Abstract
Background
A growing body of research shows that diet quality and physical activity (PA) are associated with health-related quality of life (HRQOL). However, no study to date has assessed this association using the Healthy Eating Index-2015 as a measure of diet quality. Furthermore, few studies have examined the association between PA dose and HRQOL among a nationally representative sample of older adults. Objectives: To investigate the relationship between diet quality, physical activity, and HRQOL.
Objectives
To investigate the relationship between diet quality, physical activity, and HRQOL.
Design
A cross-sectional analysis was conducted using data obtained from 5,311 adults aged 60+ years who took part in the National Health and Nutrition Examination Survey between 2007 and 2014.
Measurements
HRQOL was assessed by general health status, and number of physically unhealthy days, mentally unhealthy days, and inactive days in past 30 days. Diet quality was assessed by the Healthy Eating Index-2015 using data generated by two 24-hour dietary recalls. PA was measured by the Global Physical Activity Questionnaire. Multivariate logistic/or linear regression models were used to examine the association between diet quality, PA and HRQOL controlling for confounders and accounting for complex sampling.
Results
Approximately half of the participants (55.2%) were women, 45.1% met current PA recommendations, 65% had less healthful diets according to the Healthy Eating Index-2015. Diet quality was associated with HROQL. For every 1-point diet quality score increase, the likelihood of respondents rating their general health as being excellent/good increased by 3% (OR=1.03, 95%CI: 1.02, 1.04), and number of inactive days (β =-0.03, 95%CI: -0.05, 0.00) and mental unhealthy days (β =-0.03, 95%CI: -0.05, -0.01) declined by 0.03 days. PA was associated with all HROQL measures and respondents with high PA levels reported better general health (OR=3.53, 95%CI: 2.69, 4.63), fewer inactive days (β =-1.53, 95%CI: -2.11, -0.95), fewer physical unhealthy days (β =-1.88, 95%CI: -2.74, -1.02) than individuals with low PA levels but not fewer mentally unhealthy days.
Conclusion
Among older adults in this study, eating a healthier diet and being physically active were associated with better general health and reporting fewer physical unhealthy days and inactive days. Study results provide valuable information that could inform policies, programs and interventions designed to improve HRQOL in older adults and reduce potentially preventable health disparities.
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References
He W, Goodkind D, Kowal P. An aging world: 2015. International population reports. United States Census Bureau. https://doi.org/www.census.gov/content/dam/Census/library/publications/2016/demo/p95-16-1.pdf. Published March 2016. Accessed February 8, 2017.
National Center for Health Statistics. Health, United States 2016. https://doi.org/www.cdc.gov/nchs/fastats/life-expectancy.htm. Accessed 12 January 2018
Megari K. Quality of Life in Chronic Disease Patients. Health Psychology Research 2013;1(3):e27. doi:10.4081/hpr.2013.e27.
Lee SJ, Lindquist K, Segal MR, Covinsky KE. Development and validation of a prognostic index for 4-year mortality in older adults JAMA. 2006;295(7): 801–808.
Brown DS, Thompson WW, Zack MM, Arnold SE, Barile JP. Associations Between Health-Related Quality of Life and Mortality in Older Adults. Prev Sci. 2015;16(1):21–30. doi:10.1007/s11121-013-0437-z.
Karimi M, Brazier J. Health, health-related quality of life, and quality of life: what is the difference? Pharmaco Economics 2016; 34(7):645–649.
Zack, MM. Health-related quality of life—United States, 2006 and 2010. MMWR Surveill. Summ. 2013; 62(Suppl. 3): 105–111.
Milte CM, Thorpe MG, Crawford D, Ball K, McNaughton SA. Associations of diet quality with health-related quality of life in older Australian men and women. Exp Gerontol 2015 Apr; 64:8–16. doi: 10.1016/j.exger.2015.01.047.
National Cancer Institute, Division of Cancer Control & Population Sciences. Developing the Healthy Eating index. https://doi.org/epi.grants.cancer.gov/hei/developing.html#2015. Accessed 14 January 2018.
Brown DW, Balluz LS, Health GW, Moriarty DG, Ford ES, Giles WH, Mokdad AH. Associations between recommended levels of physical activity and health-related quality of life. Findings from the 2001 Behavioral Risk Factor Surveillance System (BRFSS) survey. Prev. Med 2003; 37 (5): 520–528
Brown DR, Carroll DD, Workman LM, Carlson SA, Brown DW. Physical activity and health-related quality of life: US adults with and without limitations. Quality of Life Research 2014;23(10):2673–2680. doi:10.1007/s11136-014-0739-z.
