MSU LIBRARIES “ RETURNING MATERIALS: Fiace in 500E drop to remove this checkout from your record. FINES W111 be charged if book is returned after the date stamped be10w. U1 ‘0 4351):?! Mm: FOOD CONSUMPTION PATTERNS OF THE ELDERLY: IMPACT OF HOUSEHOLD SIZE By Kathryn Lynn Bundy A Thesis Submitted to Michigan State University in partial fulfillment of the requirements ' for the degree of MASTER OF SCIENCE Department of Food Science and Human Nutrition 1981 ABSTRACT FOOD CONSUMPTION PATTERNS OF THE ELDERLY: IMPACT OF HOUSEHOLD SIZE By Kathryn Lynn Bundy A nationwide survey of 561 elderly individuals aged 62 years and older indicated that household size influenced food consumption patterns and dietary component intakes. Elderly living in one and two person households consumed food and beverages more frequently, at home and away from home, than did the elderly living in three or more person households. This was due to increased between meal food consumption by the smaller household size samples. At home food choices varied significantly among household sizes for most of the food groups, while away from home food frequencies were not as dependent on household size. For a majority of dietary components, elderly living in two person households obtained greater quantities than did those living in one and three or more person households. The usage of dietary supplements increased average daily intakes of dietary components already at adequate levels while contributing little to those consumed in inadequate amounts. to my husband and parents, for their love, support and patience ii ACKNOWLEGEMENTS Heartfelt appreciation is extended to Karen J. Morgan for all her assistance, knowledge and guidance throughout the last two years. Her freindship and belief in my ability were essential during my graduate program. I am especially grateful to Mary E. Zabik for the technical knowledge and direction she willingly provided. Many times, without her help, I would have floundered. I would like also to thank my other committee members, Wanda Chenoweth and Barbara Ames, through whom I obtained further knowledge of the dietary implications of nutritional status and realized the "human" aspects of my research. This thesis could not have been completed without the support of my office mate, Laurie Bander, and my husband, Dan. They both provided a listening ear and a comforting shoulder for me to vent my frustrations. Lastly, but not the least, I would like to sincerely thank Gary Stampley, my computer programmer, without whose help and willingness the analyses would have been difficult to obtain. iii TABLE OF CONTENTS Page LIST OF TABLES O O O O O O O O C O O O 0 Vi INTRODUCTION‘ . . . . . . . . . . . . . 1 REVIEW OF LITERATURE . . . . . . . . . . . 6 Nutrient Data Bank Systems . .. . . . . . 7 SOCiOlogical ImpaCt Of FOOd o o o o o o o 2? Meal Consumption Habits . . . . . . . . 26 Food Consumption Habits . . . . . . . . 29 Nutrient Intakes of the Elderly . . . . . . 39 METHODOLOGY 0 O O O O O O O O O O O O O 49 Data Collection . . . . . . . . . . . ' 49 Data Analyses . . . . . . . . . . . . 52 RESULTS 0 O O O O O O O O O O O O O 0 58 Sample Description . . . . . . . . . . 58 Frequency of Eating . . . . . . . . . 66 Food Consumption Patterns . . . . . . . . 79 At Home Food Consumption Patterns . . . ' 79 Away From Home Food Consumption Patterns . 85 Dietary Component Intakes . . . . . . . . 89 Dietary Component Intakes of the Total Elderly Sample . . . . . . . . 9O PrOportion Cf Calories . . . . . . 90 Dietary Component Intakes . . . . . 91 Dietary Component Intakes of the Elderly Classified By Household Size . . . . 101 Proportion Of Calories . . . . . . 101 Dietary Component Intakes . . . . . 103 Impact of Dietary Supplements on Nutrient Intakes O O O O O O O O O O O 106 iv Page Analysis of Total Sample . . . . 107 Analysis of Sample Classified By Household Size 0 O O O O O O O O O O O 115 Dietary Component Intakes of Elderly Classified by Household Size and Dietary Supplement usage 0 O O O O C O O O O O O 119 Dietary Supplement Usage . . . . . . 119 Specific Dieatery Supplement Usage . . 120 Dietary Component Intakes of Supple- ment Consumers . . . . . . . 130 No Dietary Supplement Usage . . . . . 132 Comparison of Nutrient Intakes By Dietary Supplement Consumers and an-Consumers. 135 Dietary Component Intakes of Elderly Classified By Household Size and Age . . . . . . 138 Proportion of Calories . . . . . . 138 Dietary Component Intakes . . . . . . 142 Dietary Component Intakes of Elderly Men and Women Classified by Household Size . . . 149 Proportion of Calories . . . . . . . 149 Dietary Component Intakes . . . . . . 154 DISCUSSION . . . . . . . . . . . . . . . 160 SUMMARY . . . . . . . . . . . . . . . . 172 APPENDICES . . . . . . . . . . . . . . . 179 I. Food Items in the 21 Food Groups Used in the Analyses . . . . 179 II. .Dietary Supplements in the General Types of S REFERENCES upplements Used in the Analyses . . . . . 184 O O O O O O O O O O O O O O O 185 Table 10 11 12 LIST OF TABLES Dietary components of selected computerized nutrient data banks . . . . . . . . . . Dietary components of selected tables of food composition . . . . . . . . . . . Distribution of elderly sample classified by household size . . . . . . . . . . . . Distribution of elderly classified by household Size and age a o o o o o o o o o o 0 Distribution of elderly males and females classified by household size . . . . . . . Demographic characteristics of sampled elderly . Average number of meals/snacks consumed during the survey week by elderly classified by household size . . . . . . . . . . . . Average number of meals/snacks consumed per day during the survey week by elderly classified by househOId Size 0 O O O O O O O O O 0 Number and percentage of elderly within each household classification who consumed at least one meal away from home during the survey week . Number of meals/snacks consumed away from home during the survey week by elderly classified by household size . . . . . . . . . . O 0 Average number of meals/snacks consumed away from home during the survey week by elderly classified by household size . . . . . . . . . . . Number of meals/snacks consumed away from home by elderly who ate at least one meal outside their home during the survey week . . . . . . vi 18 59 6O 61 62 67 68 69 7O 7O 71 Table 13 .14 15 16 17 18 19 2O 21 22 23 24 Number of meals/snacks consumed for each of the six daily eating periods during the survey week by elderly classified by household size . . . 73 Number of meals/snacks consumed away from home for each of the six daily eating periods during the survey week by elderly classified by house- hOld Size 0 O O O O O O O O O O O O 75 Number of meals/snacks consumed away from home for each of the seven days during the survey week by elderly classified by household size . . . 77 Contribution of selected food groups when eaten at home during the survey week to the diets of elderly classified by household size . . . . . . . 80 Contribution of selected food groups when eaten away from home during the survey week to the diets of elderly classified by household size . . . 86 Distribution of calories from carbohydrate, protein and fat in the diets of the elderly (n=561) o o o o o o o o o o o o o o 91 Proportion of calories obtained from complex carbohydrate and total sugar by the elderly . . 91 Average daily nutrient intakes of the elderly (n=561) o o o o o o o o o o o o o o 92 Comparison of average daily intakes by the elderly of selected vitamins and minerals with their estimated safe and adequate daily intake ranges . . . . . . . . . . . . . . 93 Percentage of elderly (n-561) whose daily nutrient intakes were always above 100% NRC-RDA as well as the percentage of elderly whose nutrient intakes fell below 100% NRC-RDA for 1 to 7 days . . . 95 Percentage of elderly (561) whose daily nutrient intakes were always above 66% NRC-RDA as well as the percentage of elderly whose nutrient intakes fell below 66% NRC-RDA for 1 to 7 days . . . 97 Percentage of elderly (n=561) whose daily nutrient intakes were always above 33% NRC-RDA as well as the percentage of elderly whose nutrient intakes fell below 33% NRC-RDA for 1 to 7 days . . . 99 vii Table Page 25 Proportion of calories obtained from total carbohydrate, complex carbohydrate, total sugar, protein and fat by elderly classified by household size . . . . . . . . . . 103 26 Average daily nutrient intakes of elderly classified by household size . . . . . . 105 27 Average daily nutrient intakes obtained from food and dietary supplement consumption by the elderly (n=561) . . . . . . . . . . . 108 28 Percentage of elderly (n=561) whose daily nutrient intakes were always above 100% NRC-RDA as well as the percentage of elderly whose nutrient intakes fell below 100% NRC-RDA for 1 to 7 days when diet- ary supplement usage was considered . . . . 109 29 Percentage of elderly (n=561) whose daily nutrient intakes were always above 66% NRC—RDA as well as the percentage of elderly whose nutrient intakes fell below 66% NRC-RDA for 1 to 7 days when diet- ary supplement usage was considered . . . . 111 30 Percentage of elderly (n=561) whose daily nutrient intakes were always above 33% NRC—RDA as well as the percentage of elderly whose nutrient intakes fell below 33% NRC-RDA for 1 to 7 days when diet- ary supplement usage was considered . . . . 113 31 Average nutrient intakes of elderly classified by household size including dietary supplements in calculations . . . . . . . . . . . . 117 32 Proportion of elderly, classified by household size, who consumed dietary supplements at least once during the survey week . . . . . . . 120 33 Types of dietary supplements used by elderly (n=157) during the survey week . . . . ». . 121 34 Dietary supplement usage by elderly (n=157) during the survey week . . . . . . . . 122 35 Proportion of elderly (n=157) who took specified amounts of dietary supplements during the survey week a o o o o o o o o o o o o o 123 36 Frequency of dietary supplements used by elderly classified by household size . . . . . . 125 viii Table Page 37 Frequency of various dietary supplement usage by elderly classified by household size . . . 126 38 Percentage of elderly classified by household size who used dietary supplements at least once during the survey week . . . . . . . 128 39 Proportion of elderly, classified by household size, who took specified amounts of dietary supplements during the survey week . . . . . 129 40 Average daily nutrient intakes from food and dietary supplement consumption of elderly classi- fied by household size who used dietary supple- ments at least once during the survey week . . 131 41 Proportion of elderly, classified by household size, who did not consume dietary supplements during the survey week . . . . . .. . . . 133 42 Average daily nutrient intakes of elderly, classified by household size, who had not used dietary supplements during the survey week . . 134 43 Average daily nutrient intakes of elderly who consumed dietary supplements at least once during the survey week and those who did not use dietary supplements . . . . . . . . . . . . 136 44 Proportion of calories obtained from carbohydrate, protein and fat by four age classifications of the elderly . . . . . . . . . . . . 139 45 PrOportion of calories obtained from carbohydrate, protein and fat by elderly classified by household size and age . . . . . . . . . . . . 140 46 Average dietary component intakes of elderly aged 62 to 64 years, classified by household size . . 143 47 Average daily nutrient intakes of elderly aged 65 to 69 years, classified by household size . 144 48 Average dailyenutrient intakes of elderly aged 70 to 74 years, classified by household size . 146 49 Average daily nutrient intakes of elderly aged 75 years and older, classified by household Size 0 o o o o c o o o o o o o o o 148 ix Table 50 51 52 53 54 55 Average daily nutrient intakes of elderly ClaSSified by age 0 o o o o o o o o o 150 Proportion of calories obtained from carbohydrate, protein and fat by elderly males and females . 152 Proportion of calories obtained from carbohydrate, protein and fat by elderly males and females classified by household size . . . . . . 153 Average daily nutrient intakes of elderly males classified by household size . . . . . . 155 Average daily nutrient intakes of elderly females classified by household size . . . . . . 156 Average daily nutrient intakes of elderly males and feIDa-les o o o o o o o o o o o o 158 INTRODUCTION With the increasing number of elderly in the United States population, problems encountered by senior citizens are coming into the forefront. One of these concerns revolves around the health status of the older adults in our communities. The health and longevity of the elderly are affected by many factors (Schlenker et a1, 1973). Nutrition is one factor which is subject to personal control. Nutritional status and food consumption habits are important components in life with far reaching effects on health. Psychological, social and physical factors all affect nutritional status (Weinberg, 1972). Dentition problems, lack of physical activity, plus a reduced taste and olfactory threshold are physical factors which adversely affect the appetite of older adults. Other physical factors which inhibit optimum nutritional status are gastrointestinal dysfunction, chronic illness and drug interference. Psychological deterrents of adequate nutrient intake include emotional depression, personal food prefer- ences and a lifetime of poor eating habits. The absence of socialization during the meal periods may also be an important inhibitor of prOper dietary habits. Many older people living alone find it inconvenient to prepare food for just 1 2 one person. This has led to the suspicion that elderly individuals living alone may have inadequate dietary nutrient intakes (Anon, 1977). Due to financial constraints placed on many elderly adults, with retirement or loss of wages, the money may not be available to purchase the proper foods to assure an adequate diet. The elderly also are believed to be more susceptible to fad nutritional claims and inap- prOpriate dietary beliefs than are individuals of other ages (Anon, 1977). In general, the nutrient requirements do not appreci- ably change as an adult ages. For the elderly, the caloric need decreases due to a lack of physical activity and lowered metabolic rate while vitamin and mineral needs remain constant. Thus, the foods consumed by the older population should be of high nutrient density quality. Foods which are considered to be "empty calorie" items should be avoided. Other consumption practices which should be discouraged are: overconsumption of salt, due to role in hypertension; excessive consumption of saturated fats and cholesterol, due to role in atherosclerotic