Abstracts of Current Research:- Dietary intake and eating patterns of elderly people in Israel:
Who is at nutritional risk?
: Objective: To determine dietary intake and eating patterns of older persons in Israel and to identify factors associated with lower intake.
Design: A cross-sectional study.
Setting: Community-dwelling participants living at the Beer-Sheva area were interviewed at home, using a 24-hour food questionnaire with additional questions regarding health and eating habits. Dietary intake was compared between people aged 65-74 and 75 and over years.
Subjects: A total of 377 people over the age of 65 (224 aged 65-74 and 153 over the age of 75) were randomly selected from the Negev population.
Results: Dietary intake of energy, fat, carbohydrates, vitamins E, C and B1 were significantly lower for people aged 75 and older compared with people aged 65-74 years. Low energy intake was associated with lower subjective health status for men (p<0.01), poor appetite (p<0.01) and more gastrointestinal problems (p<0.05) for women and lower snack consumption (p<0.01) for both genders. In a multivariate model low energy intake was associated with low appetite and higher use of medication for both sexes and with frequency of eating alone and not consuming snacks for men.
Conclusions: Dietary intake is lower among individuals older than 75 compared with those 65-74 years old. Risk factors for low intake include poor appetite and health status, gastrointestinal problem and eating alone. Snacking enhanced dietary intake and should be considered desirable in this group.
- Development of Food Frequency Questionnaire (FFQ) for the Elderly Population Based on a Population Survey. : Older people are known to have different eating patterns than their younger counterparts, although in most nutritional studies of older populations Food Frequency Questionnaires (FFQs) that were developed and validated for the general adult population are used. In this paper we present the advantages of developing an FFQ for the older population based on a population survey.
A random sample of the Negev?s (Southern Israel) Jewish population age 35 and older was recruited and interviewed for their dietary intake using 24-hr recalls. Foods eaten were aggregated into conceptually similar groups and entered into step-wise regression models to predict variation in nutrient intake.
We interviewed 796 people age 35-64y and 377 people age 65+y for the study. Significantly more items were needed to reach 80% between-person variability for zinc, magnesium, vitamin E and protein for the elderly as compared with the younger age group. Portion sizes of most items consumed by the elderly were smaller compared to the Israeli Ministry of Health portion sizes booklet and the younger age group?s intake estimates. The nutrient values assigned for each line based on a weighted mean of the intake of the elderly were different from those using the most frequently used item.
The above findings highlight some of the advantages of developing an FFQ for an older population based on a population survey. Further studies are needed to compare the validity of existing tools adapted for the elderly to those developed based on population surveys.
- Development of a Semi Quantitative Food Frequency Questionnaire (FFQ)
To Assess Dietary Intake of Multiethnic Populations.
: The Food Frequency Questionnaire (FFQ) is one of the most commonly used methods in epidemiological studies to assess long-term nutritional exposure. The purpose of this study is to develop a general FFQ for the Israeli population and present the procedures undertaken to select foods to be included in a questionnaire for a multiethnic population. Random population cluster sampling was done using voter registration lists of the Negev Jewish population, aged 35 years and over, which were divided into three groups based on where they were born, namely: Israel, Asia-Africa and Europe-America. Participants were interviewed for their dietary intake using 24h recalls. Foods eaten by our subjects were aggregated into conceptually similar food groups and entered in step-wise regression models to predict variation in nutrient intake. Separate models were created for each origin group. It was found that the dietary intake was significantly lower for energy and vitamin E among European-American born subjects and significantly lower for calcium intake among Asian-African born subjects. Differences between ethnic groups were seen in the list of foods, which explained the between-person variability for energy and zinc. For most nutrients, fewer items were needed to explain the between-person variation in the group of people born in Israel. The final list of foods included 126 items and explained over 90% of the between-person variability in selected nutrients for all three groups. The newly developed FFQ for the Negev population includes 126 items that are sufficient to rank the nutritional exposure of people over 35 years old from the three origin groups in Israel.
