Dietary Patterns of Rural Older Adults Are Associated with Weight and Nutritional Status

OBJECTIVES: To characterize dietary patterns of rural older adults and relate patterns to weight and nutritional status. DESIGN: Cross-sectional. SETTING: Rural Pennsylvania. PARTICIPANTS: One hundred seventy-nine community-dwelling adults aged 66 to 87 years. MEASUREMENTS: A home visit was conducted to collect demographic, health behavior, and anthropometric data and a blood sample. Five 24-hour dietary recall were administered. Cluster analysis classified participants into dietary patterns using food subgroup servings. Chi-square, analysis of covariance, and logistic regression were used to assess differences across clusters. RESULTS: A low-nutrient-dense cluster (n = 107), with higher intake of breads, sweet breads/desserts, dairy desserts, processed meats, eggs, and fats/oils, and a high-nutrient-dense cluster (n = 72) with higher intake of cereals, dark green/yellow vegetables, other vegetables, citrus/melons/berries, fruit juices, other fruits, milks, poultry, fish, and beans, were identified. Those in the high-nutrient-dense cluster had lower energy intake; higher energy-adjusted intake of fiber, iron, zinc, folate, and vitamins B₆, B₁₂, and D; higher Healthy Eating Index scores; higher plasma vitamin B₁₂ levels; and a lower waist circumference. Those with a low-nutrient-dense dietary pattern were twice as likely to be obese, twice as likely to have low plasma vitamin B₁₂ levels, and three to 17 times more likely to have low nutrient intake. CONCLUSION: This study provides support for recommending a high-nutrient-dense dietary pattern for older adults. Behavioral interventions encouraging diets characterized by high-nutrient-dense foods may improve weight and nutritional status of older adults.