proces- ses; an inapprOpriate dietary calcium to phosphorus ratio, due to role in osteOporosis; and excessive alcohol and calorie consumption (Anon, 1977). Nutritional surveys have been conducted at the local and national levels to determine the adequacy of dietary intakes. However, an insufficient number of these studies have been done on the national level to allow for detailed recommendations to be made. The 1965-1966 Household Food 3 Consumption Survey (U.S.D.A., 1972) revealed that energy and mean nutrient intakes decreased with age. Only the mean intake of calcium was below the 1974 NRC-RDA for adults aged 75 years or older. Data reported from the Ten State Nutri— tion Survey (U.S.D.H.E.W., 1972) indicated that there was a greater prevalence of inadequate intakes of iron and vita- min A among elderly Spanish-Americans and riboflavin inade— quacy in the diets of older blacks and Spanish-Americans. Elderly males of all racial origins reported poor ascorbic acid intakes. These same dietary inadequacies were revealed by the Health and Nutrition Examination Survey (U.S.D.H.E.W., 1977 and 1979). Among the elderly, dietary intakes were low for iron, vitamin A, ascorbic acid and calcium. The Nation- wide Food Consumption Survey, 1977-78 (U.S.D.A., 1980), however, indicated that adequate levels of all nutrients were consumed by the elderly with the exception of low intakes of calcium, magnesium and vitamin B-6 by older women. Studies done at the local level, even though extensive in scope, are inappropriate for an analysis of the general elderly pOpulation. Further, these investigations only assessed a limited number of nutrients. The most frequently analyzed nutrients were calories, protein, vitamin A, ascorbic acid, thiamin, niacin, riboflavin, calcium and iron. Additional dietary components which should be included in an investigation of intakes are fiber, zinc, magnesium and copper plus vitamins B-6 and B-12. Fiber is an important component in the diets of the elderly due to its promotion and maintenance of adequate 4 bowel functions. Without fiber in the diet, the elderly are susceptible to constipation since intestinal muscle tone decreases as the individual ages. Mineral balance is important for all biochemical processes to function properly, therefore the intakes of a wider range of minerals than previously studied should be assessed. Nutritional anemias, among the elderly, may be attributed to not only inadequate dietary intakes of vitamins B-6 and B-12 but also to a less efficient absorption, a lower rate of intestinal synthesis and reduced intestinal mucus secretion (National Research Council, 1980). Thus, the dietary intakes of vitamins B-6 and B-12, by the elderly, should be examined. The major purpose of this investigation was to examine one of the sociological factors which affects dietary intakes of nutrients: whether living alone, with another person or in a more communal situation influences food consumption habits of the elderly. The specific objectives were: a) investigate eating frequencies of individuals aged 62 years and older living in one, two or threeeand more person households; b) examine the consumption of more specific food groups than previously studied, for foods eaten at home and away from home; 0) determine the impact of household size on the elderly's dietary nutrient intakes; d) investigate the usage of vitamin and mineral supplements by the three household size groups and their impact on nutrient intakes; e) investigate the consumption levels of less researched dietary components. In addition, the impact of increasing age and consumption variations between 5 the sexes of the subjects on dietary component intakes by individuals living in each of the three household size groups were examined. REVIEW OF LITERATURE The study of dietary habits has been an important method for revealing dietary component intakes and food patterns of various population segments. In the past, such studies have been completed for elderly individuals. Of course, the nutrient composition of their diets has been reported in a variety of ways. A review of the lite erature revealed that very little research on the actual food consumption habits had been completed on a national scale. Much of the literature dealt with either small samples of elderly of varying ages or concentrated on limited nutrient intakes. When food habits were reported, most dealt with only four to five food groups. In this literature review, the results of previously reported research in the area of the elderly's food consumption habits and nutrient intakes pertaining to the impact of age, sex and household size are reported. The use of dietary supplements (vitamin/mineral) was also reviewed. Of vital concern to these types of dietary surveys is the nutrient data base system. Therefore, literature concerning the use and types of nutrient data banks import- ant for dietary survey analyses was examined. 7 Nutrient Data Bank Systems A computerized nutrient data bank is an important instrument in assessing diet quality as it is, essentially, an automated extensive food composition table. As such, this tool can provide comprehensive analyses of nutrient intake of various p0pulation groups. It also offers any analyses of the relationship of nutrient intake with socio- logical factors, food habits or other areas of interest to the user which are programmed into the computer. Through the use of a computer, more accurate detailed nutritional analyses may be obtained than might be possible if done through manual calculations due to the inevitability of mathematical errors (Flook and Alford, 1974). Computerized analyses, particularly when computing intakes of large population groups, has been found to be more cost efficient than analyses by manual methods (Clithero, 1963; Flock and Alford, 1974; Hoover, 1976). Computerized nutrient data banks have in the past been employed for a variety of purposes: menu analysis, food consumption studies, metabolic diet studies, epidemiologic studies, nutritional surveys and nutritional histories (Hoover, 1976; Hertzler and Hoover, 1977). Nutrient data bases are used for educational and research purposes, in hospitals and in the food industry. Educational applications are many; one example is the computer assisted instruction program "Foods" at Ohio State University (Willard, 1979). The "Foods" nutrient data bank contains values for fourteen nutrients in 100 food items, calculated per 100 gram portions. 8 This program has been used to assist clinical dietitians, nurses, medical students and dietetic students in evaluating diets, food intake records and menus for nutritive content plus analyze recipes. In a hospital situation data banks may be used as a standardized base of information for medical-related person- nel (Farrell, 1979). The nutrient data bank would provide, not only a nutritional assessment of a patient's previous dietary habits, it would also provide a tool for patient education dealing with new diet changes. Data banks could, also, provide an analysis of cycle menus and recipes used within the hospital, as well as be beneficial for planning menus in regards to nutrient needs, cost efficiency and purchasing requirements (Clithero, 1963). Research applications are limitless but revolve around food consumption habits, metabolic diet surveys, epidemio- logic studies and nutritional surveys. For example, Case Western Reserve University used a nutrient data bank in conjunction with research at their Weight Control Unit (Redmond, 1979). The data bank was one of the instruments used to determine correlations between biochemical, physio- logical and behavioral measures with food intakes. Another example of research applications is the ongoing use of the Michigan State University Nutrient Data Bank to determine the impact of food habits on nutrient intakes for various age segmented population groups (Morgan, 1981). 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OUTS? =.s~».> .seoc_x Au.s=ouv _ o_nop 11 Research involving the study of coronary heart disease utilized a nutrient data bank containing values for twelve nutrients and alcohol (Browe et al, 1966). At the time of this study no relationship between micronutrients and coro- nary disease existed, thus values for these nutrients were not considered. The food composition table contained 125 food items including 23 recipe items. Particularly stressed were the types and amounts of fats used by the subjects. Since this data bank was designed for a specific study it was not recommended for use by other researchers. A nutrient data bank containing thirty-six dietary components was developed for an investigation of athero- sclerosis (Hankins et al, 1965). For this system, the wieght of the edible protion of the food item or components of a mixture of food items was recorded. Optional features and operations, included meal census, sex, age, time of day and race, which provided increased flexibility and usefulness of the data bank system. Conversion factors were developed which allowed the processing of dietary data for homogeneous or heterogeneous individuals or groups (i.e., families) into average values for subsequent statis- tical analyses and comparisons. This data bank was utilized to investigate the calorie and fat intake of Louisiana pregnant women with an emphasis on fatty acid analyses (Moore et al, 1965). It was used for the analyses of food intakes by New Orleans families (Skellenger et al, 1965) and for analyses of school lunches in south Louisiana (Metzinger et al, 1965). 12 A computerized system was designed for the Clinical Research Unit at the University of Michigan to be used for metabolic diet studies (Hjortland et al, 1966). This data bank system provided values for seventeen nutrients per 100 gram samples of each food item. Programs were developed which allowed computation of nutrient composition in forms useful to the investigator, i.e., protein may have been reported in grams of protein, in grams of nitrogen or in percent NRC-RDA. It presented laboratory analyses of com- posite diets with computed nutrient values from the table for easier comparisons. This data bank provided the analyses of rotation diets so that daily or complete cycle analyses could be made. The "Nutritive Value of Foods Catalog" was compiled to analyze regular and modified menus of patients in Veterans Administration hospitals and domiciliaries (Brisbane, 1964). An adaptation of the Department of Agriculture punch card and coding system was used. This data bank was designed so that additions of new items could be made as needed. Values for fifteen nutrients per food item . were calculated for each menu. For a longitudinal study of 150 sets of twins a nutrient data bank was developed in which values for 20 dietary components per 100 gram portions were included for 763 food items (Mo et al, 1971). These food items were categorized into twenty-eight food groups for use in later studies. Three digit code numbers were assigned to each food item with a fourth digit to allow verification of input data. 13 This system allowed the nutrient intake to be analyzed on a meal basis. Edit programs were developed to insure accuracy of information plus provide a means for updating and maintenance of the data bank. Ohio State University compiled an extensive computerized nutrient data bank (Schaum et al, 1973) to be used for sev- eral research programs. Values for sixty-three nutrients were included for 100 gram edible portions of food items. The data bank had a capacity of 10,000 food items, of which 3,600 items were compiled. Programs were develOped which permitted addition of food items as desired plus allowed updating or adding nutrient information as needed. Data included in the nutrient data bank were obtained from original research whenever possible plus from food manu- facturers. A nutrient data bank was designed at the Clinical Research Center of the University of Utah Medical Center for use in the formulation of nutrient equivalent lists (de St. Jeor et al, 1970). Nutrient values for 1,692 food items were compiled using Agriculture Handbook No. 8 as the reference source. Nutrient equivalent lists were compiled from this data base to yield specified amounts of a parti— cular nutrient. This data bank had been used for quanti- tative nutrient analyses, recipe analysis and intake sum- maries. The U.S.D.A. began compiling data from various govern- ment, public and private sources to form a national Nutrient Data Bank in 1972 (Watt et a1, 1974; Murphy et al, 1973). 14 The main data source came from the Nutrient Data Research Center. Nutrient values reflected various factors which affect food composition - variety, breed, maturation, sea- sonal and geographic growing conditions and processing aspects. Features of this system included increased amount of data (both food items and nutrient information) and faster retrieval of such information. The food items have been classified into twenty-one food groups. Space for values of up to 215 nutrient constituents had been allotted with approximately one hundred generally used for each food item. The Michigan State University Nutrient Data Bank has been used to assess the dietary intakes for various age segmented population groups (Morgan et al, 1979; Gala, 1979). This data bank contained at least 3,500 food items including fresh and processed foods plus some fast food restaurant items and home recipes. It allowed calculations for 79 dietary components. This system was designed so that additional food items and nutrients could be included or updated as needed. Industrial applications focus primarily on nutrition labeling (Sevald, 1979). The most common use of data bases by the food industry is in support of their nutrition labeling function. Other uses include the analyses of intake studies (particularly for the contribution of the type of foods produced by the individual company) and calculation of the nutrient content of menus and recipes. It has been suggested that nutrient data from the 15 revised Agriculture Handbook No. 8 be used for nutrient labeling of generic foods such as produce and meats (Sevald, 1979). The national Nutrient Data Bank could be expanded to include processed brand-name foods thus creating a data base for fresh foods and at least 15,000 processed foods (Lento, 1980; Watt et al, 1974; Murphy et al, 1973). A nutrient data bank may also provide information that may be used for fortification guidelines by the food industry (Mitchell, 1980). At present, most U.S. computerized nutrient data banks are based on food composition tables compiled by the U.S. Department of Agriculture (Meyer, 1979). These food compo- sition tables (based on information contained in Agriculture Handbook No. 8 and Home and Garden Bulletin No. 72 - both available on punch cards and