Impact of the diagnosis of diabetes and/or hypertension on healthy food consumption indicators: a longitudinal study of elderly persons

Cembranel, Francieli; Bernardo, Carla de Oliveira; Ozcariz, Silvia Gisele Ibarra; d'Orsi, Eleonora

doi:10.1590/1981-22562017020.160081

Abstract

Objective:

to evaluate if the prevalence of healthy food consumption indicators among elderly persons with the self-reported diagnosis of diabetes mellitus and/or systemic arterial hypertension (DM and/or SAH) improved after diagnosis of these diseases, and to compare if the prevalence of such indicators was more frequent among elderly persons with DM and/or SAH than in elderly persons without these diseases.

Method:

a longitudinal study of 1,197 elderly persons aged 60-104 years, living in Florianopolis, Santa Catarina, Brazil, was performed, considering as an outcome the self-reported diagnosis of diabetes and/or hypertension. Healthy consumption indicators (exposures) were considered the maintenance and/or acquisition of the intake of fruit and vegetables ≥3 and ≥2 times/day, respectively, the consumption of fatty meat <2 times/week, and fried foods <2 times/week. Data was analyzed in terms of absolute and relative frequencies, and Poisson Regression was used to obtain the crude and adjusted prevalence of food consumption indicators. Values of p≤0.05 were considered statistically significant.

Results:

when comparing the prevalences of the indicators of healthy food consumption among elderly persons with DM and/or SAH with those without these diseases, it was observed that only the consumption of fried foods changed positively between the periods 2009-2010 and 2013-2014. This result was statistically significant only for women, with maintaining/acquiring the infrequent consumption of fried foods (<2 times/week) 8.2% higher among elderly women with DM and/or SAH, p=0.043.

Conclusion:

The prevalence of healthy food consumption indicators was low and there was almost no difference between older adults with and without DM and/or SAH.

Keywords:
Older adults; Food Consumption; Diabetes Mellitus; Hypertension; Longitudinal Study.

[1] Correspondence Francieli Cembranel E-mail: francielicembranel@gmail.com

Variables		Baseline 2009-1020		2nd phase 2013-2014	Value-p
Variables	n	% (IC95%)	n	% (IC95%)
Gender					0.469
Male	614	36.1 (32.4 - 40.1)	419	36.9 (33.6 - 40.3)
Female	1088	63.9 (60.9 - 66.7)	778	63.1 (59.7 - 664)
Age (years)					<0.001
60 to 69	841	49.6 (46.2 - 53.0)	412	34.4 (29.9 - 39.3)
70 to 79	615	36.3 (32.5 - 40.2)	509	42.5 (38.1 - 46.9)
≥80	239	14.1 (10.1 - 19.3)	276	23.1 (18.3 - 28.6)
Self-reported skin color					<0.001
White/Caucasian	1441	85.5 (83.6 - 87.3)	980	85.9 (83.6 - 88.0)
Brown/Mixed-race	131	7.8 (3.7 - 13.6)	100	8.8 (4.2 -16.4)
Black/Afro-Brazilian, Yellow/Asian-Brazilian and indigenous	113	6.7 (3.1 - 13.5)	60	5.3 (1.0 - 13.9)
Schooling (years of study)					0.021
12 or more	386	23.4 (19.2 - 27.9)	287	23.9 (19.2 - 29.4)
9 to 11	231	14.0 (9.7 - 18.9)	181	15.1 (10.1 - 20.9)
0 to 8	1031	62.6 (59.5 - 65.5)	729	60.9 (57.3 - 64.5)
Per capita family income					0.421
Upper tercile	552	33.3 (29.4 - 37.4)	399	33.4 (28.7 - 38.2)
Intermediate tercile	550	33.2 (29.3 - 37.4)	416	34.8 (30.3 - 39.7)
Lower tercile	554	33.5 (29.5 - 37.5)	381	31.9 (27.1 - 36.7)
Self-reported diagnosis of DM and/or SAH					<0.001
No	614	36.1 (32.4 - 40.1)	360	30.1 (25.3 - 35.0)
Yes	1088	63.9 (60.9 - 66.7)	836	69.9 (66.7 - 72.9)

Variables	Men		Women
Variables	n	% (IC95%)	n	% (IC95%)	Value-p
Self-reported diagnosis of DM and/or SAH 2009-2010 (n=1702)*					<0.001

No	277	45.1 (41.2 - 49.1)	337	30.9 (28.2 - 33.7)
Yes	337	54.9 (50.9 - 58.8)	751	69.1 (66.3 - 71.8)
Self-reported diagnosis of DM and/or SAH 2013-2014 (n=1197)					<0.001
Self-reported diagnosis of DM and/or SAH 2013-2014 (n=1197)
No	198	48.0 (42.4 - 53.7)	241	31.8 (27.8 - 35.8)
Yes	221	52.0 (46.3 - 57.6)	537	68.2 (64.1 - 72.1)
Changes in daily consumption of fruit (≥3 times/day) and vegetables					0.154
(≥2 times/day) (n=1193) * *
(≥2 vezes/dia) (n=1193)* *
Maintained consumption at <3 for fruit and <2 for vegetables	341	79.0 (73.7 - 83.5)	550	71.9 (67.5 - 76.9)
Reduced consumption to <3 for fruit and <2 for vegetables	23	6.4 (4.4 - 9.3)	67	7.6 (5.5 - 10.4)
Maintained consumption at ≥3 for fruit and ≥2 for vegetables	10	3.3 (1.3 - 7.9)	42	5.8 (4.0 - 8.3)
Increased consumption to ≥3 for fruit and ≥2 for vegetables	44	11.3 (7.9 - 15.7)	116	14.7 (11.5 - 18.6)
Changes in the consumption of fatty meat (times/week) (n=1194)* **					0.031