Cho K-O. The Positive Effect of Physical Activity on Health and Health-related Quality of Life in Elderly Korean People—Evidence from the Fifth Korea National Health and Nutrition Examination Survey. Journal of Lifestyle Medicine 2014;4(2):86–94. doi:10.15280/jlm.2014.4.2.86.
Koolhaas CM, Dhana K, van Rooij FJA, Schoufour JD, Hofman A, Franco OH. Physical Activity Types and Health-Related Quality of Life among Middle-Aged and Elderly Adults: The Rotterdam Study. J Nutr Health Aging 2018;22(2):246–253. doi: 10.1007/s12603-017-0902-7.
Cockerham WC. Health lifestyle theory and the convergence of agency and structure Journal of Health and Social Behavior 2005; 46 (1): 51–67.
Centers for Disease Control and Prevention. National Health and Nutrition Examination Survey. https://doi.org/wwwn.cdc.gov/nchs/nhanes. Accessed 12 July 2017.
United States Department of Agriculture. Food Patterns Equivalents Database. https://doi.org/www.ars.usda.gov/northeast-area/beltsville-md/beltsville-human-nutrition-researchcenter/food-surveys-research-group/docs/fped-databases/. Accessed 12 December 2017.
Nadal K. The sage encyclopedia of psychology and gender. Thousand Oaks, CA: Sage; 2017.
Moriarty DG, Zack MM, Kobau R. The Centers for Disease Control and Prevention’s Healthy Days Measures–Population tracking of perceived physical and mental health over time. Health and Quality of Life Outcomes 2003; 1:37. doi:10.1186/1477-7525-1-37.
National Cancer Institute. The Healthy Eating Index–HEI Scoring Algorithm Method. https://doi.org/epi.grants.cancer.gov/hei/hei-scoring-method.html. Accessed 14 January 2018.
Loprinzi PD, Smit E, Mahoney S. Physical activity and dietary behavior in US adults and their combined influence on health. Mayo Clin Proc. 2014 Feb;89(2):190–8.
Armstrong T, Bull, F. Development of the world health organization global physical activity questionnaire (GPAQ). J Public Health 2006; 14 (2): 66–70. doi: 10.1007/s10389-006-0024-x.
World Health Organization. Global physical activity questionnaire (GPAQ) analysis guide. https://doi.org/www.who.int/chp/steps/resources/GPAQ_Analysis_Guide.pdf. Accessed 10 August 2017.
The U.S. Department of Health and Human Services. Physical activity guidelines for Americans. https://doi.org/health.gov/paguidelines/guidelines/chapter5.aspx. Accessed 19 December 2017.
Expert Panel on the Identification, Evaluation, and Treatment of Overweight in Adults. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: executive summary. Am J Clin Nutr. 1998; 68: 899–917.
U.S. Census Bureau, Population Division, Fertility & Family Statistics Branch. Current Population Survey: Definitions and explanations. 2004. https://doi.org/www.census.gov/population/www/cps/cpsdef.html. 2004. Accessed 15 December 2017.
CDC National Center for Health Statistics. Specifying weighting parameters. 2013. https://doi.org/www.cdc.gov/nchs/tutorials/nhanes/surveydesign/weighting/intro.htm. Accessed 11 August 2017.
Basiotis PP, Carlson A, Gerrior SA, Juan WY, Lino M. The healthy eating index: 1999–2000. US Department of Agriculture, Center for Nutrition Policy and Promotion; 2002. Center for Nutrition Policy and Promotion (CNPP)-12.
Haveman-Nies A., de Groot L.C.P., van Staveren W.A. Dietary quality, lifestyle factors and healthy ageing in Europe: the SENECA study. Age Ageing 2003; 32:427–434
Ford DW, Jensen GL, Still C, et al. The Associations Between Diet Quality, Body Mass Index (BMI) and Health and Activity Limitation Index (HALEX) In the Geisinger Rural Aging Study (GRAS). J Nutr Health Aging 2014;18(2):167–170. doi:10.1007/s12603-014-0016-4.
Hiza HA, Casavale KO, Guenther PM, Davis CA. Diet quality of Americans differs by age, sex, race/ethnicity, income, and education level. J Acad Nutr Diet 2013; 113(2):297–306
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Xu, F., Cohen, S.A., Lofgren, I.E. et al. Relationship between Diet Quality, Physical Activity and Health-Related Quality of Life in Older Adults: Findings from 2007–2014 National Health and Nutrition Examination Survey. J Nutr Health Aging 22, 1072–1079 (2018). https://doi.org/10.1007/s12603-018-1050-4
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DOI: https://doi.org/10.1007/s12603-018-1050-4