magnetic tapes) are the focal point for formulation and maintenance of the nutrient data banks. Other sources used include journal articles (reports of research on one or more nutrients in a particular food item or food group), food manufacturers and/or industry associations, books, other nutrient data banks, nutrition labels, individual laboratory analyses, calculated values for recipes and imputed values (Petot, 1979; Hertzler and Hoover, 1977). The sources of data used will be determined by output use, food unit, data availability and personal perferences (Brisbane, 1969). The U.S.D.A. first published Agriculture Handbook No. 8, "The Composition of Foods", in 1963 (Watt et al, 1963). This contained tables listing nutrient values in several 16 ways: Table 1 contained values for 17 dietary components . per 100 grams of edible portion; Table 2 listed 15 nutrient values for the edible portion of one pound of food as pur- chased; Table 3 detailed selected fatty acids and refuse per 100 grams and one pound of edible portion of foods; Table 4 contained cholesterol values and refuse percent of 35 selected foods; Table 5 listed the magnesium content of 444 foods plus their amount of refuse; Tables 6-8 detailed conversion factors in calculating the nutrient values. Tables 1, 2 and 3 gave the nutrient values for 2,483 foods each. The U.S.D.A. has since revised these tables into separate sections by food groups. The data in these tables are presented on a 100 gram basis, in two common measures and in edible portion of one pound as purchased. The revised Agriculture Handbook No. 8 series includes: No. 8-1, Dairy and Egg Products - RawéProcessed-Prepared (Posati.and Orr, 1976). contained 144 food items; No. 8-2, Spices and Herbs - Raw-Processed-Prepared (Marsh et al, 1977), listed 217 food items; No. 8-3, Baby Foods - Raw-Processed-Prepared (Gebhardt et al, 1978), contained 217 food items; No. 8-4, Fats and Oils - Raw-Processed-Prepared (Reeves and Weihrauch, 1979), detailed 128 food items; No. 8-5, Poultry Products - Raw-Processed-Prepared (Posati, 1979), listed 304 food items; No. 8-6, Soups, Sauces and Gravies - Raw-Processed-Prepared (March,l1980), included 214 food items; No. 8-7, Sausages and Luncheon Meats - Raw-Processed-Prepared (Richardson et a1, 1980), contained 80 food items; and No. 8-8, Breakfast Cereals - Raw—Processed-Prepared is yet to be published. 17 Sections No. 8-1 through 8-4 list values for 64 dietary components while sections No. 8-5 through 8-7 detail 66 dietary components. Values for copper and manganese were included in the last three tables but not in the first four. Handbook 456, "Nutritive Value of American Foods in Common Units" (Adams, 1975).also has been extensively used for manual calculations of nutrient composition of foods (also available on magnetic tape for computer usage). This publication contains three tables: Table 1 - Nutritive values for household measures and market units of foods, includes information on 15 nutrient composition values; Table 2 - Fatty acid values for household measures and market units of foods, includes information on fat, saturated fatty acids and unsaturated fatty acid values; Table 3 - Data on food composition to supplement Tables 1 and 2, includes additional values for 20 dietary components. Tables 1 and 2 list values for 2,483 food items each while Table 3 gives more information for 14 of these foods. Other food composition tables, along with those compiled by the U.S.D.A.,also are available to be used for the cal- culation of nutrient content of foods (detailed in Table 2). Many of these have been traditionally put to practical use by dietitians and nutritionists. Bowes and Church's "Foodr Values of Portions Commonly Served" (Church and Church, 1975) and McCance and Widdowson's "The Composition of Foods" (Paul and Southgate, 1978) are two texts which provide food tables. Bowes and Church's tables have been continually revised since their first publication by Bowes in 1937. 18 lable 2. Dietary Components of Selected Tables of Food Cmsition Proaieate - liscellaneoas , 1 W 0 al of food Ihiit of Amino total Fatty Choles- Carbo- Veer Source itees eeasure later [earn Protein Acid Fat Acid terol hmrate Fiber 1975 Bones 8 Church's 4134 household I I 81 1 NH 1 s 054101: values for 1a) Food Values of leasures con-eercial products Portions Comnly Served, 12th ed. 1920 McCance a aiddoason's 3073 1009 x x? 13 x 1‘ x the Cuposition of Foods, 4th ed. 1963 USDA PWUCATIOIS handbook lo. 8 lable l - Conosi- 2483 100 g I I x x l X tion of Foods. 1009. Edible Portion 1ah1e 2 - Mtrients 2483 llh. FF 2 x x l x refuse percent in the edible portion of 110. of food as purchased table 3 - Selected 2483 100 9. l SPA refuse percent Fatty Acids in 110, EP 18:1 Foods 18:2 laole 4 - Chole- 35 100 9. I refuse percent sterol Content 110. SF of Foods table 5 - Iagnesh- 444 100 9, refuse percent Content of Foods 110. [P 1976 “Moot lo. 8 - m Revised, Io. 8-1 1009. X x x 185 x 196 X X X phytosterols, refuse Dairy 8 2” Products 2 col-Ion laa- rocessed-Prepared eeasures.llo [P 1977 an. 0-2 Spices 4:1 1009. x x x 105 x 195 x x x tosterol r 8 Herbs - l.P.P. 2 canon W h re u" nasuresnlo [P we no. 0-3 Baby 217 1009 x x x 135 x 196 x x x phytosterols. refuse Foods - I.P.P. 2 coll-on nasuresdlh EP 1979 lo. 8-4 Fats a 120 1009 x x x 105 x 195 x x x phytosterols, refuse Oils - 8.2.2. 2 canon uasuresdlh EP 1970 lo. a-s Poultry 304 1009 x x x 105 x 196 x 1 x osterol r Products - I.P.F. Z couon phyt " u use nasuresfllo EP 190 an. 04 Soups, 214 1009 x x x 135 x 195 x l 1 phytosterols, refuse Sauces 8 Gravies 2 can-on 8.2.2. leasures,ilo [1‘ in lo. 0-7 . Sausages 00 1009 x x x 105 x 196 x i x phytosterols, refuse and Luncheon 2 canon hats - I.P.P. nasureleb EP 1975 W 80.456 table 1- Nutritive 2483 household 1 l x x x values for household eeasures ms. 8 eareet units aartet units of foods Fable 2—Fatty 2483 household 11 SH, Acid values for eeasures 18:1 household nas. 8 18:2 eertet inits foods tum 3-Oata 14 household 1 x x SH 1 on food cmition Ieasures. 18:1 to supple-at tales 18:2 1 Individual aim-o acids included: Food .0?" 3 Protein 4 Carbohydrate included: 5 Individual nino acids included: landZ tyrosine. threonine. phenylalanine. hthionine, leucine, valine. isoleucine, lysine. expressed as tiiocalories and tiloJoules. expressed as era of protein and total nitrogen. starch. deatrins. total sugar. tyrosine. threonine, isoleucine. leucine lysine. eethionine, phenylalanine, tryptophan, valine, arginine, histidine, alaine, aspartic acid, glutuic acid. glycine, proline, serine. ‘ individual fatty acids included: 20:1, 22:1; polyunsaturated fatty acids - 18:2. saturated fattyaacids - 4:0 6:0 8:0. 10:0. 12:0. 14:0, 16:0, 18:0; msaturated fatty acids - 16:1, 18:1, :3. 10:4. 26.4. 20:5. 22:5. 22:6. 19 i_a_111e 2 (cont'd) Ii 1 Vita-in nera Panto Ascorbic 3100 "19"“ Year Scarce Ash Ca Fe in P I ha Zn Others Acid Yhiuain flavin hiacin Acid Folecin 8-6 8-17- A 9 E Others 1975 Bowes I. Church X X X X X X X X X X X X 1973 McCance O Iiddouson X X X X X X X Cu.S.Cl X X X X X X X X X X X Biotin 1963 USDA 11mm lo. 8 Table l X X X X X X X X X X lable 2 x 11 1 x X x x x x I Table 3 laole 4 table 5 l 1976 MM lo. 8- ' Revised b. B-l X X X X X X X X X X X X X X X X X 1972 he. 8-2 X X X X X X X X X X X X X X X X X 1978 h. 8-3 X X X X X X X X X X X X X X X X X 1979 h. 84 X X X X X X X X X X X X X X X X X 197’ M. 8-5 X X X X X X X X Cth X X X X X X X X X I” M. 8-6 X X X X X X X X C0,!“ X X X X X X X X X 1980 no. 0-7 x X x x x X x x Cu.iin x x 1 1 x X x x x 1975 hmdiook 110. 456 Table 1 X X X X X X X X X X X table 2 Tflle 3 X X X X X X X X X X X ........... 20 These tables currently provide values for 26 nutrients in common household portion sizes of approximately 4,000 food items. The food composition tables by McCance and Widdowson were compiled to respond to a need by investigators, parti- cularly in Great Britain, for knowledge of the nutrient content of foods in 1940. These tables have been continually updated and revised through the years. They currently contain 35 nutrient constituents for 3,873 food items per 100 gram portions. Cholesterol and phytic acid phosphorus values were also compiled for selected foods. One of the problems of nutrient data banks is their proliferating number. The main concern revolves around the evaluation and comparison of output from the various data banks. To alleviate part of this problem it is wise to include the data reference sources for each food item (Petot, 1979; Schaum et al, 1973; Hjortland et al, 1966). This will give good documentation of values in the different data banks, however, it will not provide much help in devel- Oping consistency for all data banks. These references source codes provide a useful means of comparing not only several data banks but also new information and values. They are useful for checking the accuracy of recorded data. There are several other problems inherent in a nutrient data bank system (Petot, 1979; Hertzler and Hoover, 1977). Most food manufacturers will provide nutrient information when requested, however, the values are generally provided on a 100 gram basis not in volumetric equivalent weights or portion sizes. Chemical analyses have not been done for 21 all nutrients in a majority of foods and groups of foods. Imputed values or assumptions done on similar foods or groups of foods may be used. This might discredit the accurate data, particularly if various users overlook the fact that part of the data is imputed or assumed. Therefore, of concern is the need for further and more extensive nutrient analyses of all foods, particularly for the nutrients vitamin E, molybdenum, phosphorus, iodine, chromium, man- ganese, selenium, amino acids, folacin and individual carbo- hydrates. Currently there is little information regarding the values for added or fortified nutrients. For example, non-fortified foods may be used for enriched items, or vice versa. The total amount of a particular nutrient may be known but not the quantity that was used for enriching the product. Nutrient calculations for recipes may or may not take into consideration nutrient losses which occur during preparation. Standards for nutrient losses during prepara- tion should be established which could be used for recipe cdlculations. Other problems also include variations in food composition due to variety, growing conditions, process- ing, storage and cooking. The lack of nutrient information for foreign foods, which are becoming more a part of the American diet also complicates diet assessments. As previously mentioned, missing values for some nutrients are an inherent problem when compiling a nutrient data bank. This lack of information may be due to various factors (Schaum et al, 1973). The primary reason is limited chemical analyses of nutrients in foods. Nutrient analyses 22 are expensive and mainly done primarily on the nutrient under study. Also food manufacturers provide limited infor- mation, again due to limited facilities. Despite problems within the nutrient data bank system, it is an efficient tool for a variety of purposes. There are problems comparing output from various data banks; reference sources readily available for comparison may alleviate part of this problem. More complete analyses of the nutrients within foods also are needed. However, computerized nutrient data banks do provide more accurate and detailed analyses than manual tabulations, at a lower expense and at a faster rate. Sociological Impact of Food In order to grasp any understanding regarding nutrient intakes of the elderly, factors which affect their food habits must be explored. Food and eating represent an important supportive device necessary to achieve satis- faction and a high quality of life in old age (Mann, 1973), The choice of food is determined by economic, social, physiological and psychological factors (Beeuwkes, 1960). After retirement the elderly generally experience a decrease in income. Most older people will feel a monetary squeeze if they try to maintain the same standard of living as they had during their wage-earning years. Thus, the amount of money available to spend for food purchases is decreased (Troll, 1971; Current Comment, 1971; Mann, 1973). The Select Committee on Nutrition and Human Needs of the 23 U.S. Senate recommended that consideration be given to elderly individuals in terms of nutritional aspects (Krehl, 1974). They identified the elderly, particularly the low income aged, as vulnerable to malnutrition. This is in agreement with many nutritionists who believe that the elderly often have nutritionally inadequate diets. Food is a medium for socialization, as well as a biological necessity (Weinberg, 1972). The adult life, to a large extent, evolves around food and drink experi- ences. The biological basis of food consumption may be disassociated from the social significance of eating. Sherwood (1973) asserted that food and eating also may be a source of aesthetic and creative satisfaction for this population group. The significance of the meal in the socialization process has been established by Howell and Loch (1969) as being dependent on the persons sharing the meal, the length of time involved, the emotional atmosphere and the apprOpriateness of conversation and ideas exchanged during the eating period. It has been established that food habits are founded early in life and do not change appreciably with age (Mann, 1973). However, certain factors may affect the expression of these food attitudes in later life. Old age is a time of loss due to the death of friends and relatives and/or due to the loss of physical abilities (Troll, 1971; Mann, 19733 R088 Laboratories, 1979). If food had been used as a means of comfort in the past, food consumption will change since more comfort will be needed to compensate 24 for increased losses (Troll, 1971). With the loss of physical abilities the strength required to prepare or purchase foods may diminish which, most probably, will adversely affect food consumption (Troll, 1971; Mann, 1973). Improper food selection of the aged may be due to a variety of other reasons including loneliness, depression and isolation (Brown, 1976; Weinberg, 1972; Garetz, 1976; Sebrell, 1966; Swanson, 1964). Depression in the elderly may be associated with a lack of food or undernutrition or with the overconsumption of food. The lives of many older Americans are marked by loneliness either deepseated or brought on by living alone, eating alone, being separated from their family or from suffering losses of loved ones. If the aloneness is not self-imposed the aged adult will have a difficult time managing an adequate life for most aspects, including food selection. Pelcovits (1972) report— ed that lonely individuals find it difficult to prepare adequate meals for just themselves. Thus, loneliness does not stimulate good eating practices. Lack of incentive for meal preparation exhibited in the elderly living alone may result in deficient diets (Weinberg, 1972). Krehl (1974) reported that living alone often limits nutritional selection to easily prepared foods. Beeuwkes (1960) cited a study in which malnourished patients admitted to a Cleveland nursing home were reported to have had poor lifetime eating habits. Many of these patients had been living alone and had consumed inadequate diets, particularly in regards to meat and citrus fruits. 