1. DIFFERENCES IN DIETARY PATTERNS BETWEEN YOUNGER AND OLDER OBESE AND OVERWEIGHT OUTPATIENTS TOFFANELLO ED, INELMEN EM, SERGI G, COIN A, BUSETTO L, MANZATO E, ENZI G DIPARTIMENTO DI SCIENZE MEDICHE E CHIRURGICHE UNIVERSITA’ DEGLI STUDI DI PADOVA CLINICA GERIATRICA International Symposium: OBESITY IN THE ELDERLY Rome, January 26th - 28th 2006

2. BACKGROUND AND AIM OF THE STUDY Though the Mediterranean diet has been associated with positive effect on longevity and comorbidities, obesity can occur despite a healthy diet, even in seniors (excessive energy-intake?) Traditional dietary patterns are favoured by seniors, whereas Western diet is preferred by younger adults The aim of the study was to describe differences in dietary patterns between younger and older obese, overweight outpatients

3. DESIGN AND METHODS Food intake patterns were investigated using scores for the daily frequency of consumption of different foodstuffs according to gender and age group. Food scores were calculated as follows: No-starchy vegetables, potatoes and fresh fruit scores were the sum of the average number of meals a day when fruit and vegetables were eaten Dairy products were scored as daily frequency of consumption of milk and cheese Sweets and desserts scores included sweets, biscuits, cakes, ice-cream, jams, chocolates, and honey Pasta, pizza and bread were scored separately as the number of times each of these foods were eaten per day Meat scores were calculated according to the number of times a day that white meat and red meat were eaten Alcohol scores were obtained by calculating the daily frequency of consumption of different alcoholic beverages, e.g. wine, beer, spirits

4. NumberHeight (m)*†‡Weight (Kg)*†‡BMI (Kg/m 2 *Waist (cm)*‡ Men 18-34y191.77±0.05113.3±13.136.6±5.5117.6±10.0 35-64y471.74±0.06113.3±26.936.7±6.1116.8±9.4 ≥65y131.68±0.0894.0±22.036.5±4.5 117.7±16.1 All men791.72±0.06106.9±20.736.6±5.3117.3±11.8 Women 18-34y471.63±0.0793.1±19.436.2±5.1 111.7±13.8 35-64y1961.60±0.0688.7±16.231.5±11.3113.7±12.7 ≥65y731.57±0.0685.4±14.234.4±4.5114.6±9.3 All women 316 1.60±0.0689.0±16.634.0±6.9113.3±11.9 TABLE 1: SUMMARY OF ANTHROPOMETRIC INDICES ACCORDING TO AGE GROUP AND GENDER (MEAN AND STANDARD DEVIATION) * statistically significant difference in mean values between genders (P <0·001; ANOVA) † statistically significant difference in mean values across age groups in males (P<0·05; two-tailed Student’s t test). ‡ statistically significant difference in mean values across age groups in females (P<0·05; two-tailed Student’s t test). DESCRIPTION OF THE SAMPLE

5. Bread § 18-34 years1.57±1.202.14±1.97Ns 35-64 years1.88±1.101.91±1.16Ns >65 years2.11±1.051.94±0.996Ns P-value†<0.02Ns Pasta 18-34 years0.74±0.421.18±0.91<0.02 35-64 years0.86±0.670.96±0.43Ns >65 years1.06±0.830.96±0.42Ns P-value†<0.02Ns Pizza 18-34 years0.12±0.120.17±0.08Ns 35-64 years0.06±0.040.03±0.01<0.001 >65 years0.00±0.000.01±0.01<0.001 P-value†<0.001 FoodstuffsFemale (n=316)Male (n=79)P* * Mean values difference between genders (two-tailed Student’s t test). † Mean values difference across age groups (two-tailed Student’s t test). § wheat bread and crackers were included. DIETARY HABITS

