future research is needed to determine if there are health-related consequences to these differences.