25 It has been pointed out by Sebrell (1966) that food is enjoyed more when it is shared with others. Howell and Loeb (1969) reported that eating patterns of couples living together over many years will be mutually reinforcing. The foods used will tend to become habits and mutually adopted. However, problems may also arise in family eating situations. Poor dietary habits of the senior member in an extended family may be the major reSponse to any per- ceived threat to self or role within the family. ‘Thus, inadequate food consumption may be used as a means, by some elderly family members, to express feelings of displeasure in two- or three-generation living arrangements (Howell and Loeb, 1969). Dietary inadequacies, of any kind, generally constitute health problems for the aged. These same dietary inade- quacies may, on the other hand, be caused by social and health problems. As summarized by Sherwood (1973), the aged are frequently economically impoverished, poorly edu- cated, uninformed about sound nutritional practices and may be socially isolated. These factors have all been found to be positively correlated with poor nutritional status, plus have a relationship with the general well- being of the elderly. 26 Meal Consumption Habits The investigation of food consumption patterns encom- passes a broad spectrum of topics ranging from the number of meals consumed daily to the types of food consumed each day. Since food and eating is considered to be a source of socialization and a recreational activity it is necessary to examine research which has investigated the frequency of eating periods. In a study of 24-hour dietary recalls of 3,500 aged persons before they participated in the Admini- stration of Aging's Research and Demonstration Nutrition Program, Pelcovits (1972) reported that one-fourth of the sample consumed less than three meals per day. Of these individuals one-half ate breakfast and lunch only, one- eighth ate lunch and supper only, while the remainder only consumed one meal per day. The balance of the sample (75%) ate at least three meals per day. In another study, analysis of the dietary patterns of 182 elderly volunteers revealed that 45 percent of the subjects ate three full meals, 45 percent ate two full meals and 10 percent ate only one full meal per day (Hunter and Linn. 1979). Seventy percent of the subjects normally ate a full breakfast. A full meal, for this investigation, consisted of at least three of the four major food groups. There were no significant differences found in the percentage of elderly subjects who snacked or did not snack between meals. A snack, for this study, may have contained as little as an apple or a cookie. "Unbalanced diets", e.g., those containing a predetermined inapprOpriate quantity or 27 quality of portions of three of the four major food groups, were observed in 34 percent of the subjects. The importance and number of meals consumed by 104 Boston area elderly who were interested in a center for the aged was part of an investigation by Davidson and co-workers (1962). Both a dietary recall and food record for a week were used to evaluate the food practices of the sample population. This research indicated that most of their subjects ate the traditional three meals per day. More than one-third, though, ate more frequently. Also of importance was the finding that more than one-half of the members of the study ate their meals alone or most frequently alone. Eating frequencies of 100 Westchester County, New York elderly individuals aged 65 years and older were examined using diet histories by Jordan and associates (1950). Ninety percent of the subjects ate three meals per day, while only 9 percent ate 2 meals a day. The main meal of the day was reported to be the mid-day meal for 40 percent of the sample. This study, also, revealed that only 45 percent of the subjects consumed food or beverages between meals. Three meals per day was the main frequency pattern found for meals consumed by the elderly population in the above studies. This pattern was also evident in research conducted by Lyons and Trulson (1956) of 100 Boston area low to moderate income individuals aged 65 years or older. No significant differences were found between the two types of data collection methods used for this investigation - 28 diet histories of individuals (58% of sample) who expressed an interest in the study and diet histories of individuals (42% of sample) who had no prior knowledge of the study. Sixty-five percent of the men and 87 percent of the women consumed three meals per day, the remainder of the subjects cOnsumed two meals per day. Eating between meals was considered in this investigation with fifty-two percent of the men and fifty-eight percent of the women consuming one or more snacks per day. This frequency of snacking was substantiated by later research performed by Reid and Miles (1977) which investigated the food consumption habits of 50 noninstitutionalized Canadian senior citizens aged 65 years to over 85 years through the use of a four day food diary. Snacking was observed by 60 percent of this popula- tion sample. Food items most frequently comed by the subjects between meals included breads, cakes, cookies and candies. Milk, milk products and fruits were also popular snack items but not to the extent of the previously mentioned foods. The importance of meal location was reported by Kaplan and associated (1955) and Lyons and Trulson (1956). A study of 53 New York City elderly, of which 74 percent of the sample lived alone, was conducted by Kaplan and co-workers (1955) using a 24-hour dietary recall and a social and economic history. Of the total sample population, 27 (51%) ate most of their meals in restaurants while 25 (47%) never ate meals out. An investigation of 100 Boston low to moderate income elderly by Lyons and Trulson (1956) revealed 29 that 3 percent of the subjects (1 man and 2 women) ate all of thier meals away from home. An additional 30 percent (11 men and 19 women) consumed some of thier meals away from home. An investigation conducted by Jordan and co-workers (1950) and Guthrie and associates (1972) indicated other patterns of away from home meal consumption. A study of 100 Westchester County, New York elderly who lived alone revealed that 78 percent of the sample pOpulation ate all of their meals at home while 8 percent regularly ate in restaurants (Jordan et al, 1950). The remainder of this elderly popu- lation (14%) ate most of their meals at home with an occa- sional meal at a restaurant or with friends. An investiga— tion of 99 rural Pennsylvannia low and moderate income elderly uas conducted by Guthrie and associates (1972), using a 24—hour dietary recall of food eaten both at home and away from home. Only 8 percent of the sample ate lunch away from home and 6 percent ate dinner away from home on the survey day. The mid-day meals consumed outside the home provided less calcium and vitamin A than did the lunches eaten at home while the dinners eaten away from furnished more vitamin A and ascorbic acid than did the evening meals consumed at home. ' Food Consumption Habits Since the elderly have apparently been consuming an appropriate number of meals each day, it was necessary to examine which foods they are eating. Nutritional status 3O reflects to a large extent, the types of foods which the aged choose for their meals (Monagle, 1967). Several studies have investigated the general, overall quality of the diets of the elderly. LeBovit (1965) investigated the food consumption patterns as part of a study of 283 Rochester, New York elderly households who were beneficiaries of Social Security Old Age, Survivors and Disability Insurance. Households were included only if the beneficiary lived alone or with someone at least 55 years of age. Those sampled were at least 65 years old, maintained their own home and ate most of their meals at home. Data was collected using the 24- hour recall method. Diets were classified according to how well they met recommended allowances for eight nutrients (calories, protein, calcium, iron, vitamin A, thiamin, riboflavin and ascorbic acid): good- met full allowance for all nutrients; fair - met at least two-thirds recommend- ation but fell below full allowance for one or more nutrient; poor - fell below two-thirds of recommended allowance for one or more nutrients. Men living alone had a higher percentage of good diets (52%) than did women living alone (46%) or couples (48%). Poor diets were consumed by more men living alone (35%) than by women living alone or couples (24%, each). A study of 700 Canadian senior citizens, obtained from alist of those receiving Old Age Security, was under- taken by Monagle (1967) who used the 24-hour recall method for four consecutive days. The food records obtained were 31 evaluated according to Canada's Food Guide: minimal intake of any food group was considered to less than one-half of the recommended amount for that group. Diet ratings were evaluated as good, fair, borderline and poor. Borderline diets were those which were below minimum in three or four groups while poor diets were below minimum in five or more groups. Results from this portion of the study revealed that nine percent obtained food diets and 41 percent consumed fair diets. Almost one-half of the sample ate inferior diets: borderline, 42 percent and poor, 6 percent. The most frequently neglected foods, reported in this investigation, were cheese, whole grain cereals, citrus fruits, eggs, vegetables and fruits. A large percentage of inadequate diets also was found in a study done by Kohrs and co-workers (1978). Food fre- quencies per day, week, month or year were taken for 55 male and 81 female Missouri residents over 59 years of age. Diet quality was assessed on the nutrient intake levels for eight nutrients (protein, calcium, iron, vitamins A and C, thiamin, riboflavin and preformed niacin): excellent - equal to or above the 1974 recommended amounts; good - met at least two-thirds allowance for all nutrients; poor - one or more nutrient consumed in amounts less than two- thirds allowance. Only 20 percent of the sample, for both male and females, obtained excellent diets. The major- ity of men (58%) consumed good diets while one-half of the women had poor diet ratings. Vitamin A rich fruits and vegetables were consumed in amounts less than one-half 32 of the Basic Four Food guide for servings per day by 20 percent of the males and 12 percent of the females. As noticed in these last studies, the consumption of fruits and vegetables by the elderly may be inadequate. Other investigations have indicated this trend of insuffi- cient amounts of fruits and vegetables being consumed. Lyons and Trulson (1956) examined the diets of 100 Boston area elderly and found that two-thirds of their sample failed to consume a serving of yellow or green leafy vege- tables per day. However, 68 percent of the subjects did consume at least one serving of citrus fruit daily. The amount of citrus fruit consumed corresponds with that reported from the study by Pelcovits (1972). Of the 3,000 elderly subjects interviewed 34 percent consumed no fruit per day while only 18 percent did not eat any vegetables daily. This vegetable consumption is markedly different from that reported by Lyons and Trulson.(1956). The importance of fruit and vegetables to elderly individuals' dietary intakes also was evident in several other investigations. A diet survey of 27 older households (adults all 50 years and older) in Everett, Washington was taken using a week's dietary record (Van Syckle, 1957), The results of this study indicated that even though 33 percent of the households had intakes less than 100 percent of the recommended level of ascorbic acid, fruits and vege- tables acoounted for approximately 97 percent of the food supply for ascorbic acid. Researchers reported that of 60 elderly women living alone in London, England only 33 3 women (5%) consumed as little as 3 mg. of vitamin 0 per day (Exton-Smith and Stanton, 1965). These women consumed no fruit or vegetables for the six days examined. Similar findings were reported from a study of 264 individuals aged 65 years and over living in N. Glasgow (Macleod et al, 1974a). Thirty-seven members (14%) of the sample did not eat green vegetables or citrus fruits during the week studied. This group accounted for 5 of the 6 subjects whose daily intakes of ascorbic acid of less than 10 mg. All but two of the 141 subjects with adequate intakes of vitamin C (over 30 mg. per day) consumed some vegetables and fruits during the week. The contribution of other food groups to the importance of dietary intakes has been examined. The 100 Boston elderly examined by Lyons and Trulson (1956) revealed that less than one-half of the sample (48% men and 41% women) consumed one pint of milk or the equivalent incheese daily. Slightly more women (75%) than men (71%) obtained the standard for the number of meat or meat alternate servings, however, the size of the servings was not considered. The standard of four eggs per week was only obtained by 65 percent of the men and 52 percent of the women. The most adequately consumed food group was the bread and cereal group - all of the men and all but one percent of women met the standard (1 portion). Jordan and associates (1950) investigated diet histories of 24 men and 76 women, 65 years or older living alone in Westchester County, New York. Findings similar to the aforementioned research results were reported from this examination. Approximately 74 percent of the sampled 34 population met the standard of four eggs per week, 60 per- cent consumed one daily serving of citrus fruits/juices or uncooked greens while 57 percent used at least one pint of milk or cheese equivalent per day. The meat or meat alter- nat standard was met by 66 percent of elderly in this inves- tigation. The entire sample consumed at least one daily portion of enriched or whole grain bread or cereal. The food group most frequently lacking in this sample was yellow and green leafy vegetables (only 41% met the standard of one serving daily) while only 10 percent did not meet the standard for other vegetables and non-citrus fruits. The contribution of various food groups was examined by Durnin