@article {10142, title = {Latent profile analysis of dietary intake in a community-dwelling sample of older Americans.}, journal = {Public Health Nutrition}, year = {2019}, abstract = {

OBJECTIVE: To estimate latent dietary profiles in a community-dwelling sample of older Americans and identify associations between dietary profile membership and individual demographic, socio-economic and health characteristics.

DESIGN: Secondary analysis of the 2012 Health and Retirement Study (HRS) and linked 2013 Health Care and Nutrition Study (HCNS). Latent profile analysis identified mutually exclusive subgroups of dietary intake and bivariate analyses examined associations between dietary profile membership, participant characteristics and nutrient intakes.

SETTING: USA.

PARTICIPANTS: An analytic sample of 3558 adults aged 65 years or older.

RESULTS: Four dietary profiles were identified with 15{\textperiodcentered}5 \% of the sample having a {\textquoteright}Healthy{\textquoteright} diet, 42{\textperiodcentered}0 \% consuming a {\textquoteright}Western{\textquoteright} diet, 29{\textperiodcentered}7 \% having a diet consisting of high intake of all food groups and 12{\textperiodcentered}7 \% reporting relatively low intake of all food groups. Members of the {\textquoteright}Healthy{\textquoteright} profile reported the greatest socio-economic resources and health, and members of the {\textquoteright}Low Intake{\textquoteright} profile had the fewest resources and worst health outcomes. Macronutrient and micronutrient intakes varied across profile although inadequate and excessive intakes of selected nutrients were observed for all profiles.

CONCLUSIONS: We identified dietary patterns among older Americans typified by either selective intake of foods or overall quantity of foods consumed, with those described as {\textquoteright}Low Intake{\textquoteright} reporting the fewest socio-economic resources, greatest risk of food insecurity and the worst health outcomes. Limitations including the presence of measurement error in dietary questionnaires are discussed. The causes and consequences of limited dietary intake among older Americans require further study and can be facilitated by the HRS and HCNS.

}, keywords = {Community-dwelling, Dieting, HCNS}, issn = {1475-2727}, doi = {10.1017/S1368980019001496}, author = {Nicholas J Bishop and Krystle E Zuniga and Christina M Ramirez} } @article {9769, title = {Latent Profiles of Macronutrient Density and their Association with Mobility Limitations in an Observational Longitudinal Study of Older U.S. Adults.}, journal = {The Journal of Nutrition, Health and Aging}, volume = {22}, year = {2018}, pages = {645-654}, abstract = {

OBJECTIVES: Our first objective was to estimate empirically-derived subgroups (latent profiles) of observed carbohydrate, protein, and fat intake density in a nationally representative sample of older U.S. adults. Our second objective was to determine whether membership in these groups was associated with levels of, and short term change in, physical mobility limitations.

DESIGN AND SETTING: Measures of macronutrient density were taken from the 2013 Health Care and Nutrition Study, an off-year supplement to the Health and Retirement Study, which provided indicators of physical mobility limitations and sociodemographic and health-related covariates.

PARTICIPANTS: 3,914 community-dwelling adults age 65 years and older.

MEASUREMENTS: Percent of daily calories from carbohydrate, protein, and fat were calculated based on responses to a modified Harvard food frequency questionnaire. Latent profile analysis was used to describe unobserved heterogeneity in measures of carbohydrate, protein, and fat density. Mobility limitation counts were based on responses to 11 items indicating physical limitations. Poisson regression models with autoregressive controls were used to identify associations between macronutrient density profile membership and mobility limitations. Sociodemographic and health-related covariates were included in all Poisson regression models.

RESULTS: Four latent subgroups of macronutrient density were identified: "High Carbohydrate", "Moderate with Fat", "Moderate", and "Low Carbohydrate/High Fat". Older adults with the lowest percentage of daily calories coming from carbohydrate and the greatest percentage coming from fat ("Low Carbohydrate/High Fat") were found to have greater reported mobility limitations in 2014 than those identified as having moderate macronutrient density, and more rapid two-year increases in mobility limitations than those identified as "Moderate with Fat" or "Moderate".

CONCLUSION: Older adults identified as having the lowest carbohydrate and highest fat energy density were more likely to report a greater number of mobility limitations and experience greater increases in these limitations than those identified as having moderate macronutrient density. These results suggest that the interrelation of macronutrients must be considered by those seeking to reduce functional limitations among older adults through dietary interventions.

}, keywords = {Activities of Daily Living, Nutrition, Physical limitations}, issn = {1760-4788}, doi = {10.1007/s12603-017-0986-0}, author = {Nicholas J Bishop and Krystle E Zuniga and Lucht, A. L.} }