6. No-starchy vegetables‡ 18-34 years0.64±0.600.88±0.61Ns 35-64 years1.33±1.211.14±0.98Ns >65 years1.78±0.971.43±0.91Ns P-value†<0.001<0.05 Potatoes (all preparations) 18-34 years0.07±0.060.27±0.12<0.001 35-64 years0.00±0.00 - >65 years0.00±0.00 - P-value†<0.001 Fresh fruit 18-34 years0.81±0.800.59±0.49Ns 35-64 years1.50±1.491.23±1.17Ns >65 years1.56±0.761.67±0.81Ns P-value†<0.001 FoodstuffsFemale (n=316)Male (n=79)P* * Mean values difference between genders (two-tailed Student’s t test). † Mean values difference across age groups (two-tailed Student’s t test). ‡ all vegetables were included except potatoes (including French fries). DIETARY HABITS

7. Meat 18-34 years0.78±0.571.38±0.81<0.002 35-64 years0.87±0.591.01±0.57Ns >65 years0.77±0.751.06±0.61Ns P-value†Ns Fish 18-34 years0.00±0.000.01±0.01<0.001 35-64 years0.17±0.150.10±0.07<0.02 >65 years0.22±0110.30±0.15<0.05 P-value†<0.001 White to red meat ratio 18-34 years0.30.1 35-64 years0.50.3 >65 years0.6 FoodstuffsFemale (n=316)Male (n=79)P* * Mean values difference between genders (two-tailed Student’s t test). † Mean values difference across age groups (two-tailed Student’s t test). ¶ poultry, beef, pork, lamb, sliced ham and processed meat were included. DIETARY HABITS

8. Milk 18-34 years0.34±0.230.36±0.18Ns 35-64 years0.89±0.510.57±0.21<0.001 >65 years1.10±0.900.74±0.36Ns P-value†<0.001 Cheese 18-34 years0.64±0.590.58±0.41Ns 35-64 years0.70±0.640.44±0.40<0.01 >65 years0.72±0.410.54±0.51Ns P-value†Ns Eggs 18-34 years0.06±0.060.04±0.01Ns 35-64 years0.11±0.100.06±0.01<0.001 >65 years0.11±0.100.09±0.02Ns P-value†<0.005<0.001 FoodstuffsFemale (n=316)Male (n=79)P* * Mean values difference between genders (two-tailed Student’s t test). † Mean values difference across age groups (two-tailed Student’s t test). DIETARY HABITS

9. Sweets and desserts 18-34 years1.77±1.492.03±1.02Ns 35-64 years1.30±1.010.76±0.42<0.001 >65 years0.75±0.150.73±0.41Ns P-value†<0.001 Sweetened beverages 18-34 years0.19±0.180.25±0.12Ns 35-64 years0.07±0.050.19±0.09<0.001 >65 years0.00±0.000.17±0.08<0.001 P-value†<0.001<0.005 Alcoholic beverages 18-34 years0.00±0.00 - 35-64 years0.23±0.150.86±0.81<0.001 >65 years0.68±0.381.25±0.81<0.001 P-value†<0.001 FoodstuffsFemale (n=316)Male (n=79)P* * Mean values difference between genders (two-tailed Student’s t test). † Mean values difference across age groups (two-tailed Student’s t test). DIETARY HABITS

10. RESULTS Main differences in dietary patterns have been observed, according to age in both gender. Seniors reported, compared to younger patients, the lowest daily consumption of sweet high-fat-fat foods, and the highest frequency of consumption of fresh fruit and vegetables. All the participants reported to eat cereals while the consumption of white meat and fish was higher in seniors. The consumption of red wine at mealtime was common in older patients. The frequencies of consumption of cheese did not differ accross age groups, but compared to normal-weight Italian population frequencies, was higher in older patients.

11. CONCLUSIONs Our study provides evidence of two different dietary patterns: A Western diet which may have influenced weight gain in younger outpatients An Italian Mediterranean diet in older ones Despite its healthy effect, Mediterranean diet style did not prevent our older obese outpatients from additional weight gain. Information on dietary habits may be useful to improve weight management and obesity prevention even in seniors