and associates (1961) in a study of 21 women with an average age of 60 years living in the Glasgow area. The ffod was weighed before it was put on the plate, any wastage also was recorded. Protein contributed 13 percent of the calories; fat, 43 percent; carbohydrate, 44 percent; and alcohol, less than one percent (0.6%). The important contributions by the food groups to the caloric value were cakes and biscuits (20%), meat (12%), bread and rolls (12%), milk, eggs and cheese (11%) and butter (9%). LeBovit (1965) examined food group contribution in another way. Food brought into the homes of elderly singles or couples was studied for 283 Rochester, New York elderly citizens. During the week, the foods which were brought into the home included an average of four quarts of milk; four pounds of meat, poultry and fish; one-half dozen eggs; ten pounds of citrus fruits and green/yellow vegetables; 35 two pounds of grain products; one pound of sugar and sweets; and three-fourths pound of fats and oils. This survey method did not detail how much of each food group was eaten but it did indicate what was available for consumption. Macleod and co-workers (1974a) included food group contribution to dietary intakes in their study of 264 Glasgow area elderly individuals. Seven day dietary records were analyzed. The principal sources of calories for men were biscuits, cakes, etc. (20%), fats and oils (15%), meat and meat dishes (13%), and bread (11%). Protein con— tributed 14-15 percent of the calories; carbohydrate, 44-46 percent; and fat, 42-44 percent. Using the Basic Four Food Groups as a guideline, Kohrs and associates (1978) also examine food group consumption in their investigation of 136 elderly Missouri subjects. Three-fourths of the subjects consumed less than two serv- ings of dairy products daily. More than twice as many women as men had intakes of less than 4 ounces of high quality protein daily and 4 servings of breads and cereals per day. Also, more men (32%) than women (19%) consumed less than the recommended number of servings of fruits and vegetables. The incidence of milk drinking by the elderly of three races was investigated by Marrs (1978). The sample consist- ed of 344 subjects who participated in the Title VII Nutri- tion Program for the Elderly in Harris County, Texas. The sample was asked to respond to a questionaire regarding their milk consumption habits. Seventy percent of the subjects reported that they drank some type of milk daily. 36 Whole milk was drunk most frequently by all races - Mexi- can-Americans, 52%; Blacks, 32%; and Anglos, 43.5%. A similar finding of milk consumption frequency by the aged was reported by Pelcovits (1972), where 20 percent of the sample did not consume milk or milk products. Little or no milk was drunk, however, by the Everett, Washington older household members (Van Syckle, 1957). The women, in this study, were reported to have consumed less milk than did the men. Another dietary component which must be considered is the use of vitamin and mineral supplements and the impact they have on dietary nutrient intakes. This factor has been examined by several investigators. A study of 27 Washington state older households reported 10 families (37% of the sample) used vitamin/mineral supplements.(Van Syckle, 1957). The supplements were used by households whose food supplies appeared to be adequate. Of the families whose food supplies provided less than the full allowance for a nutrient, the following used supplements containing the lacking nutrient: calcium, 1 household; ascorbic acid, 3 households; and iron, 1 household. An investigation of 104 Boston area residents aged 50 years to 97 years by Davidson and co-workers (1962) revealed that vitamin/mineral preparations and/or other food supplements were used daily or almost daily by one- half of the sample, irregularly by 8 percent and not at all by the remainder of the sample. The impact of the supplements was evaluated for seven nutrients: vitamin A, 37 thiamin, riboflavin, niacin, ascorbic acid, calcium and iron. For all the nutrients, supplements decreased the percentage of subjects falling below the set intake standard. Seven day dietary records of 567 San Mateo County, California individuals aged 50 years or older were examined by Steinkamp and associates (1965). Dietary supplements were used by 35 percent of the subjects. 0f the total sample, 26 percent took multiple vitamin tablets, 10 percent used oneror more single vitamin tablets, 6 percent took mineral tablets and 10 percent used other food supplements. Thirty-seven percent of the individuals who took supple- ments.had diets adequate for these nutrients before including supplements in the nutrient intake calculations. Of the individuals lacking the full allowance for a nutrient, the following adequately supplemented their diets for the deficinet nutrient: vitamin A, 19%; vitamin C, 26%; preformed niacin, 18%; riboflavin, 14%; thiamin, 27%; calcium, 26%; and iron, 0%. Thus, many diets were supplemented with vitamins and minerals when they were already adequate while inadequate diets were rarely supplemented to recom- mended levels. This was consistent with the previously mentioned study. 1 McGandy and co-workers (1966) investigated the nutrient intakes of 252 men, aged 20 to 99 years, residing in Balti- more. Seven day food diaries were used as the examination tool. One-half of the sample reported taking vitamin and mineral supplements during the week studied. The impact of their usage, however, was not analyzed. The use of 38 supplements did not appear to be related to the subject's age. The contribution of vitamin/mineral supplements to the elderly's diets was examined by LeBovit (1965). Of the 283 households studied, 37 percent of the subjects consumed some type of vitamin or mineral preparation. Almost all of the supplements included several vitamins. Forty-seven percent of those taking supplements obtained adequate nutrient intakes from thier diets. Diet shortages were sufficiently supplemented for 20 percent of the sample and only partially covered for 50 percent, while 30 percent of the sample took supplements which enhanced nutrients already appropriately supplied in the diet but not those for which inadequate intakes were noted. Guthrie and associates (1972) studied the usage of vitamin/mineral supplements by 99 low and moderate income elderly in rural Pennsylvannia. Forty-six percent of the sample reported that they used dietary supplements, however, only 2 percent obtained nutrients which had been at inade- quate levels. Some of the vitamins and minerals which had been supplied in low amounts from the diets were supplemented for 19 percent of the subjects while 5 percent did not obtain additional amounts of nutrients low in their diets. Another invetsigation also looked at the impact dietary supplements made on nutrient intakes. Of the 50 elderly Canadian subjects surveyed by Reid and Miles (1977), 24 percent consumed dietary supplements. Only one-third of these individuals took vitamin/mineral tablets which 39 alleviated the dietary shortages. One-fourth of the sample unnecessarily took dietary supplements considering that their food intake supplied the nutrients in adequate amounts. The 136 elderly Missouri subjects participating in a study by Kohrs and associats (1978) reported some vitamin and mineral supplement usage. Vitamin/mineral supplements were consumed at least once per week by more women (42%) than by men (32%). More men than women used calcium tablets (5 and 2%, respectively) and vitamin C tablets (11 and 6%, respectively). On the other hand, more women (16%) took multivitamin tablets than did the men (6%). A greater number of women (22%) also used iron tablets than did men (15%). As seen above, the usage of dietary supplements is common in the elderly population. However, there appears to be a variation in usage in individual nutrient tablets. The appropriateness of vitamin and mineral supplements is suspect since many of the elderly taking the tablets already had an adequate consumption of nutrients through their food choices. Nutrient Intakes of the Elderly Food consumption habits directly affect nutritional status. This is, in part due to the fact food contains nutrients. Thus, nutritional status is partially dependent on dietary nutrient intakes (Goodhart and Shils, 1979). Other factors which affect nutritional status include biochemical processes and physiological status of the 40 individual. However, if the nutrients are not obtained from foods or food supplements, the other factors will have little bearing on the overall nutritional status. Since it has been shown that males and females have different food con— sumption patterns, how does this affect the nutrient intake of each sex? For a study of 53 New York elderly, aged 60 years and older, Kaplan and co-workers (1955) examined 24-hour dietary recalls of 27 men and 26 women. Approximately, the same number of men (11%) as women (12%) consumed more than 120 % of the recommended allowance of calories. However, more women (46%) than men (33%) were consuming less than 20% of the recommended level. The allowances were based on average caloric requirements, as suggested by Joliffe. More men than women obtained satisfactory diets for protein (67 and 54%, respectively), calcium (44 and 31%), iron (30 and 19%) and thiamin (30 and 23%). More women consumed better diets than did men for niacin (50 and 41%, respectively) and ascorbic acid (69 and 33%). Twice as many men (67%), then, had consumed diets inadequate in ascorbic acid as had women (31%). Contradictory results were obtained by Lyons and Trulson (1956) in a study of 100 Boston area senior citizens. Males met or exceeded the NRC-RDA for all nutrients except for calories. Women met the recommended levels for all nutrients and calories except for iron and thiamin. The nutrients most frequently observed as low (less than 75% recommended level) for women were iron (36%). calcium (27%), and ascorbic 41 acid (26%), while men most frequently had inadequate intakes of calories (39%), thiamin (32%), calcium (26%) and ribo- flavin (26% . Most men and women met the full recommended amount for protein (71 and 74%, respectively), vitamin A (74 and 81%), niacin (68 and 67%) and ascorbic acid (61 and 67%). More women than men (52 and 35%, respectively) met or exceeded the standard for calories. The follow-up study of the 567 San Mateo County, California elderly subjects was taken for 68 men and 73 women (Steinkamp et al, 1965). The percentage of subjects with dietary intakes which were below two-thirds the 1964 NRC-RDA for the following nutrients were: calories - 22% of men, 11% of women; protein - 12% men, 8% women; calcium - 25% men, 45% women; iron - 0% men, 5% women; vitamin A - 24% men, 27% women; thiamin - 12% men, 4% women; riboflavin - 7% men, 10% women; niacin - 66% men, 62% women; and ascorbic acid - 25% men, 19% women. Thus, men had more inadequate dietary intakes tham women for 5 of the 9 nutrients examined. Preformed niacin was consumed in low amounts for almost two-thirds of the subjects, both male and female. The contribution of protein, fat, carbohydrate and alcohol to the total caloric intake was not significantly different for men and women. Macleod and co-workers (1974a, 1974b, 1975) reported that mean intakes of energy nutrients were less in the 187 women than the 77 men in the Glasgow area which they studied. These differences, however, were reduced when the mean intakes were expressed accoridng to lean body mass. 42 Differences also were noted for vitamin and mineral intakes. More than one-half of the women had low intakes of thiamin while one-third of the men had intakes below the recom- mended level. A large proportion of men (69%) and women (89%) had inadequate intakes of nicotinic acid. Almost one-half of both the men and women consumed less than the recommended allowance for riboflavin. Pyridoxine intake was within the safe range for men but just below this for women. More women (14%) than men (4%) consumed less than 500 mg. of calcium per day while twice as many men (4%) had intakes of less tham 6 mg. iron daily than did women (2%). Women, in this study, also had lower intakes of potassium amd magnesium than did the men. Fourteen percent of the women had potassium intakes less than this level. Twice as many women (43%) as men (21%) had magnesium intakes below 0.30 mEq/kg daily. An assessment of the diets of 55 males and 81 females who participated in the 1973 Missouri Nutrition Survey was made by Kohrs and associates (1978). One-half of the women compared to one-fifth of the men had eaten diets which contained at least one nutrient below two-thirds of the 1974 NRC-RDA. The percentage of women consuming this level of the allowances for the nutrients were: 10% for protein, iron, vitamin A, riboflavin, vitamin C; 13% for energy, thiamin, preformed niacin; and 33% for calcium. Some women consumed less than 50 percent of the 1974 NRC-RDA for iron (2%) and calcium (15%). The percentage of men 43 consuming less than two-thirds of the recommended amount for the nutrients were: 2% for protein and riboflavin; 3% for calcium; 5% for thiamin; and 11% for niacin. One percent of both sexes consumed less than one-half of the NRC-RDA for preformed niacin. As is evident, there are many contradictory findings regarding the impact of the sex variable on nutrient intake. Where one study reported a low intake of one nutrient, another indicated that an adequate amount was consumed. All of these studies were done on individuals from a local- ized area. This may be responsible for the wide variations in results. To obtains a better understanding of the dietary status of the elderly, studies covering a wider geographical area need to be considered. The Ten State Survey, 1968-70 (1972), the H.A.N.E.S. study (1977) and the National Food Consumption Survey 1977-78 (1980) are investigation which examined individuals across large geographical areas. The Ten State Survey revealed that individuals aged 60 years and over consumed less food than was needed to achieve nutrient adequacy. None of the subjects met the set allowance for food energy. Nutrients consumed in limited amounts were protein, iron and vitamin A. Women had more adequate intakes of vitamin C than did men. These results were similar to those reported from the H.A.N.E.S. survey for persons aged 65 years and older (USDHEW, 1977 and 1979). Inadequate amounts of calories, protein, iron and preformed niacin were consumed by both sexes. Fmeales did not meet the standards set for calcium, while 44 men did not.consume adequate levels of vitamin A and vitamin C. The Nationwide Food Consumption Survey, however, reported that adequate levels of all nutrients were consumed by bothasexes with the exception of low intakes of