Skip to main content
Top
Published in: The journal of nutrition, health & aging 9/2018

01-11-2018

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

Authors: Furong Xu, S. A. Cohen, I. E. Lofgren, G. W. Greene, M. J. Delmonico, M. L. Greaney

Published in: The journal of nutrition, health & aging | Issue 9/2018

Login to get access

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.
Literature
4.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
5.
go back to reference 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.CrossRefPubMedPubMedCentral 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.CrossRefPubMedPubMedCentral
6.
go back to reference 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.CrossRef 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.CrossRef
7.
go back to reference Zack, MM. Health-related quality of life—United States, 2006 and 2010. MMWR Surveill. Summ. 2013; 62(Suppl. 3): 105–111. Zack, MM. Health-related quality of life—United States, 2006 and 2010. MMWR Surveill. Summ. 2013; 62(Suppl. 3): 105–111.
8.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
10.
go back to reference 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): 520–528PubMed 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): 520–528PubMed
11.
go back to reference 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.CrossRefPubMedPubMedCentral 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.CrossRefPubMedPubMedCentral
12.
go back to reference 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.CrossRefPubMedPubMedCentral 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.CrossRefPubMedPubMedCentral
13.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
14.
go back to reference Cockerham WC. Health lifestyle theory and the convergence of agency and structure Journal of Health and Social Behavior 2005; 46 (1): 51–67.CrossRefPubMed Cockerham WC. Health lifestyle theory and the convergence of agency and structure Journal of Health and Social Behavior 2005; 46 (1): 51–67.CrossRefPubMed
17.
go back to reference Nadal K. The sage encyclopedia of psychology and gender. Thousand Oaks, CA: Sage; 2017.CrossRef Nadal K. The sage encyclopedia of psychology and gender. Thousand Oaks, CA: Sage; 2017.CrossRef
18.
go back to reference 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.CrossRefPubMedPubMedCentral 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.CrossRefPubMedPubMedCentral
20.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
21.
go back to reference 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.CrossRef 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.CrossRef
24.
go back to reference 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. 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.
27.
go back to reference 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. 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.
28.
go back to reference 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; 32:427–434CrossRefPubMed 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; 32:427–434CrossRefPubMed
29.
go back to reference 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.CrossRefPubMedPubMedCentral 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.CrossRefPubMedPubMedCentral
30.
go back to reference 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):297–306CrossRefPubMed 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):297–306CrossRefPubMed
Metadata
Title
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
Authors
Furong Xu
S. A. Cohen
I. E. Lofgren
G. W. Greene
M. J. Delmonico
M. L. Greaney
Publication date
01-11-2018
Publisher
Springer Paris
Published in
The journal of nutrition, health & aging / Issue 9/2018
Print ISSN: 1279-7707
Electronic ISSN: 1760-4788
DOI
https://doi.org/10.1007/s12603-018-1050-4

Other articles of this Issue 9/2018

The journal of nutrition, health & aging 9/2018 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.