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

• Published in: European journal of clinical nutrition 2021-03, Vol.75 (3), p.521-530
• Main Authors: Madeira, Teresa, Severo, Milton, Oliveira, Andreia, Gorjão Clara, João, Lopes, Carla
• Format: Article
• Language: English
• Subjects: 692/699/1702/295; 692/700/2814; Adults; Aged; Aging; Body mass index; Body size; Cereals; Clinical Nutrition; Demographic aspects; Energy intake; Epidemiology; Fisheries; Food; Food consumption; Food habits; Health aspects; Internal Medicine; Legumes; Malnutrition; Medicine; Medicine & Public Health; Metabolic Diseases; Nutrition; Nutrition assessment; Nutritional status; Older people; Olive oil; Population studies; Product/Service Evaluations; Proteins; Public Health; Regression analysis; Regression models; Skewed distributions; Tubers
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/s41430-020-00745-w

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.