calcium, magnesium and vitamin B—6 by women. Contradictory results also were obtained from the various studies which examined the impact of age on the elderly's nutrient intakes. In general, the researchers tend to agree that all nutrient intakes decrease as the age of the subjects increase with the exception of several nutrients. The nutrients which did not follow the decreased consumption trend, however, varied for the populations studied. Fry and co-workers (1963) evaluated the weighed food intakes and seven day records of 32 women, aged 65 to 85 years. The nutrients which did not have a lower intake with increased age were calcium and riboflavin. These two actually increased slightly with age. Food energy, protein and calcium were the nutrients reported as having a decreased intake for an increased in age of 1,072 Iowa women aged 30 to 90 years (Swanson, 1964). The food energy intakes decreased by 85 calories for every 10 year increase of age, while protein intake dropped 4 grams and calcium decreased 0.3 grams. The low protein diets observed in the older subjects were thought to be related to the lower caloric values of the diets. A prominent decreased of caloric and protein intakes due to increased age also was observed for 60 elderly 45 English women (Anon, 1966). Calcium consumption for this sample did not decrease with advanced ages as previously reported; it increased. The intake of iron showed no in- crease or decrease in the amount consumed by the subjects while vitamin C intakes were so varied it was impossible to make any correlations with age. The intake patterns of men in Baltimore (McGandy et al, 1966) differed from that found of the English women. An examination of the seven day food diaries recorded by 252 men aged 20 to 99 years revealed a decrease in consump- tion for some nutrients with advancing age and no change for others. There was a progressive decrease in intakes of iron, thiamin, riboflavin and niacin. There was no fall in amount consumed of calcium, vitamin A and ascorbic acid. As the age of subjects increased from 45-54 years to 80 years the percentage of calories obtained from fat dr0pped from 42 to 36 percent, while the percentage of calories from carbohydrate increased. The protein contribution to caloric intake remained constant. There was a drop in cholesterol intake observed due to a decrease in meat usage. Macleod and co-workers (1974a, 1974b, 1975) reported that for their sample of elderly the percentage of calories obtained from carbohydrate consumption decreased with age rather than increased as reported by McGandy and associates (1966). This decrease was due to a reduction of complex carbohydrates in the diets rather than from sucrose. Intake of all vitamins and minerals decreased with increasing age. An analysis of the impact of age on dietary habits was 46 reported by Brown (1976). Frequency recalls were taken for 303 elderly individuals aged 65 years and older, of which 74 percent of the subjects were women. The reported results indicated that there were no significant differences between men or women. No correlations could be made between diet quality and age. However, more men and older members of the sample reported higher quality food intakes than did women and younger members of the sample. The younger the age group, the greater the percentage of fair or poor dietary intakes (less than two-thirds of the recommended level for at least one nutrient). This was especially true for women under 80 years of age - most of the fair or poor diet ratings were in this group. Caloric intake was found to be the limiting factor in these diets. Judge (1976) asserted that intakes of calcium, potas- sium, iron and probably magnesium are most likely to be low. Inadequate intakes of vitamins C and D were reoirted to be low in the elderly. These intakes decreased even further with advancing years. Thirty-eight percent of the men aged 65 to 74 years and 50 percent of those at least 75 years had low intakes of vitamin C. Forty-two and 57 percent of the women of these age groups consumed low intakes of vitamin C. A similar increase of low intakes of vitamin D was observed for 47 percent of the men aged 65 to 74 years to 70 percent for those 75 years and older. Vitamin D intakes slightly improved for women as age increased - from 82 percent to 78 percent consuming low intakes. Thus, as can be seen, the elderly population may be 47 at nutritional risk cue to the reported low dietary intakes, in general. This was especially indicated by previous researchers for the older women. Even though there was a variation in reported low intakes of specific nutrients, it can be summarized that dietary intakes of the elderly are suspect. The use of food supplements (vitamin/mineral/ protein) appeared to be of little help in achieving adequate nutrient intakes in the majority of cases. Those elderly individuals who used dietary supplements had, in general, adequate intakes from thier food. It appeared that if the individuals were concerned about their diet enough to take the dietary supplements, they also were making appropriate choices about the food they ate. Another factor which may greatly affect the food consumption patterns and, thus, the intakes of dietary components is the living accomodations of the elderly individual. If food and eating are integral part of the socialization process for this age papulation, then it is important to investigate the impact of family or household size on their habits. Only a few research studies have examined this factor, and then only briefly touching on it. Monagle (1967) reported that2of the elderly living alone the women consumed better diets than did the men. Men living with families or relatives, though, had eaten better diets than women. It is believed that living alone often limilts the selection of food to those which provide inadequate nutrients or to foods which are easily prepared (Krehl, 1974). Not only may the food choices be limited 48 to foods which require little preparation, there may be little variation in foods consumed. Reid and Miles (1977) reported that 62 percent of the 50 Canadian senior citizens they surveyed lived with someone else. These individuals had eaten a greater variety of foods than the subjects who lived alone.. If a wider variety of foods are consumed, the chances that a more adequate, nutritionally sound diet will be consumed are increased. However, Guthrie and co- workers (1972) reported that elderly living in two person households obtained less adequate intakes of vitamin A than did elderly living in one person households. Thus, this characteristic of household size should be further investigated. METHODOLOGY Seven day dietary records were used as the investiga- tion tool for the study of food patterns of non-institution- alized elderly living in various sized households. These food diaries were examined for a nationwide sample of 561 individuals aged 62 years and older. Data Collection Market Facts of Chicago, Illinois collected the informa- tion used for this study. Seven day food diaries were mailed to 2,000 of the firm's Consumer Market Panel II members in early September, 1977. Of the initial 61,552 households belonging to this panel, the sample population used was se39 selected to be representative of households within the United States. The households used were balanced by geographic area, population density, urbanization, income and age. The seven day dietary records were filled out during the week of September 18 tSSeptember 24, 1977 (Sunday through Saturday). The diaries contained spaces for ten menu items for the three main meals and six menu items for the snack periods. Main meal food consumption was recorded for morning, mid-day and evening meals. Between meal food consumption was recorded for mid-morning, mid-afternoon and 49 50 evening snacks. Panel members recorded all foods and beverages consumed, including the amount eaten or drunk. Any toppings or additions for each menu item was recorded with the appropriate amounts. The brand name, type, flavor and/or method of cooking was indicated for most entries. Information regarding the location of the meal or snack was also recorded. Locations included at home, at school, away from home and did not eat. The diary also included a "General Family Information" page. For each member of the family this section was completed with the personal data requested, e.g., name, age, height, weight, general health, dental history, pregnant or lactating and any special diet information, if appropri- ate. The family's ethnic background and the amount of money spent on food during the week were also recorded here. A detailed set of instructions were stated in the diary which included a sample of one day's menu to be used as an accurate example to follow. A sample also was included for the "General Family Information" page. For a more detailed description of the seven day diary used see Cala, 1979. Of the 2,000 diaries-distributed to the panel members, 1,550 diaries were returned to Market Facts in Chicago. These diaries were determined to be usable or non-usable. Diaries were considered to be usable if menus for at least four days were recorded. There were 1,494 diaries (75% of original 2,000 dietary records) which were determined to be usable. These usable diaries were then sent to Michigan 51 State University. Market Facts included with the diaries demographic information for each of the 2,000 original households. This information detailed the following facts: geographic division within which the subject lived, educa- tional level attained, employment status of the member, total household income, population density and degree of urbanization of the locality and marital status. This information was analyzed for all families surveyed including the panel members who returned diaries and those who did not return diaries. Thes analyses were then compared with similar statistics for the national elderly population to determine if the sample was biased. After the diaries arrived at Michigan State Univerdity, the recorded information was coded to permit computerized analyses to be performed using the Michigan State University Nutrient Data Bank (Morgan and Zabik, 1979). Twelve under- graduate coders were trained to transmit the menu items of the diaries into six-digit food code numbers and two digit measure code numbers. This facilitated the use of the MSU Nutrient Data Bank. (For detailed coding information see Cala, 1979.) After the diaries were‘coded, they were keypunched and verified by Data Entry, Incorporated of Lansing, Michigan. The information was then put on magnetic tape and returned to Michigan State University for correction of any coding or keypunching errors. The diaries were checked for accuracy for each of the seven days. This thorough checking revealed numerous errors on the raw data tapes which had to be edited 52 to the correct code numbers. After this initial editing a pre-designed program was run to make sure all inaccurate code numbers and quantity amounts had been corrected. If some of the initial wrong numbers were still on the tape then a second editing of the tapes was done. These corrected tapes were then sent to the University of Missouri-Columbia for further analyses. Data Analyses The computing facilities at the University of Missouri- Columbia were used for the analyses of the sample data. The University of Missouri Computer Network Operates an Amdahl 470/V7 (OS/V82 MVS Release 3.8 and NJE Release 3.0) and an IBM 3031 processor (VM/370 Release 6 with BSEPP Release 2). The programming language used to process the sample data was SAS Release 79.4B running under MVS. The initial programs were written by the Business,and Public Administration Research Center, of Columbia, Missouri, in consultation with the Michigan State University Application Programming Department and Drs. M.E. Zabik and K.J. Morgan. These programs were later re-written and expanded by Gary Stampley of the University'of Missouri-Columbia. Before the programs were processed the sample p0pulation was divided into three groups according to the number of individuals living in each household. The groupings were: households with one person; households with two persons; and households with three or more people. This classifica- tion system facilitated the analysis of the impact of 53 household size on the dietary habits of the elderly. This classification yielded a disproportionate distribution of the sample: one person household group contained 125 sub- jects (22.3% of sample); two person households, 360 (64.2%); three or more person households, 76 (13.5%). To determine the meal frequencies for each group, the number of times each meal was consumed per week was recorded for each of the subjects. This hand tabulation allowed for the total meals per week to be calculated, from this tabulation the average number of meals eaten per day was computed. There were six possible eating occasions for each day, e.g., breakfast, A.M. snack, lunch, P.M. snack, dinner and EVE. snack. The number of times each meal was eaten during the week was tallied for all six of the possible meals. To determine the average daily number of meals consumed by each subject, the individuals' weekly meal total was divided by seven days. Meals which had been assumed eaten (subjects had failed to properly record food items for a meal eaten at least four other days during the observation week) were included in the consumed meal tallies. The individual average daily meal frequencies were summed for each household group and divided by the representative sample sizes. This calculation determined the respective average daily number of meals which were eaten by individuals living in the three household size classes. Similar calculations were performed to determine average weekly meal consumption frequencies for each of the household size groups. Since tabulations were made for each 54 meal it was possible to determine which meal was most frequently consumed or skipped. Percentages for each of the meals were then calculated based on the number of subjects within each household size group. Meals consumed away from home also were compared for the three household groups. This, again, was done by hand tabulation for each meal for the seven days surveyed. The frequency percentage of eating outside the home during the observation week was then calculated for each of the three household groups. After this stage of tabulations the remaining analyses were performed using the computer system at the University of Missouri. A copy of the Michigan State University Nutrient Data Bank was shipped to Columbia, Mo. for the analyses. The data bank contained 3,500 food items including fresh and processed foods plus some fast food restaurant items and home recipes. It allowed for the calculations