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Journal ArticleDOI

Self-Perception of Economic Means Is Associated with Dietary Choices, Diet Quality and Physical Health in the Oldest Old Men from the Highest Socioeconomic Group.

01 Jan 2019-Journal of Nutrition Health & Aging (Springer Paris)-Vol. 23, Iss: 1, pp 60-62

TL;DR: Self-perception of economic means was associated with dietary choices and physical health even among affluent older men, and inversely associated with body weight and weight loss.

AbstractIntroduction Self-perception of economic means may affect dietary choices, diet quality, and health behavior. We examined these associations in the oldest-old men from the highest socioeconomic class. Methods The participants in this cross-sectional analysis were the oldest- old home-dwelling men (n = 314, mean age 87 years, range 82-97 years) from the longitudinal Helsinki Businessmen Study cohort. They responded to a postal health and nutrition questionnaire, whereupon dietary intakes were assessed using 3-day food diaries and two diet quality indices. The questionnaire also included items about health, exercise, falls, and economic means. Results Higher self-perception of economic means was linearly associated with higher fish intake (p = 0.021), fruit and vegetable intakes (p = 0.027), use of alcohol (p = 0.003), overall diet quality according to IDQ (p = 0.008), self-perceived physical condition (p = 0.002) and inversely associated with body weight (p = 0.011), weight loss (p = 0.008), blood glucose levels (p = 0.020), and falls (p = 0.029). Conclusion Self-perception of economic means was associated with dietary choices and physical health even among affluent older men. This information is important, because self-perception of economic means, however real, may affect health and nutrition behavior of older people.

Topics: Weight loss (50%)

Summary (1 min read)

Jyväkorpi , S K , Urtamo , A & Strandberg , T E 2019 , ' Self-Perception of Economic Means

  • Is Associated with Dietary Choices, Diet Quality and Physical Health in the Oldest Old Men from the Highest Socioeconomic Group ' , Journal of nutrition, health & aging , vol. 23 , no.
  • The participants in this cross-sectional analysis were the oldest- old home-dwelling men (n = 314, mean age 87 years, range 82-97 years) from the longitudinal Helsinki Businessmen Study cohort.
  • They responded to a postal health and nutrition questionnaire, whereupon dietary intakes were assessed using 3- day food diaries and two diet quality indices.
  • Results: Conclusion: Self-perception of economic means was associated with dietary choices and physical health even among affluent older men.

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https://helda.helsinki.fi
Self-Perception of Economic Means is Associated with Dietary
Choices, Diet Quality and Physical Health in the Oldest Old
Men from the Highest Socioeconomic Group
Jyväkorpi, S. K.
2019-01
Jyväkorpi , S K , Urtamo , A & Strandberg , T E 2019 , ' Self-Perception of Economic Means
is Associated with Dietary Choices, Diet Quality and Physical Health in the Oldest Old Men
from the Highest Socioeconomic Group ' , Journal of nutrition, health & aging , vol. 23 , no. 1
, pp. 60-62 . https://doi.org/10.1007/s12603-018-1102-9
http://hdl.handle.net/10138/310204
https://doi.org/10.1007/s12603-018-1102-9
acceptedVersion
Downloaded from Helda, University of Helsinki institutional repository.
This is an electronic reprint of the original article.
This reprint may differ from the original in pagination and typographic detail.
Please cite the original version.

Self-perception of economic means is associated with dietary choices, diet quality and physical
health in the oldest old men from the highest socioeconomic group
Running title: Self-perception of economic means and dietary choices in the oldest old men
Jyväkorpi SK
1
, PhD, Urtamo A
1
, Msc, Strandberg TE
2
, MD, Professor
1
University of Helsinki, Department of General Practice and Primary Health Care, and Helsinki
University Central Hospital, Unit of Primary Health Care
2
University of Helsinki, Clinicum, and Helsinki University Hospital, Helsinki, Finland; University
of Oulu, Center for Life Course Health Research, Oulu, Finland
Corresponding author:
Satu Jyväkorpi
Tukholmankatu 8 B, 00014 University of Helsinki
Tel: +358 50 4920970
satu.jyvakorpi@gery.fi
Keywords: Self-perception of economic mean, fruits and vegetables intake, diet quality, body
weight, oldest old men, nutrition

