Lifestyle

Diet and food consumption (including side study)


Contact: Marjolein Visser

Background
In several LASA cycles, qualitative information on diets, use of milk products, fruits and vegetables was obtained. In addition, the number of eating moments during the day was assessed. This information was only obtained for the original LASA cohort that started in 1992/93.
Quantitative information on dietary intake was assessed using a self-administered questionnaire during the Lifestyle study conducted in 2007. The Lifestyle study was conducted among 1421 persons meeting the following eligibility criteria: participation in 2005/2006 LASA cycle, alive on January 15, 2007, age <80 years, living independently, and cognitively well-functioning (Mini Mental State Examination score >23). Complete lifestyle data were obtained from 1058 persons (response rate 74.5 %; n 326 no response, n 18 refused, n 8 not able due to physical problems, n 11 deceased). Of the 1058 persons, 516 indicated to be willing to participate in an additional nutrition sub-study of which 210 were randomly selected to be interviewed.

Variables in regular LASA cycles original cohort
The information obtained during the medical interview and/or the self-administered questionnaire of the regular LASA cycles is shown in table 1 (pdf). A separate documentation is available for alcohol consumption.

Variables Lifestyle study
An overview of the dietary intake information collected by questionnaire in 1058 participants of the Lifestyle study is shown in table 2 (pdf). Identical questions have been used in the Dutch national nutrition surveys (Voedselconsumptie Peiling – see www.rivm.nl/vcp ) and the National Health Monitor conducted by regional GG&GDs. For fruit and vegetables the average daily intake can be estimate by multiplying the frequency with the amount consumed.

An additional nutrition interview was obtained from 200 of the 210 selected participants (response 95.2 %). The participants were sent a booklet with colour pictures of different food products (ranging from a buttered slice of bread to a plate with vegetables or pasta sauce) using different portion sizes. In this booklet persons were also instructed to measure the content of frequently used glasses, cups and serving spoons. The persons were telephoned unexpectedly by specifically trained dietetic students to recall their food intake of the previous 24 h. The weight of the used food products was estimated using the portion size booklet, the measured content of commonly used kitchenware, and used recipes. Data on food intake were obtained from all days of the week, minimizing daily variation. For most respondents (81 %) two recalls were obtained and used for analysis (one weekday and one weekend day). For the remaining group only one recall was available.

Analyses of the consumed food items were based on energy and nutrient data of the Dutch Food Composition Database (NEVO 2006). The calculated variables are listed in table 3 (pdf). In addition, information was collected on the eating moments (ranging from 1 = before breakfast to 7 = after dinner), normal or special day (e.g. sick or holiday), and following a special diet (e.g. energy restricted or reduced salt).

Previous use in LASA
Information regarding problems chewing was incorporated in the paper by Schilp et al. (2011) as a potential determinant of incident undernutrition in older persons. An example of using the dairy consumption data can be found in the paper by Van Schoor et al (2008).

Nutritional information regarding the fruit, vegetable and fish consumption from the Lifestyle Study was used for the LASA 2010 and 2011 reports for the Dutch ministry of Health, Welfare and Sports (Visser & Dijkstra 2010, 2011).

The 24-hour recall data have been used in two studies and the ministry report listed above. In the paper by Waterlander (2010), individual dietary energy densities (DED) was calculated based on the 24-hour recall data. DED was defined as amount of energy per unit weight and was calculated by summing both the edible weight (ΣW) and the energy content (ΣE) of all foods consumed during a day and dividing those outcomes (Maillot 2007). In a more recent study, Waterlander et al (submitted) used the dietary information from the 24-hour recall to calculate the costs of the diet and the change in costs when the diet should be improved to a healthier diet.

References

  1. Maillot, M, Darmon, N, Vieux, F et al. (2007) Low energy density and high nutritional quality are each associated with higher diet costs in French adults. Am J Clin Nutr 86, 690–696. Voedingscentrum (2006).
  2. NEVO tabel: Nederlands Voedingsstoffenbestand 2006/Stichting Nederlands Voedingsstoffenbestand (Dutch Food Composition Database). Den Haag: Voedingscentrum.
  3. Schilp J, Wijnhoven HAH, Deeg DJH, Visser M. Early determinants for the development of undernutrition in an older general population - Longitudinal Aging Study Amsterdam. Br J Nutr 2011;30:1-10.
  4. Van Schoor NM, Visser M, Pluijm SM, Kuchuk N, Smit JH, Lips P. Vitamin D deficiency as a risk factor for osteoporotic fractures. Bone 2008;42:260-6.
  5. Visser M, Dijkstra C. Het eetgedrag van ouderen. LASA report for Dutch ministry of Health, Welfare and Sports, 2010.
  6. Visser M, Dijkstra C. Naar verklaringen voor het eetgedrag van ouderen. LASA report for Dutch ministry of Health, Welfare and Sports, 2011.
  7. Waterlander WE, van Amstel I, de Haas W, Roodenburg A, Seidell JC, Visser M, Steenhuis IHM. What are the costs of shifting to a healthier daily menu based on international dietary recommendations? Submitted.
  8. Wilma E Waterlander WE, de Haas WE, van Amstel I, Schuit AJ, Twisk JWR, Visser M, Seidell JC, Steenhuis IHM. Energy density, energy costs and income – how are they related? Public Health Nutrition 2010;13:1599-1608.