Evaluation of dietary quality in relationship to nutritional and lifestylefactors in elderly people of the US Framingham Heart Study and the European SENECA study

Objective: To evaluate dietary quality of European and American elderly Sub jects using different derivatives of dietary patterns (dietary scores and c lusters) and to investigate the relationship or these approaches to nutriti onal and lifestyle factors. Design: Data from the cross-sectional SENECA baseline study and Framingham Heart Study (original cohort and offspring) were used for data analysis. Fo od intake data were summarised into dietary clusters and into dietary score s (Healthy Diet Indicator and Mediterranean Diet Score). These measures of dietary quality were then tested for associations with lifestyle factors an d measures of nutritional status. Subjects/Setting: The study population, aged 70-77 y, consisted of 828 subj ects from Framingham, MA (USA) and 1282 subjects from the following Europea n centres: Hamme, Belgium, Roskilde, Denmark; Padua, Italy; Culemborg, The Netherlands; Vila Franca de Xira, Portugal; Betanzos, Spain, and Yverdon, B urgdorf and Bellinzona, Switzerland. Results: Dietary intake varied widely across the European and American rese arch centres. In general, Southern European centres and Framingham had high er mean diet scores, indicating a higher dietary quality, than Northern Eur opean centres (MD-scores: 4.2-4.4 vs 2.7-3.5). Cluster analysis identified the following five dietary patterns characterised by: (1) sugar and sugar p roducts; (2) fish and grain, (3) meat, eggs and flat; (4) milk and fruit; a nd (5) alcohol intake. The meat, eggs and fat pattern had significantly low er average dietary quality, as measured with all three diet scores than all other groups except the alcohol group. The fish and grain group had signif icantly better Mediterranean diet scores than all other groups. Conclusions: Dietary scores and dietary clusters are complementary measures to classify dietary quality, The associations with nutritional and lifesty le factors indicate the adequate categorisation into dietary quality groups .