NE1023: Improving Plant Food (Fruit, Vegetable and Whole Grain) Availability and Intake In Older Adults
Statement of Issues and JustificationFruit, vegetables and whole grains contain numerous bioactive compounds that are involved in reducing oxidative damage in tissues, improving gastrointestinal function, and other physiological processes. A large body of evidence suggests that diets rich in fruit, vegetables and whole grains are associated with a lower incidence of coronary heart disease, hypertension, and some cancers (1-4). Furthermore, low intakes are associated with obesity, an independent risk factor for coronary heart disease, type 2 diabetes, and other chronic diseases. Conversely, improving consumption may also lower the risk of certain functionally debilitating diseases associated with aging, such as those that impair vision (age-related macular degeneration or cataracts), or negatively impact the digestive system (diverticular disease) (5,6). Thus, the habitual consumption of fruit, vegetables, and whole grains may be a means of extending the number of healthy and productive years for older adults and enhancing their overall quality of life.
Although older Americans are the most rapidly growing segment of the U.S. population, data are limited with respect to dietary and other lifestyle factors involved in achieving or optimizing their health status. Poor physical health also exacts an economic toll, as older adults who are disabled by or hospitalized for largely preventable, diet-related diseases represent a disproportionate amount of national health care costs (7,8). Many of these seniors burden the already stretched resources of social service and community-based agencies such as congregate and home delivered meal programs, and the adult day care system. For example, it has been estimated that for each line of vision lost, use of social services increases by 12% in this population.
Despite the importance of fruit, vegetable and whole grain intake in maintaining health and functional status, older adults are not meeting minimum dietary recommendations. Healthy People 2010: Objectives for Improving Health (HP2010) has set specific goals for Americans relative to fruit, vegetable and whole grain intake based on a broad scientific consensus (9). However, the Continuing Survey of Food Intakes by Individuals (CSFII) found that only about one-third of adults over the age of 60 consumed the recommended number of servings of fruit per day, half consumed the minimum daily number of vegetable servings, and about 40% consumed the minimum recommended servings of grains, including whole grains. Furthermore, only a fraction of those seniors surveyed selected vegetables and grain-based foods considered to be good sources of protective food constituents such as fiber and antioxidants. In addition and perhaps as a consequence, obesity is extremely high in the older adult population. One major concern facing nutrition educators related to this sub-optimal intake is that aging consumers are confused by conflicting media reports and advertisements related to the properties of fruit, vegetables and whole grains, making apparent the need for clearer informational messages. Disease prevention in the older population with the goal of fostering independent living and a high quality of life has been set as a national priority within federal health policy (HP2010) (9). Toward this goal, considerable integrated research needs to be conducted in order to improve fruit, vegetable and whole grain intake to reduce diet-related disability, obesity and chronic disease rates among rapidly growing numbers of older Americans.
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