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Background Sodium, potassium, and the balance between these 2 nutrients are associated with hypertension and cardiovascular disease, and prevalence of these conditions increases with age. However, limited information is available on these intakes among older adults. Objective Our aim was to explore the socioeconomic and health factors associated with usual sodium and potassium intakes and the sodium to potassium (Na:K) ratio of older adults. Design This was a cross-sectional, secondary analysis of the 2011-2012, 2013-2014, and 2015-2016 National Health and Nutrition Examination Survey. Participants/setting This study included the data of 5,104 adults 50 years and older, with at least one reliable 24-hour dietary recall and an estimated glomerular filtration rate ≥60 mL/min/1.73 m2. Main outcome measures Sodium and potassium intake, as absolute intake, density (per 1,000 kcal) and ratio of Na:K intake. Statistical analyses We used t tests and χ2 tests to examine significant differences in intakes on a given day by characteristics. Linear and logistic regression models were used to assess associations of socioeconomic and health characteristics with usual sodium and potassium intakes, determined using the National Cancer Institute method. Results Only 26.2% of participants consumed Conclusions Participants consumed too much sodium and not enough potassium, based on current recommendations. A higher Na:K ratio was significantly associated with established risk factors for cardiovascular disease. The study findings suggest that more research on cardiovascular health should include both sodium and potassium, as well as balance between these nutrients.

Objectives: To examine: (1) diet quality of older adults, using the Healthy Eating Index 2010 (HEI-2010) and self-rated diet quality, (2) characteristics associated with reported awareness and use of nutrition information and (3) factors associated with HEI score and self-rated diet quality. Design: Cross-sectional study. Based on Day 1 and/or Day 2 dietary recalls, the Per-Person method was used to estimate HEI-2010 component and total scores. T-tests and ANOVA were used to compare means. Logistic and linear regressions were used to test for associations with diet quality, controlling for potential confounders. Setting: National Health and Nutrition Examination Survey, 2009–2014. Participants: Three thousand and fifty-six adults, aged 60 years and older, who completed at least one 24-h recall and answered questions on awareness and use of nutrition information. Results: Mean HEI score for men was significantly lower than for women (56·4 ± 0·6 v. 60·2 ± 0·6, P < 0·0001). Compared with men, more women were aware of (44·8 % v. 33·7 %, P < 0·05) and used (13·7 % v. 5·9 %, P < 0·05) nutrition information. In multivariable analyses, awareness and use of nutrition information were significant predictors of both HEI and self-rated diet quality for both women and men. Groups with lower nutrition awareness included men, non-Whites, participants in nutrition assistance programmes and those with lower education and socio-economic status. Conclusions: Nutrition awareness and use of nutrition information are associated with diet quality in adults 60 years and older. Gaps in awareness of dietary guidelines in certain segments of the older adult population suggest that targeted education may improve diet quality for these groups.

Objectives:To examine: (1) diet quality of older adults, using the Healthy Eating Index 2010 (HEI-2010) and self-rated diet quality, (2) characteristics associated with reported awareness and use of nutrition information and (3) factors associated with HEI score and self-rated diet quality.Design:Cross-sectional study. Based on Day 1 and/or Day 2 dietary recalls, the Per-Person method was used to estimate HEI-2010 component and total scores.T-tests and ANOVA were used to compare means. Logistic and linear regressions were used to test for associations with diet quality, controlling for potential confounders.Setting:National Health and Nutrition Examination Survey, 2009–2014.Participants:Three thousand and fifty-six adults, aged 60 years and older, who completed at least one 24-h recall and answered questions on awareness and use of nutrition information.Results:Mean HEI score for men was significantly lower than for women (56·4 ± 0·6v. 60·2 ± 0·6,P< 0·0001). Compared with men, more women were aware of (44·8 %v. 33·7 %,P< 0·05) and used (13·7 %v. 5·9 %,P< 0·05) nutrition information. In multivariable analyses, awareness and use of nutrition information were significant predictors of both HEI and self-rated diet quality for both women and men. Groups with lower nutrition awareness included men, non-Whites, participants in nutrition assistance programmes and those with lower education and socio-economic status.Conclusions:Nutrition awareness and use of nutrition information are associated with diet quality in adults 60 years and older. Gaps in awareness of dietary guidelines in certain segments of the older adult population suggest that targeted education may improve diet quality for these groups.