Maintained consumption at ≥2	98	22.8 (17.0 - 29.9)	98	13.6 (8.5 - 21.0)
Increased consumption to ≥2	61	19.1 (12.8 - 27.5)	141	19.8 (14.5 - 26.4)
Maintained consumption at <2	169	42.1 (33.7 - 50.8)	361	46.5 (38.2 - 55.0)
Reduced consumption to <2	90	16.1 (12.0 - 21.2)	176	20.1 (15.1 - 26.3)
Changes in the consumption of fried foods (times/week) (n=1194) *					<0.001

Maintained consumption at ≥2	74	16.5 (12.6 - 21.4)	64	7.4 (5.4 - 10.1)
Increased consumption to ≥2	39	9.5 (6.3 - 14.2)	63	7.1 (5.4 - 9.3)
Maintained consumption at <2	192	48.9 (41.8 - 56.1)	495	66.5 (61.4 - 71.1)
Reduced consumption to <2	113	25.0 (19.8 - 31.0)	154	19.0 (15.6 - 22.9)

Variables of change in food consumption between 2009-2010 and 2013-2014 phases	Without DM and/or SAH		With DM and/or SAH		Value-p
	n	% (IC95%)	n	% (IC95%)
Changes in daily consumption of fruit (≥3 times/day) and vegetables (≥2 times/day) (n=1193) **					0.184
Maintained consumption at <3 for fruit and <2 for vegetables	334	78.2 (73.7 - 82.7)	557	72.2 (68.4 - 76.1)
Reduced consumption to <3 for fruit and <2 for vegetables	27	5.8 (3.5 - 8.0)	63	8.1 (5.1 - 11.0)
Maintained consumption at ≥3 for fruit and ≥2 for vegetables	16	3.2 (1.6 - 4.9)	36	5.9 (2.8 - 8.9)
Increased consumption to ≥3 for fruit and ≥2 for vegetables	61	12.8 (8.8 - 16.7)	99	13.8 (10.5 - 17.2)
Changes in the consumption of fatty meat (times/week) (n=1194) ***					0.669

Maintained consumption at ≥2	79	18.7 (12.3 - 25.1)	117	15.9 (10.6 - 21.2)
Increased consumption to ≥2	73	19.2 (13.0 - 24.7)	129	19.7 (13.3 - 26.1)
Maintained consumption at <2	191	43.2 (34.4 - 52.1)	339	45.9 (37.7 - 54.1)
Reduced consumption to <2	95	18.9 (13.1 - 24.7)	171	18.5 (13.9 - 23.1)
Changes in the consumption of fried foods (times/week) (n=1194) *					0.018

Maintained consumption at ≥2	65	12.8 (8.8 - 17.0)	73	9.5 (6.9 - 12.2)
Increased consumption to ≥2	45	10.9 (7.2 - 14.7)	57	6.2 (4.1 - 8.3)
Maintained consumption at <2	234	56.2 (48.6 - 63.7)	453	62.3 (57.5 - 67.2)
Reduced consumption to <2	94	20.0 (15.5 - 24.6)	173	21.9 (17.8 - 26.1)

		Men			Women
	Type of analysis	Without DM and/or SAH (n=198)	With DM and/or SAH (n=220)	Value-p	Without DM and/or SAH (n=240)	With DM and/or SAH (n=535)	Value-p
		% (IC95%)	% (IC95%)		% (IC95%)	% (IC95%)
Maintenance and/or acquisition of daily consumption of fruit (≥3 times/day) and vegetables (≥2 times/day)**	Crude	13.9 (8.9 - 19.0)	15.1 (8.1 - 22.2)	0.777	17.9 (12.0 - 23.7)	21.8 (17.3 - 26.2)	0.282
	Adjusted*	12.8 (7.8 - 17.7)	13.8 (7.7 - 19.8)	0.802	16.5 (11.3 - 21.8)	23.0 (18.3 - 27.7)	0.079
Maintenance and/or acquisition of infrequent consumption of fatty meat (<2 times/week)***	Crude	56.1 (45.9 - 66.2)	60.1 (49.5 - 70.6)	0.472	67.4 (56.7 - 78.1)	66.3 (57.2 - 75.4)	0.829
	Adjusted*	55.8 (45.0 - 66.5)	60.3 (50.1 - 70.6)	0.430	68.9 (57.5 - 80.4)	65.6 (56.9 - 74.4)	0.510
Maintenance and/or acquisition of infrequent consumption of fried foods (<2 times/week)	Crude	69.3 (61.2 - 77.4)	78.2 (72.5 - 84.0)	0.105	82.3 (77.0 - 87.7)	86.9 (84.1 - 89.7)	0.134
Adjusted*	68.4 (60.4 - 76.3)	78.0 (72.3 - 83.7)	0.080	80.9 (75.3 - 86.6)	87.5 (85.0 - 90.1)	0.043