Abstract
Introduction: Self-perception of economic means may affect dietary choices, diet quality, and health
behavior. We examined these associations in the oldest-old men from the highest socioeconomic class.
Methods: The participants in this cross-sectional analysis were the oldest- old home-dwelling men (n = 314,
mean age 87 years, range 82-97 years) from the longitudinal Helsinki Businessmen Study cohort. They
responded to a postal health and nutrition questionnaire, whereupon dietary intakes were assessed using 3-
day food diaries and two diet quality indices. The questionnaire also included items about health, exercise,
falls, and economic means.
Results: Higher self-perception of economic means was linearly associated with higher fish intake (p =
0.021), fruit and vegetable intakes (p = 0.027), use of alcohol (p = 0.003), overall diet quality according to
IDQ (p = 0.008), self-perceived physical condition (p = 0.002) and inversely associated with body weight (p
= 0.011), weight loss (p = 0.008), blood glucose levels (p = 0.020), and falls (p = 0.029).
Conclusion: Self-perception of economic means was associated with dietary choices and physical health
even among affluent older men. This information is important, because self-perception of economic means,
however real, may affect health and nutrition behavior of older people.
Introduction
Self-perception of economic means may affect dietary choices and health behavior. Foods considered too
expensive may be consumed less due to lack of funds to purchase them (1). However, self-perception of
economic means is subjective, and regardless of whether it is real or not it could influence dietary choices
and ultimately health over the course of decades. Our study population differs in many ways from general
population by being from the highest socioeconomic class and the oldest-old survivors of a longitudinal
cohort. Consequently, they are financially better off than general population of older people (2). The
objective of this study was to explore whether self-perception of economic means is associated with dietary
choices, diet quality and health even in this special population of older men without economic constraints.

Methods
The participants in this cross-sectional analysis were the oldest-old home-dwelling men from the longitudinal
Helsinki Businessmen Study cohort (2). In 2016, a postal health and nutrition questionnaire was sent to them,
and economic situation was assessed by asking: “How well do you get along financially?” (Very well,
Moderately, Badly). The nutrition survey included a 3-day food diary, Mediterranean Diet Adherence score
(3) and Index of Diet Quality (IDQ) designed to measure adherence to Finnish dietary recommendations (4).
Food intakes were retrieved using the diet quality indices indicated as portions, deciliters, tablespoons,
glasses, or frequencies per week. The portion sizes were calculated to grams and validated with 3-day food
diaries obtained from a subgroup of participants; the validation procedure is explained in more detail
elsewhere (5). The participants were divided into groups corresponding to their self-perceived economic
situation. Diet quality scores, food intakes, and other health indicators were classified according to the
groups. The statistical significance for the hypotheses of linearity was evaluated for a trend using ANOVA
for continuous variables, and with the Mantel-Haenszel test for categorical variables. The statistical analysis
was performed, using the SPSS statistical program, version 24 (SPSS IBM, Armonk, NY, USA).
All participants signed an informed consent and the study protocol was approved by the Ethics Committee of
the Helsinki University Hospital, Department of Medicine.
Results
Of the participants 476 men (response rate 67%) returned the survey, and 314 filled in both the economic
means question and the diet quality indices. A subgroup of the participants (n= 142) also returned 3-day food
records. Mean age of the participants was 87 years (range 82-97 years). Of the participants, 73% and 26%
classified themselves as having very good and moderate economic situation, respectively; no one indicated
as having bad economic situation. As compared to moderate, very good economic situation was associated
with higher fish (p = 0.021), fruit and vegetable (p = 0.027), and vegetable (p = 0.033) intakes, more alcohol
consumption (p = 0.002). overall better diet quality according to IDQ (p = 0.008), and better self-perceived
physical condition (p = 0.002). The reverse situation was observed with body weight (BW) (p = 0.011),
weight loss (p = 0.008), blood glucose levels (p = 0.020), and falls (p = 0.029) (Table 1).

Age, MeDi, other food intakes, or plasma cholesterol levels were not associated with self-perceived
economic situation.
Discussion
Even in this overall affluent cohort of older men, the best economic situation was associated with healthier
dietary choices, higher diet quality, and better physical health, and less signs of unsuccessful aging.
Although lower economic status has been associated with poor diet quality and health outcomes in previous
studies (6), our results are surprising considering that no one in this socioeconomically homogenous group
reported having less than moderate economic situation (2). Furthermore, those reporting moderate economic
means, also had higher body weight and blood glucose levels than those reporting very good economic
situation. This is in line with studies indicating that subjects with lower income often eat more energy-dense
foods and have higher BMI and risk of metabolic syndrome (7). The moderate income group also reported
having lower self-rated physical condition and they had had more falls than the higher income group, again
in line with previous studies (8). So far it is unclear, whether feeling economically secure is associated with
physical, mental and psychological well-being (9). The associations between perceived economic situation,
food choices, and health in our study indirectly suggest that even affluent people may be affected by feeling
economically insecure.
The strength of this study was a reasonably high participation of the oldest old men. The nutrition data was
gathered using various instruments which allowed us to validate the reports of consumed amounts.
Economic situation of the participants was assessed using only one question, and more accurate income data
was not collected. However, this cohort of businessmen and executives could be considered affluent in the
first place, and although this was a retired cohort, pension system in efficient in Finland. The cross-sectional
design of the study is a major limitation and it prevents drawing any conclusions about causal relationships.
In conclusion, self-perception of economic means was associated with diet quality, dietary choices, and
health behavior. Feeling insecure about one’s economic situation may thus influence healthy aging even in
those from the highest socioeconomic class.