Functional limitations in homebound older adults may cause difficulties with obtaining and preparing adequate healthy food. Services exist to help with these difficulties, however, not all individuals who could benefit receive them. This secondary analysis of observational data, obtained via questionnaires from homebound, recently hospital discharged older adults (n = 566), aimed to identify the prevalence and correlates of unmet need for such services, and to examine the disagreement between self-reported need for a service and functional limitation that could be addressed by that service. One-fifth of respondents reported unmet need for vision services and oral health services, and one-tenth reported unmet need for transportation services and physical therapy. There was a significant association between reported need and functional limitation (p 0.001) for all services, except mental health and grocery delivery. However, for each service there were participants who under-reported need, compared with functional ability indicators. More research is required to determine the best methods for measuring these needs to ensure that nutritional vulnerability is detected and addressed in those returning from hospital.

Older adults are at higher risk of invasive listeriosis compared with the general population. Some foods are more likely than others to be contaminated with or to contain high levels of Listeria monocytogenes. The objectives of this study were to (i) determine dietary consumption patterns among older adults in the United States; (ii) evaluate sociodemographic and economic characteristics of older adults associated with each pattern; (iii) determine intake of foods associated with larger relative risk of listeriosis within these patterns; and (iv) rank these patterns based on risk. Data related to older adults (age 60 and older) participating in the cross-sectional National Health and Nutrition Examination Surveys (NHANES) 2009 to 2010, 2011 to 2012, and 2013 to 2014 (n = 4,967) were included in these analyses. Cluster analysis was used to define dietary patterns based on 24-h dietary recalls from day 1 and day 2. Mean intake of foods associated with higher risk of listeriosis was examined within each pattern, and analysis of variance with Dunnett's method of adjustment was used to evaluate significant differences in mean intake of foods. Patterns were ranked based on relative risk of listeriosis, using outbreak illness attribution data. Five distinct dietary patterns were identified. Patterns ranked at highest relative risk of listeriosis, based on U.S. outbreak illness attribution data, were characterized by relatively higher intakes of fruits, vegetables, and cheeses (∼13% respondents) or cereal, milk, and yogurt (∼14% respondents). Individuals consuming these dietary patterns differed in sex, race, food security, self-rated diet quality, and self-rated health. Cluster analysis, despite methodological limitations, provides new information on consumption, sociodemographic, and economic characteristics of subgroups within susceptible populations, which may be used to target educational messages. HIGHLIGHTS

OBJECTIVES: This study aimed to investigate: 1) the diet quality of older adults, using the Healthy Eating Index 2015 (HEI-2015) and self-rated diet quality, 2) characteristics associated with reported awareness and use of nutrition information, 3) factors associated with HEI-2015 score and self-rated diet quality, including the relationship with awareness and use of nutrition information. METHODS: A cross-sectional analysis of 24-hour recall and questionnaire data from the National Health and Nutrition Examination Survey 2009–2014, including 4493 subjects, aged 60 years and older. The population ratio method was used in SAS 9.4 to calculate mean HEI scores. Data was stratified by gender, then t-tests and ANOVA were used to compare means and chi-squares were used to compare proportions. Logistic and linear regression were used to test for associations with diet quality, controlling for potential covariates. RESULTS: The mean total HEI score for men was significantly lower than for women (63.7 ± 0.8 vs. 66.6 ± 0.8 respectively, P

