Lifestyle study (ancillary study)

Lifestyle study (ancillary study)

Contact: Marjolein Visser

Background
In order to obtain more detailed and extensive information regarding dietary intake, the Lifestyle study was conducted in 2007. This side study was performed among 1421 persons meeting the following eligibility criteria: participation in 2005/2006 LASA cycle, alive on January 15, 2007, age <80 years, and cognitively well-functioning (Mini Mental State Examination score >23). Complete lifestyle data (i.e. diet, physical activity, smoking behavior and alcohol intake, weight, oral health) 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 these 1058 persons, 516 indicated to be willing to participate in an additional nutrition sub-study of which 210 were randomly selected to be interviewed (24-hour recalls).

Variables Lifestyle study
An overview of the dietary intake information collected by questionnaire in the participants of the Lifestyle study is shown in table 2.

Identical questions have been used in the Dutch Food Consumption 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 estimated by multiplying the frequency with the amount consumed. The questionnaire used in the Lifestyle study can be found here (link to pdf LASA questionnaire about lifestyle, shortly available).

24-hour dietary recalls
An additional nutrition interview Twenty-four-hour dietary recalls were obtained by telephone from 200 of the 210 selected participants (response 95.2 %). The participants were sent a booklet with color 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 day covering all foods and beverages consumed from waking up until the next morning. 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 (1). The calculated variables are listed in table 3.

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
Dietary intake has been used as outcome variable by e.g. Dijkstra et al. (2) who investigated the proportion of Dutch older adults adhering to the fruit, vegetables and fish guidelines and to examine the independent associations of different SES indicators with adherence to these guidelines. In addition, misperception of self-reported adherence (3) or perceived barriers (4) in adherence to the fruit, vegetables and fish guidelines, and motivations to eat healthily (5) has been described.

Nutritional information regarding the fruit, vegetable and fish consumption from the Lifestyle Study was also used for the LASA 2010 and 2011 reports for the Dutch ministry of Health, Welfare and Sports (6, 7).

The 24-hour recall data have been used in the ministry report listed above and a paper by Waterlander et al. (8). In that study, individual dietary energy densities (DED) were 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 (9).

References

  1. NEVO. tabel. Nederlands Voedingsstoffenbestand 2006/Stichting Nederlands Voedingsstoffenbestand (Dutch Food Composition Database). Den Haag: Voedingscentrum., 2006.
  2. Dijkstra SC, Neter JE, Brouwer IA, Huisman M, Visser M. Adherence to dietary guidelines for fruit, vegetables and fish among older Dutch adults; the role of education, income and job prestige. J Nutr Health Aging 2014;18(2):115-21.
  3. Dijkstra SC, Neter JE, Brouwer IA, Huisman M, Visser M. Misperception of self-reported adherence to the fruit, vegetable and fish guidelines in older Dutch adults. Appetite 2014;82:166-72.
  4. Dijkstra SC, Neter JE, van Stralen MM, Knol DL, Brouwer IA, Huisman M, Visser M. The role of perceived barriers in explaining socio-economic status differences in adherence to the fruit, vegetable and fish guidelines in older adults: a mediation study. Public Health Nutr 2015;18(5):797-808.
  5. Dijkstra SC, Neter JE, Brouwer IA, Huisman M, Visser M. Motivations to eat healthily in older Dutch adults–a cross sectional study. Int J Behav Nutr Phys Act 2014;11:141.
  6. Visser M, Dijkstra C. Het eetgedrag van ouderen. LASA report for Dutch ministry of Health, Welfare and Sport, 2010.
  7. Visser M, Dijkstra C. Naar verklaringen voor het eetgedrag van ouderen. LASA report for Dutch ministry of Health, Welfare and Sport, 2011.
  8. Waterlander WE, de Haas WE, van Amstel I, Schuit AJ, Twisk JW, Visser M, Seidell JC, Steenhuis IH. Energy density, energy costs and income – how are they related? Public Health Nutr 2010;13(10):1599-608.
  9. Maillot M, Darmon N, Vieux F, Drewnowski A. Low energy density and high nutritional quality are each associated with higher diet costs in French adults. Am J Clin Nutr 2007;86(3):690-6.


Date of last update: August, 2017