The Association Between Diet Quality and Quality of Life in Overweight and Obese Older Adults KLARA ZOLOTNITSKAYA Nutrition and Dietetics Major Department of Nutrition and Food Sciences FACULTY SPONSOR: INGRID LOFGREN

Obesity Category Value Underweight < 18.5 kg/m2 Normal weight Prevalence of obesity has continued to rise since 19761 Body mass index (BMI) classifications1 Obesity-related chronic diseases include diabetes, hypertension, stroke, heart disease, cancers2 Category Value Underweight < 18.5 kg/m2 Normal weight 18.5-24.9 kg/m2 Overweight 25.0-29.9 kg/m2 Obese ≥ 30.0 kg/m2

Older Women Obesity impacts health related quality of life3 In 2008, 35.5% of women were obese1 31% of older women, ages 65+, are limited in their ability to perform daily acitivities4 Physical functioning declines as women get older4 31% of older women have a condition of diability that limits full participation in daily activities

Participant Information University of Rhode Island Dietary Education and Active Lifestyle (UR-IDEAL) Phase II Participants recruited from four senior centers Two in urban setting – Warwick and Cranston Two in rural setting – North Kingstown and South Kingstown 109 older adults Ages – 55-80 years 20 males 89 females

Methodology Participants completed Dietary Screening Tool (DST) Identifies nutritional risk and overall dietary intake Three levels of nutritional risk: at risk (<60), possible risk (60-75), and not at risk (>75)

Methodology Participants completed Short Form 12 (SF-12) Measures health related quality of life (HRQOL) Physical Component Score (PCS-12) and Mental Component Score (MCS-12) Summary Score Ranges 0-100 Higher Score indicates better HRQOL

Sample SF-12 Questions

Participant Characteristics Mean ± SD Height 109 Weight Body mass index Waist Circumference Hip Circumference 108 Total DST Score Total SF-12 Score The number of participants who’s hip circumference was recorded is less than the number of participants in all other categories

Participant Characteristics Mean ± SD Height 109 63.3 ± 3.17 Weight 190.3 ± 30.81 Body mass index 33.4 ± 4.26 Waist Circumference 39.75 ± 4.82 Hip Circumference 108 45.28 ± 3.94 Total DST Score 65.42 ± 12.89 Total SF-12 Score 32.31 ± 2.44 Mean BMI of participants is 33.4, indicating obesity Mean DST score among participants is 65.42, indicating possible nutritional risk Mean SF-12 score is 32.31, indicating that most participants have a low HRQOL as this study categorized HRQOL score <33 to be low, >33 to be high HRQOL

Dietary Screening Tools Scores 60 50 Possible risk 40 Number of Participants 30 At risk Not at risk 20 10

Health Related Quality of Life Results Number of Participants Low HRQOL High HRQOL

Correlation Between DST and SF-12 Scores p=0.739 Not significant Participant SF-12 Scores Participant DST Scores

Results N Value Significance No significant association between DST category and HRQOL category after Chi-square test for independence Comparing the number of participants in each category Chi-Square Tests N Value Significance Pearson Chi-Square 109 1.894 0.388 Likelihood Ratio 2.011 0.366 Linear-by-Linear Association 1.189 0.276

Conclusion Both DST and SF-12 reduce participant burden Shorter in length than alternatives – Food Frequency Questionnaire (FFQ) and SF-36

Conclusion FFQ and SF-36 may yield different results because both provide different data FFQ - macronutrient breakdown of participants typical diet over a month SF-36 - eight domains of health Assesses two main subscales: physical component and mental component subscales, and overall summary score Other studies have found an association between physical component score and diet quality

References References 1. Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and Trends in Obesity among US Adults, 1999-2008. JAMA 2010; 303: 235-241. 2. Malnick SD, Knobler H. The Medical Complications of Obesity. QJM 2006; 99: 565-579. doi: 10.1093/qjmed/hcl085 3. Blissmer B, Riebe D, Dye G, Ruggiero L, Greene G, Caldwell M. Health and Quality of Life Outcomes. Health and Quality of Life Outcomes 2006; 4: 1-8. 4. Wyn R, Solis B. Women’s Health Issues Across the Lifespan. Women’s Health Issues 2001; 11: 148-159.

Questions . . . .