Citations
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Abstract: Among older adults, engagement in education can potentially have positive effects on cognition and psychological well-being and can prevent social isolation. The aim of this study is to investigate the role of individual motivations specific to older learners that underlie the frequency of participation at a senior university and how health or socioeconomic dimensions may affect the possibilities for participation. With data on participants from the senior university program at the University of Zurich (N = 811), we show that greater individual motivations regarding different aspects of learning have an effect on the frequency of lecture attendance, while other life circumstances do not. However, the findings show that when different forms of motivations are compared, instrumental motivation—meaning that the intention to use the gained knowledge now or in the future is responsible for the participant’s learning aspirations—is the only motivation that significantly increases lecture attendance. Hence, we conclude that to increase people’s engagement in this specific form of education in later life and to intensify lecture attendance, these programs should meet the expectations fueled by individual motivations.

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TL;DR: Older age, postmenopausal status, Mexican American ethnicity, higher body mass index, current smoking, low household income, high carbohydrate intake, no alcohol consumption, and physical inactivity were associated with increased odds of the metabolic syndrome.
Abstract: Coronary heart disease (CHD) is the leading cause of death in the United States.1 Factors associated with an increased risk of developing CHD that tend to cluster in individuals include older age, high blood pressure, a low level of high-density lipoprotein (HDL) cholesterol, a high triglyceride level, a high plasma glucose concentration, and obesity.2 These associated risk factors have been called syndrome X,3 the insulin resistance syndrome,4 or the metabolic syndrome.5 The mechanisms underlying the metabolic syndrome are not fully known; however, resistance to insulin-stimulated glucose uptake seems to modify biochemical responses in a way that predisposes to metabolic risk factors.3,6,7 Insulin resistance is thought to be primarily due to obesity or an inherited genetic defect.8 As the prevalence of obesity increases in the United States, the prevalence of the metabolic syndrome may be expected to increase markedly. Estimates of the prevalence of the metabolic syndrome have varied substantially in part because of the variability of evaluated populations and of diagnostic criteria.9 The recent Third Report of the National Cholesterol Education Program Adult Treatment Panel (ATP III) included clinical diagnosis guidelines for the metabolic syndrome.10 Compared with findings from earlier studies3-5 and World Health Organization guidelines, the new ATP III defines criteria readily measured in clinical practice. These consensus-generated guidelines provide the opportunity to assess the overall prevalence of the metabolic syndrome in the US population according to an accepted standard definition. In an initial study, Ford et al11 reported un-adjusted and age-adjusted metabolic syndrome prevalences of 21.8% and 23.7%, respectively, for the US population. The objectives of this study are to examine the prevalence of the metabolic syndrome by ethnicity, age, body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters), socioeconomic status, and lifestyle factors.

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Abstract: Objective: Independently of total caloric intake, a better quality of the diet (for example, conformity to the Mediterranean diet) is associated with lower obesity risk. It is unclear whether a brief dietary assessment tool, instead of full-length comprehensive methods, can also capture this association. In addition to reduced costs, a brief tool has the interesting advantage of allowing immediate feedback to participants in interventional studies. Another relevant question is which individual items of such a brief tool are responsible for this association. We examined these associations using a 14-item tool of adherence to the Mediterranean diet as exposure and body mass index, waist circumference and waist-to-height ratio (WHtR) as outcomes.

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Frequently Asked Questions (1)
Q1. What are the contributions in "Self-perception of economic means is associated with dietary choices, diet quality and physical health in the oldest old men from the highest socioeconomic group" ?

The authors examined these associations in the oldest-old men from the highest socioeconomic class. The participants in this cross-sectional analysis were the oldestold home-dwelling men ( n = 314, mean age 87 years, range 82-97 years ) from the longitudinal Helsinki Businessmen Study cohort. The objective of this study was to explore whether self-perception of economic means is associated with dietary choices, diet quality and health even in this special population of older men without economic constraints. The participants in this cross-sectional analysis were the oldest-old home-dwelling men from the longitudinal Helsinki Businessmen Study cohort ( 2 ). All participants signed an informed consent and the study protocol was approved by the Ethics Committee of the Helsinki University Hospital, Department of Medicine. Although lower economic status has been associated with poor diet quality and health outcomes in previous studies ( 6 ), their results are surprising considering that no one in this socioeconomically homogenous group reported having less than moderate economic situation ( 2 ). The moderate income group also reported having lower self-rated physical condition and they had had more falls than the higher income group, again in line with previous studies ( 8 ). The strength of this study was a reasonably high participation of the oldest old men. The nutrition data was gathered using various instruments which allowed us to validate the reports of consumed amounts. The cross-sectional design of the study is a major limitation and it prevents drawing any conclusions about causal relationships. Furthermore, those reporting moderate economic means, also had higher body weight and blood glucose levels than those reporting very good economic situation. The associations between perceived economic situation, food choices, and health in their study indirectly suggest that even affluent people may be affected by feeling economically insecure.