Maradee A. Davis

Long-term physical functioning in persons with knee osteoarthritis from NHANES. I: Effects of comorbid medical conditions.

This study examined the effects of comorbid medical conditions (heart disease, pulmonary disease, hypertension and obesity) on the association of radiographic knee osteoarthritis (OA) with long-term difficulty in physical function. Data are from the National Health and Nutrition Examination Survey, 1971-1975 (NHANES I), a prospective epidemiologic cohort study, and the NHANES Epidemiologic Follow-up Study, 1982-1984 (NHEFS) and included 4059 persons who were 45-74 years old and participated in the detailed examination component of NHANES I. Knee OA was ascertained by anterior-posterior bilateral radiographs of the knee and self-report of knee pain, heart and pulmonary disease by self report of disease or symptoms, and hypertension and obesity by blood pressure and weight measurements. The presence of symptomatic knee OA at NHANES I was associated with reported difficulty at NHEFS 1982-84 in functions which used the lower extremity (ambulation and transfer). The presence of coexistent chronic conditions, particularly heart disease, pulmonary disease and obesity, increased the likelihood of subsequent disability. These findings suggest that knee OA is associated with long-term physical disability, and that the presence of coexistent chronic disease may increase the amount of long-term disability from knee OA.

Obesity and osteoarthritis of the knee: Evidence from the national health and nutrition examination survey (NHANES I)

The importance of systemic/metabolic factors in the association of obesity with radiographic knee osteoarthritis (OA) was examined for 3,905 adults aged 45 to 74 from the United States National Health and Nutrition Examination Survey, 1971 to 1975 (NHANES I). Obesity was associated with both bilateral and unilateral OA, but more strongly with bilateral OA. Obesity was also associated with both symptomatic and nonsymptomatic knee OA. Controlling for age, sex, serum cholesterol, serum uric acid, diabetes, body fat distribution, bone density, and blood pressure did not significantly reduce the association between obesity and knee OA. Findings from these data are not supportive of a metabolic link between obesity and knee OA.

Factors influencing the dietary adequacy and energy intake of older Americans

Abstract The impact of sociodemographic, health-related, and behavioral variables on the dietary adequacy of the younger old (65 to 84 years, N = 2496) and oldest old (85 years and older, N = 159) was investigated using data from the Nationwide Food Consumption Survey 1977–78. The percent of individuals with poor diets (defined as mean three-day intake below 67% of the 1989 Recommended Dietary Allowances for at least five of the nine nutrients examined) was greater for women (18%) than for men (13%) and for the oldest old (21%) than for the younger old (16%). Better diet quality was associated both with increased quantity and with increased nutrient density of diets. Multivariate analyses identified two factors of importance for nutrient quality for both the younger and oldest old: mean energy intake and percent of calories from ready-to-eat cereal. Positive predictors of energy intake for both age groups included: number of meals, percent of calories from snacks, and money per person spent on food by the household. These results suggest that nutritional guidance for older Americans should focus on maintenance of adequate (but not excessive) energy intakes by consuming three meals a day plus snacks. Selection of foods of high nutrient density, such as fortified ready-to-eat cereals, should be emphasized, particularly when energy intakes are low. Nutrition programs should target individuals at risk of low food intakes: women, the oldest old, and persons in poor health, on weight-loss diets, or with inadequate money for food.

Dietary patterns of older adults in the United States, NHANES II 1976–1980

The second National Health and Nutrition Examination Survey (NHANES II) 1976–1980 provided detailed information concerning the dietary patterns of older Americans. By using 24‐hour dietary recall and food frequency questionnaires, the dietary patterns of 2,615 adults aged 65–74 years were evaluated by types of living arrangements (living alone, with a spouse, or with someone other than a spouse) and income level (below poverty, at or above poverty). Analyzed indicators of dietary quality were caloric and nutrient intake, food group intake and frequency, and number of meals skipped. The most favorable dietary patterns of elderly persons were associated with living with a spouse, especially for men. Low‐income men not living with a spouse were at highest risk of dietary inadequacy. For women, income was more strongly associated with dietary patterns than type of living arrangement. Results from NHANES II compare favorably to those of the first National Health and Nutrition Examination Survey (NHANES I) 1971–1974.

Age and sex differences in variation of nutrient intakes among U.S. adults.

Studies assessing associations of diet with health frequently use multi-day dietary records to estimate usual dietary intakes. We examined variation in intakes of 13 nutrients for 13,388 U.S. adults using 3 days of dietary data from the 1977-1978 Nationwide Food Consumption Survey. Ratios of within-person variability to between-person variability in intakes were large and would result in attenuated linear regression estimates of diet-health associations. For many nutrients, the magnitude of the attenuation decreased with age for both sexes but particularly for men, implying that fewer days of dietary intake per person would correctly assess diet-health associations among older adults than have been suggested for younger adults.