of the intakes for 79 dietary components. The program used most frequently was an evaluation of dietary intakes for 24 of these nutrients. The dietary components analyzed included: calories, protein, total fat, total carbohydrate, total sugar, cholesterol, crude fiber, ascorbic acid, thiamin, niacin, vitamins B-6 and B-12, panto- thenic acid, vitamin A, vitamin E, iron, calcium, phosphorus, sodium, potassium, magnesium, c0pper and zinc. The first run of this program was for the total food intake of the elderly sample papulation, including and excluding the calculations of dietary supplements. The program 55 was then altered to compute the dietary intakes for each of the three household size groups. This program also included the calculation of the percentage of 1980 NRC-RDA for fifteen of the eighteen nutrients which have recommended dietary intake levels. This analysis was done for the intakes of calories, protein, ascorbic acid, thiamin, niacin, riboflavin, vitamins B—6, B—12, A, and E, iron, calcium, phosphorus, magnesium and zinc. Vitamin E values were based on the amount of alpha-tocopherol present due to the insufficiency of analytical data for other compounds with vitamin E activity (National Research Council, 1980). The dietary intakes of four nutrients (pantothenic acid, copper, sodium and potas- sium) were compared to the safe and adequate daily intake ranges set by the National Research Council. The dietary intakes of each household group were analyzed including and excluding dietary supplements. This analysis assessed the impact such supplements made on the total intake levels. To further investigate this contribution, the house- hold groups were divided into groups of supplement takers and non-supplement takers. Dietary intakes were then calcu- lated for each of the sub-groups. The frequency of supplement use by those who consumed-them was hand tabulated for each (household group. From this tally, the average consumption of dietary supplements was calculated. The intakes for the 24 dietary components were analyzed for sub-groups of the household classifications. These three household divisions were separated into sub-groups according to the sex of the subject. Each main sample was 56 also divided by age classifications. To further examine the impact of age on nutrient intakes the samples were divided into four groups of increasing age: 62 to 64 years, 65 to 69 years, 70 to 74 years and 75 years and older. The other program used was a frequency count of the number of times a particular food item was consumed. To facilitate comparison of the usage of the 3,500 foods contained in the MSU Nutrient Data Bank, foods were assigned to one of twenty-one food groups. The food groups used were: beverages (other than alcohol, friut juices, milk); dairy products; eggs; alcoholic beverages; breads - breads requiring preparation and breads requiring little prepara- tion; crackers; pasta, rice and potatoes; cereals; meats - meats requiring preparation and meats requiring little pre- paration; main meal items - main meal items requiring pre- paration and main meal items requiring little preparation; soups - soups requiring preparation and soups requiring little preparation; fruits; vegetables; candy; desserts; chips and nuts; and vitamin/mineral supplements; As noted, some groups were designated as requiring preparation or requiring little preparation. Foods which took time to make or cook were listed in the requiring preparation cate- gories (e.g., roast beef, spaghetti with meatballs), those which took little effort to make or cook were included under the requiring little preparation categories (e.g., hot dogs, canned soups). For amore complete description of each food group see Appendix I. This differentiation of the extent of preparation difficulty was made to assess 57 the attention given to certain types of foods; e.g., commer- cially packaged meals versus complex casseroles. As pre- viously hypothesized, elderly living alone may not use foods which require preparation, thus these analyses examined this susposition. The number of times an item from each food group was consumed was tabulated. This frequency count was computed for meals eaten at home and for meals eaten away from home. The at home food consumption tally indicated which foods the elderly prepare for themselves while the away from home food consumption revealed food items the elderly might prefer to choose. The percentage contribution of each food group was calculated for the week's intakes. For example, if soup was eaten 200 times out of 2,000 food items consumed, then its percentage contribution was 10 percent. The statistics employed in these analyses included one sample Chi square (Siegel, 1956), analysis of variance (Glass and Stanley, 1970) and SAS General Linear Model (Barr et al, 1976) to determine if significant differences at the 0.05 level of probability were observed. Where significant differences were evident, Duncan's Multiple Range Test (Duncan, 1957) was utilized to pinpoint the differences among the means. RESULTS Six facets of the impact of household size on food consumption patterns of non-institutionalized elderly were investigated: the frequency of meal consumption, the fre- quency and types of foods consumed during the survey week, the dietary component intakes by the sample population, the impact of dietary supplements on nutrient intake levels and the differences in dietary component intakes observed due to increasing age and consumption variations between the sexes. Sample Description Of the original 2,000 diaries mailed to Market Facts' panel members, 1,494 diaries (75% of original dietary records) were mailed to Michigan State University where they were sorted so that dietary records for individuals at least 62 years of age were available for this investigation. These diaries were complete and considered to be in usable form- food was recorded for at least four of the seven survey days. Information pertaining to the food patterns of 561 elderly individuals was contained in 399 diaries, i.e., 399 households had elderly individuals. The elderly subjects' diaries were divided into three household size classes: one person households, two person households-and three or more 59 person hohseholds. The age, sex and number of elderly in each household classification are indicated in Tables 3 through 5. This division yielded a disproportionate distri- bution of the total sample (Table 3). The one person house- hold group contained 125 members (22% of the sample), the two person household group had 360 subjects (64%), while the three or more person household sample contained 76 members (14%). This distribution was only slightly different than that for the 1978 United States elderly population - 30 percent of the national elderly papulation lived alone during 1978 while 63 percent lived with at least one other person (U.S. Department of Commerce, 1979). Table 3. Distribution of elderly sample classified by household size. Household Number of Percentage Classification Subjggts of Sample One Person 125 22.3 Two Person 360 64.2 Three or More Person 76 13.5 The one person household sample consisted of 124 female households (99% of sample) and 1 male household (1%). The age of the participants in the one person household sample ranged from 62 to 88 years. The two person household sample included 219 households of which 135 households contained one male and one female member who were used in the study (75% of two person household sample). An additional 65 60 two person households contained one male and one female, of which 55 of these households had only males who participated in the survey (15% of sample) and 10 households had females only in the study (3%). Nineteen households in the two person household sample contained females only, both members in 6 of these households were included in the study (3%). The individuals living in two person households ranged in age from 15 to 88 years. The three or more person household sample consisted of households of various size compositions: 37 households contained three persons (75% of subjects), 9 households had four members (12%), 4 households had five members (5%) while 2 households contained six persons (3%) and 4 households had seven persons (5%). Three of the house- holds with three pe0ple contained individuals who were all used in this study (two males and one female, each). The age of the members in the three or more person households ranged from 7 months to 88 years. To determine if unequal distributions of age and sex of the subjects within the household size groups influenced the results, the three samples were sub-divided into groups accord- ing to age and sex. The total sample consisted of 123 individ- uals aged 62 to 64 years (22% of sample), 195 subjects aged 65 to 69 years (35%), 132 members aged 70 to 74 years (24%) and 111 subjects aged 75 years and older (20%) (Table 4). Of those aged 62 to 64 years, 8.9 percent were in one person households, 77.2 percent in two person households and 13.8 percent in three or more person households. In the 65 to 70 year old category, 25.1 percent were in the one person 61 Table 5. Distribution of elderly males and females classified by household size. Household Classification Three or More Sex One Person Two Person Person Classification (n=125)7 (n=360) (n516) Male 1 190 37 Female 124 170 39 An analysis of the demographic data for the elderly and, when appropriate, for their families was performed to determine if the sample used was biased by non-returned diaries. The demographic characteristics which pertained to this sample are indicated in Table 6. Market Facts pro- vided this information for 374 families but failed to supply the demographic characteristics for 25 of the families which had returned diaries and for 11 of the families which had not returned diaries. As shown in Table 6, the sanple population used was not unduly biased by the elderly who had not returned diaries. However, more elderly individuals living in the South Atlantic and Middle Atlantic geographic divisions did not return diaries compared to surveyed families living in the other geographic areas. A greater proportion of the surveyed full-time or self-employed elderly did not return diaries than did the part-time or non-employed eld- erly individuals. The largest proportion of the elderly who returned diaries were from the East North Central division which included Illinois, Indiana, Michigan, Ohio and Wisconsin. 62 Table 6. Demographic characteristics of sampled elderly. Percentage Distribution Families Families Not Families Returning Returning Surveyed Diaries Diaries Characteristics (n=514) (n=374) (n=104) Geographic Location New England Middle Atlantic E. North Central W. North Central South Atlantic E. South Atlantic W. South Atlantic Mountain Pacific Education Level No School Elementary Some High School -High School Graduate Some College College Graduate Post Graduate Degree Not Specified Employment Status Full-time or Self Employed Part-time Not Employed Homemaker Not Specified Marital Status Married Widowed Divorced Separated Single Not Specified NUl amowtooo .4 “#OO‘WKOQQW eeeeeeeee —3 CthKOOOhUlUlUlm amwaa A##I\DOO’\—IO #UJOO-l-SVJ-QO A \NKN samq 4 e as e KOKOUTO Q a e e e e \ON-§\)C\N _s_sr\)_s ssmmm—Aomm e e e e e e e e e #UlkOChVIO-‘CD# —.8 AmwAA e e e e e e e e" \flOO\U~ll\)CD(I)O m 00 -tl\) iv 4m04#m04# O O O O O O O _L eucawoqsu _L #OO-hmko-hO ANN-4.4 ammmmd—so 0 Wm amomow e #quom 63 Table 6 (cont'd.). Percentage Distribution Families Families Not Families Returning Returning Surveyed Diaries Diaries Characteristics (n=514) (n=374) (n=104) Household Income (8) Up to 3,000 16.7 17.9 13.6 3,000 to 3,999 20.4 19.0 24.3 4,000 to 5,999 14.2 13.6 15.7 6,000 to 7,999 10.9 12.0 7.9 8,000 to 8,999 9.9 9.1 12.1 9,000 to 9,999 8.4 9.1 6.4 10,000 to 11,999 5.1 4.0 7.9 12,000 to 14,999 3.1 3.7 1.4 15,000 to 17,499 4.3 3.2 7.1 17,500 and up 7.0 8.2 1.4 P0pulation Density Up to 2,500 17.5 19.0 13.6 2,500 to 49,999 13.0 13.4 12.1 50,000 to 499,999 19.3 19.3 17.9 500,000 to 1,999,999 24.7 23.5 27.8 2,000,000 and up 25.5 24.4 28.6 The Mountain division was the least represented area for this population which was expected since this area is less densely populated than the other geographic areas. The distribution of the sample used in the analyses reported herein was (in descending order): East North Central (20.1%), Middle Atlantic (15.8%), Pacific (14.4%), South Atlantic (12.3%). West North Central (11.0%), West South Atlantic (9.9%), New England (6.4%), East South Atlantic (5.6%) and Mountain (4.5%). The percentage distribution for educational level attained by the sample used indicated that the subjects were, on the average, more educated than the general national 64 elderly population. National statistics for 1978 indicated that nearly one-half of the individuals at least 65 years of age had never attended high school while only 16 percent of the national elderly p0pulation had completed one or more years of college (U.S. Department of Commerce, 1979). Appro- ximately 40 percent of the elderly sample used for this investigation attended college for at least one year. The majority of subjects were not employed full-time outside their home which was anticipated due to the age of this sample. This characteristic was representative of the U.S. elderly p0pulation since one of every five men and one of every twelve women aged 65 years and older were employed outside their home, at least part-time, in 1978 (U.S. Depart- ment of Commerce, 1979). The marital status of this sample was generally represen- tative of the national elderly population (U.S. Department of Commerce, 1979). A greater percentage of married individ- uals (60%) participated in this investigation than was expected from the national p0pulation (54%), more widowed individuals, however, exist in the U.S. population (37%) than in this sample (29%). These distributions are very similar, though, which would indicate that the sample used was representative of the national elderly population for this characteristic. Approximately one—half of the families with an elderly member was in the lower income bracket which was surprising since in this type of survey research the low income groups are generally underrepresented. However, many of these 65 subjects were retired thus the income level was not indica- tive of their total net worth, since the Market Facts data only reported money coming into the home which was earned from employment or Social Security and retirement benefits. These income levels also were lower than expected from 1978 national statistics which reported approximately 3 percent of the elderly had household incomes of $3,000 or less (U.S. Department of Commerce, 1979). However, this sample had more members earning over $15,000 than would have been expected from the national elderly population statistics (4%). The distribution of this sample was representative of the U.S. elderly population according to population density (U.S. Department of Commerce, 1979). Approximately 67 percent of the elderly used for this investigation lived in metropolitan areas whereas 62 percent of the national elderly population lived in metropolitan areas in 1978. Thus, the sample used in this investigation was generally representative of the national population, demonstrated by the distributions of geographic location, employment status, marital status and population density. However, this sample was not balanced by education level and household income to be indicative of the national population. 