Older adults returning home from the hospital may encounter health issues that cause anxiety about their ability to obtain enough food. Home-delivered meal (HDM) programs support nutritional needs and improve food security of those who cannot provide for themselves. A study conducted in six states examined feelings of anxiety about getting enough food in older adults (aged 60 years and older), comparing three time points: prior to hospitalization, at hospitalization (n = 566) and after receiving HDMs for two months posthospitalization (n = 377). Food anxiety during hospitalization was significantly higher among Hispanic ethnicity, current and former smokers, diabetics, and those who eat alone or have difficulty shopping. Food anxiety was significantly lower from baseline to two months follow-up (P 0.0001), and participants showed improvements in certain coping strategies they used to get their meals. Indicators of food anxiety can help the health care system and community nutrition programs target those at highest risk of negative health outcomes.

The trend among older adults in the United States is to "age in place" instead of opting for institutionalization. To maintain older adults with chronic conditions in their homes and to improve health after hospitalization, comprehensive social, health, and nutrition services are essential. Quality of dietary intake is crucial and yet often underestimated. Calorie needs decrease with age while nutrient needs remain the same, even increasing for some nutrients. This poses difficulties for individuals with functional disabilities who are unable to shop and cook due to physical or mental limitations or on a limited budget. The Older American Act home-delivered meal (HDM) program offers at least 1 healthy meal per day, 5 or more days per week, and targets individuals homebound due to illness, disability, or social isolation and those with greatest economic or social need. This review summarizes the available literature on the relationship between HDM and health outcomes. The HDM program is difficult to evaluate because of the multifactorial effect on health status. However, national surveys and smaller studies show that it is well targeted, efficient, and well liked; provides quality food to needy individuals; and helps individuals remain living independently. Studies show that HDMs improve dietary intake, with greater health benefits when more meals reach the neediest individuals. HDMs also decrease institutionalization of older adults and resulting healthcare expenditures. However, funding has not kept up with increased demand for this program. More studies with improved designs may provide more information supporting the program's impact on nutrition status and decreased health expenditures.

OBJECTIVES: 1) Determine dietary consumption patterns, among older adults in the United States; 2) Evaluate sociodemographic and economic characteristics associated with each pattern; 3) Determine intake of foods associated with larger relative risk of listeriosis within these patterns; and 4) Rank these patterns based on risk. METHODS: The study included older adults, age 60 and older, from What We Eat in America, National Health and Nutrition Examination Surveys 2009–2010, 2011–2012 and 2013–2014 (n = 4967). Cluster analysis based on day 1 24-hour dietary recalls was used to define dietary patterns. ANOVA with Dunnett's method of adjustment used to evaluate significant differences in mean intake of foods associated with higher risk of listeriosis within each pattern. Patterns were ranked based on relative risk of listeriosis using outbreak illness attribution and risk assessment data. RESULTS: Five distinct dietary patterns were identified -Vegetables, Fruits & Oils; Mixed Dishes; RTE (Ready-To-Eat) Cereal, Milk & Yogurt; Meat & Potatoes; and Cured Meats & Cheese. The patterns ranked at highest relative risk of listeriosis, based on 2013 outbreak illness attribution data, were (1) the Vegetables, Fruits & Oils, characterized by relatively higher intakes of fruits, vegetables, and vegetable oils (∼22% respondents), (2) the RTE (Ready-To-Eat) Cereal, Milk & Yogurt, with relatively higher intakes of cereal, milk, and yogurt (16% respondents); and, based on 2003 risk assessment data, (3) the Cured Meats & Cheese with relatively higher intakes of breads, cheese, and cured meats (∼9.6% respondents). Individuals consuming these dietary patterns differed in sex, race/ethnicity, food security, self-rated diet quality, and self-rated health. CONCLUSIONS: Cluster analysis, despite methodological limitations, provides new information on consumption, sociodemographic, and economic characteristics of subgroups within susceptible populations that can be used to target educational messages. FUNDING SOURCES: Agricultural Research Service, US Department of Agriculture; Food and Drug Administration.