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Publications:- Fraser D, Bilenko N, Vardy H, Abusaad K, Shahar DR. . Socio-cultural differences in food intake between adult Jewish and Bedouin populations in Southern Israel Ethn Dis 18: 13-8. (2008)
- German L, Feldblum I, Bilenko N, Castel H, Harman -Boehm I, Shahar DR. Depressive symptoms and nutritional risk factors among hospitalized elderly people J Nutr Health and Aging 12: 313-8 (2008)
- Feldblum I, German L, Castel H, Harman-Boehm I, Bilenko N, Eisinger M, Fraser D, Shahar DR. . Characteristics of undernourished older medical patients and the identification of predictors for undernutrition status. Nutr J 6: (2007)
- Peled R, Dahan D, Endevelt R, Shahar DR. Osteoporosis among Ethiopian Immigrant Women: A Risk Analysis Arch Osteopor 2: 45-52 (2007)
- Heller T, Maislus M, Shahar DR. Attitudes and knowledge of physicians and nurses toward the dietary treatment of Diabetes Harefuah 146: 670-674 (2007)
- Shahar DR, Abel R, Elhayany A, Vardi H, Fraser D. Does dairy calcium intake enhance weight loss among overweight diabetic patients? Diabetes Care 30: 485-489 (2007)
- Melzer I, Kurtz I, Shahar DR, Levi M, Oddsson LIE. . Application of the Voluntary Step Execution Test to Identify Elderly Fallers Age & Aging 36: 532-7 (2007)
- German L, Gidron Y, Shahar A, Yirmiyahu T, Castel H, Harman -Boehm I, Shahar DR. Depressive symptoms are associated with both immune-suppression and leukocytosis among elderly with acute hospitalization Geriatr Gerontol Int 6: 53-59 (2006)
- Castel H, Shahar DR, German L, Harman-Boehm I. Under-detection of depressed mood in older inpatients and related over-prescription of depression-associated medications Geriatr Gerontol Int 6: 248-253 (2006)
- Endevelt R, Shahar DR, Henkin Y. . Development and Implementation of a Nutrition Education Program for Medical Students: A New Challenge. Educ Health 19: 321-30 (2006)
- Shahar DR, Grotto I. Mediterranean diet and longevity Current Nutrition & Food Science 2: 337-342 (2006)
- Shahar DR, Levi M. Nutritional factors, balance and falls in the old age Gerontology 3: 59-66 (2006)
- Castel H, Shahar DR, Harman-Boehm I . Gender differences in factors associated with nutritional status of older medical patients J Am Coll Nutr 25: 128-34 (2006)
- Shahar DR, Shai I, Vardi H, Shahar A, Fraser D . 2005 May;. Diet and Eating Habits in High and Low Socio-economic Groups Nutr J. 21(5) : 559-566 (2005)
- Shahar DR, Shai I, Vardi H, Fraser D.. Factors Associated with Low Reported Energy Intake in the Elderly 9: 300-304 (2005)
- Shahar A, Shahar DR, Kahal Y, Nitzan-Kalusky D. . Low-weight and weight loss as predictors for morbidity and mortality in the old age Harefuah 144: 443-452 (2005)
- Golan M, Shriki-Kaufman V, Shahar DR. . 2006;(5):.. Childhood obesity treatment: targeting parents exclusively vs. parents and children. B J Nutr 95: 1008-15 (2005)
- Bilenko N, Fraser D Vardi H, Shahar DR, Shai I. . Mediterranean Diet and Cardiovascular Diseases in an Israeli Population Preventive Medicine 40: 299-305 (2005)
- Shai I, Shahar DR, Fraser D. . Selection of Food Items for Inclusion in a Newly Developed Food Frequency Questionnaire Public Health Nutr 7(6): 745-9 (2004)
- Endevelt R, Shahar DR. . Omega-3: the Vanishing Nutrient beyond Cardiovascular Prevention and Treatment. Isr Med Assoc J. 6(4): 235-239 (2004)
- Bilenko, N., Shahar, D.R., Shai, I., Weizman, S. & Fraser, D. . Prevalence and characteristics of myocardial infarction, diabetes and hypertension in the adult Jewish population: results from the Negev Nutrition Study/ Harefua (hebrew). 142: 17-21 (2003)
- Shai, I., Vardi, H., Shahar, D.R., Azrad, A. & Fraser D. . Adaptation of international nutrition databases and data entry system tools to a specific population. Public Health Nutr. 6: 401-406 (2003)
- Shahar, D.R., Shai, I., Vardi, H., Brener-Azrad, A. & Fraser, D. . Development of a Semi Quantitative Food Frequency Questionnaire (FFQ) to assess dietary intake of multiethnic populations. Eur. J. Epidemiol. 18: 855-861 (2003)
- Shahar, D.R., Shai, I., Vardi, H. & Fraser, D. . Development of Food Frequency Questionnaire (FFQ) for the elderly population based on a population survey. J. Nutriiton. 133: 3625-9. (2003)
- Shahar, D.R., Shai, I., Vardi, H. & Fraser, D. . Dietary intake and eating patterns of elderly people in Israel: Who is at nutritional risk? Eur. J. Clin. Nutr. 57: 18-25 (2003)
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