66 Frequency of Eating The diaries used for this investigation provided spaces for six possible meals per day. The subjects could have recorded food and beverage consumption for morning meal, A.M. snack, mid-day meal, P.M. snack, evening meal and EVE. snack. The meal frequencies for each individual was hand tallied according to the meal consumed and the location where it was eaten. The tabulation were divided in such a way that daily, weekly and away from home meal consump- tion could be examined for three household classification groups. There were a total of 16,072 meals eaten during the week by the sample pOpulation of elderly. There was a total of 23,562 possible meals for this population (6 meals/day X 7 days/week X 561 individuals). Thus, a total of 68.21 percent of the possible number of meals/snacks were eaten. To determine the individual average weekly eating fre- quencies, the means of each household group were computed. No significant differences were determined between the average number of meals/snacks consumed in the one week per- iod for the individuals belonging to the one person or two person household groups. Asishown in Table 7, the average weekly meals consumed for each of the two groups, respectively, were 29.13 and 28.76 meals. Individuals in both of these house- hold groups consumed a significantly greater number of meals for the week than did subjects living in a three or more person household. The elderly of this group only consumed an average of 26.83 meals per week. As noted, there is some 67 variance among each group. This can be expected due to individual variation in eating frequency habits. The range of meals per week consumed for each group were: 15 to 42 meals; 14 to 42 meals; and 14 to 41 meals, respectively. Table 7. Average number of meals/snacks consumed during the survey week by elderly classified by household size. Household Classification Three of One Person Two Person More Person Meals/Snacks (n=125) (n=360) (n=76) Average number 29.13at6.42 28.76a15.92 26.83b15.97 Percentage of possible 69.36 68.48 63.88 aRow means with same letter are not significantly different (p <0.05) (Duncan, 1957). This eating frequency trend also was noted after examin- ation of the daily consumption habits of the three samples. Each individual's daily eating frequency was tallied and then averaged within the household group to obtain the household size group means. The total sample consumed 2295.53 meals per day out of a possible 3366 meals (6 meals/ day X 561 individuals). Thus, the total elderly sample consumed 68.20 percent of the meals/snacks which could have been eaten. The individuals of the one and two person house- holds consumed approximately the same number of meals daily; the one person household group averaged 4.22 meals per day while the two person household group averaged 4.11 meals per day, as shown in Table 8. Both of these groups ate significantly more times each day than did individuals 68 in the three or more person households. This last group, on the average, ate 3.83 times per day. Table 8. Average number of meals consumed per day during the survey week by elderly classified by household size. Household Classification Three or One Person Two Person More Person MealslSnacks (n=125), ((n=360) (n=76) Average number 4.22ato.84 4.11at0.84 3.83bt0.85 Percentage of possible 69.36 68.48 63.88 aRow means with same letter are not significantly different (p< 0.05) (Duncan, 1957). The incidence of eating away from home also was tallied (Table 9). There were a total of 431 subjects who consumed at least one meal outside their home during the one week observation period. The majority of these individuals lived in two person households (60.52%). However, when adjusted for sample sizes, the one person household group had the greatest percentage of individuals (84.80%) who ate a minimum of at least one meal away from home during the week. These meals included not only meals eaten in restaur- ants but also those consumed at friends' homes or at work. Individuals living in three or more person households were least likely to eat a meal outside their home - only 60.53 percent of this sample consumed at least one meal away from home. In the two person household size sample, 279 of the 360 subjects (77.50%) ate at least one meal away from home. 69 Table 9. Number and percentage of elderly within each house- hold classification who consumed at least one meal away from home during the survey week. Household Classification Away from Three or Home Meal One Person Two Person More Person Consumption g(n=125) (n=360) (n=76lg Number of subjects 106 279 46 Percentage of subjects 84.80 77.50 60.53 To determine the impact of away from home meal consump- tion on the eating frequency habits of the elderly, tabula- tions regarding the actual number of meals eaten outside the home were made. As presented in Table 10, the total meals per week eaten away from home were compared with the total meals possible to have been consumed and with the actual number of meals consumed for the week. As suspected from the percentages of subjects who consumed at least one meal outside their home during the survey week, the one and two person household samples consumed a greater percent- age of possible meals away from home (10.19% and 8.84%) than did the three or more person household sample (4.98%). This also was true regarding the percentage of meals consumed away from home compared with the actual number of meals eaten. The one and two person household samples consumed more meals away from home (14.49% and 12.93%) than did the three or more person household sample (7.80%). The average weekly consumption of meals/snacks away from home also revealed that individuals living in one and two person households consumed a greater percentage of meals/snacks 70 Table 10. Number of meals/snacks consumed away from home during the survey week by elderly classified by household size. Household Classification Three or One Person Two Person More Person MealslSnacks A(n=125) (n=360) (n=76) Total number 535 1337 159 Possible number 5250 15120 3192 Percentage of possible 10.19 8.84 4.98 Actual number 3691 10342 2039 Percentage of actual 14.49 12.93 7.80 outside the home than did the subjects living in three or more person households (10.12%, 8.79% and 4.98%, respectively) (Table 11). As shown, significantly more meals/snacks were eaten away from home by individuals in one and two person households (4.25 and 3.69 meals per week) than by subjects living in three or more person households. Table 11. Average number of meals/snacks consumed away from home during the survey week by elderly classified by household size. "Household Classification Three or One Person Two Person More Person MealilSnacks (n=125) (n=360) (n=76) Average number 4.25at4.39 3.69at4.18 2.09b13.68 Percentage of possible 10.12 8.79 4.98 aRow means with same letter not significantly different (p <0.05) (Duncan, 1957). 71 A further investigation of away from home meal consump- tion was made (Table 12) by examining the frequency of away from home meal consumption for only those individuals who had eaten at least one meal during the week outside their home. Not surprisingly, the one and two person household subjects ate significantly more meals away from home (5.50 and 4.76 meals, respectively) than did those living in three or more person households (3.46 meals). When comparing the number of meals eaten outside their home to the total number of meals consumed by individuals who ate meals in places other than their own homes, the trend above was observed. The individuals in the one and two person household groups consumed a greater percentage of their meals away from home (17.20% and 16.79%) than did the subjects in the three or Table 12. Number of meals/snacks consumed away from home by elderly who ate at least one meal outside their home during the survey week. Household Classification Three or One Person Two Person More Person MealsZSnacks (n=106) (n=279), 4(n=46) Average number 5.50at6.59 4.76814.19 3.46bt4.21 Percentage of possible 13:10 11,33 8.24 Number eaten away 535 1337 159 from home Weekly number 3110 7971 1224 Percentage of weekly 17,20 15,79 12,99 away from home aRow means with same letter not significantly different (p< 0.05) (Duncan, 1957). 7? more person household sample (12.99%). The question of eating frequency habits by the three sample pOpulations needed further examination. The meals consumed were tallied for the six possible meals/snacks of the day: morning meal, A.M. snack, mid-day meal, P.M. snack, evening meal and EVE. snack. The percent of possible meals/snacks eaten was then recalculated to determine which meal/snacks were most frequently consumed or skipped. As shown in Table 13, at least 90 percent of all three main meals were eaten by individuals in the one and two person household samples. The morning meal was the most frequently consumed meal (98.97% and 99.56%) followed by the evening meal (95.89% and 98.17%) and mid-day meal (93.03% and 92.98%) for each of these two groups. The meal habits of three or more person household group was markedly different. The evening meal was most frequently eaten (97.56% of possible meals) followed by the morning meal (94.92%). Less than 90 percent of the possible mid-day meals (84.96%) were consumed by this sample. The snacking patterns for the three groups of this population followed the same trend. All three of the sample divisions most frequently ate the EVE. snack (54.86%, 55.16% and 48.12%) with the P.M. snack next (44.34%, 36.90% and 31.77%) and the A.M. snack least often consumed (34.74%, 27.62% and 25.94%). The one person household sample ate a greater percentage of the A.M. and P.M. snacks than did the other two samples. The two person household sample consumed the EVE. snack more frequently than did the other two household size groups. 73 mm.mw mmom oe.mm memos cm.o> soon made: HH< ms.mv mmm ma.mm omme mm.vm owe xomnm .m>m om.sm mem we.mm esem mm.mm mmm Hem: mzsceem >>.am mm? om.mm cmm vm.¢¢ mmm xomnm .z.m rm.em mme mm.mm memm mo.mm eem are; segues: ew.mm wma mo.>m 0mm ¢>.¢m <0m xomzm .z.« mm.vm mom mm.mm mOmN >m.mm mmm How: mnflsnoz mxomsm mxowpm mxomsm mxomsm mxomsm mxomsm cownom1mafivmm \mfiwma \mamwe \mamme \mamoe \mHMmE \mamma manflmmom mo ofipflmmoa mo manwmmom Ho mo amnezz mo Honssz mo ponesz mmmpcmonmm mwmpcooumm mmmpcmonmm Amsuev Aoomusv Ammrupv comnmfi who: no monnml somnmm 039 :oHPMoHMHmmmHo vaonmmzom somnmm mco .ouflm caosomsos an coHMflmmmHo masouflo mp xmoz mo>Hsm esp wnwssc mvoanmg wsfipmo maflmv me map Ho some now coesmsoo mxomcm\mamoa mo Hopesz .mp canes 74 Similar analyses were run for meals eaten away from home compared with total meals actually consumed (Table 14). This analyses permitted the determination of which meal or snack was most frequently consumed outside the home. Nearly one-fourth of the mid—day meals eaten by the one person household subjects (22.48%) were consumed in a location other than their own home. The A.M. and P.M. snacks were also frequently consumed away from home (18.42% and 18.56%). The morning meal was most frequently eaten at home by this one person household sample - only 5.43 per- cent of breakfasts were eaten away from home. The two per- son household subjects most frequently ate the A.M. snack outside the home (22.70%); the mid-day meal was also fre- quently eaten away from home (20.66%). The EVE. snack and morning meal were most likely to have been consumed at home; only 5.68 percent and 3.95 percent of the reapective meals/ snacks were eaten away from home. The individuals living in three or more person households consumed more A.M. and P.M. snacks (19.57% and 15.98%) away from home than other meals. Very few of the evening meals and EVE. snacks were eaten outside this group's homes (5.97% and 4.69%). Only four of the 505 morning meals (0.79%) were consumed away from home by the three or more person household subjects. A greater percentage of all six of the eating periods occurred outside the subjects' homes by the one and two person household samples than by the three or more person household group except for the A.M. snack. The two person household group consumed more A.M. snacks away from home 75 ow.s mm? vm.mr wmmr m¢.¢a mmm mama: HH< mo.e me mm.m on ma.@ me serum .m>m sm.m em me.ee emm mo.me mme are: meane>m mm.ml «w rm.se are mm.ma ms xomnm .z.m mm.ne mm mm.om ewe we.wm Mme Hem: arenas: em.me em os.mw mme me.we mm xomnm .z.< ms.o e mm.m mm me.m as are: masque: wxomsm mxomzm mxomsm mxomcm mxomnm mxomnm doauom mnfipmm \mamme \mamwe \mamme \mamme \mHmmE \mHmms Hmspom Mo Hassom Ho Hmspom mo mo monasz Mo Monasz mo Honssz mmesoosmm ommpzoohma ommpcmonmm arenas Normans Ammeuev nomnom who: Ho mouse somsmw 039 :omhmm one coapmowwflmmmao caonmmsom .mmfiw Ufloxmumos an umawflmmmao manmvao hp xmmz ho>nsm esp mnflnsc mcownmm museum maamu wa mxp mo some now macs Eon“ zm3m dossmzoo mxomzm\mamma mo Honazz .er canoe 76 than the three or more person household group. The one person household sample consumed the lowest percentage of A.M. snacks outside the home. To investigate which day of the week meals were consumed away from home most frequently, hand tabulations for each of the seven days' meal patterns were made. This allowed the determination of which day the elderly of each household size group was most likely to consume a meal outside their home. The results of this analysis, as presented in Table 15, compared the number of meals consumed away from home for a particular day with all meals eaten away from home. The meals consumed outside the home by the subjects living in one person households were fairly evenly distributed through- out the week. The daily percentages ranged from 12.34 per- cent for Saturday's meals to 16.26 percent for Friday's meals. There was a larger variation for daily away from home meal consumption evident in the eating patterns of the two person household subjects. Sunday was the most pOpular day to eat away from home with 17.49 percent of the meals consumed outside the home occurring on this day; Saturday, on the other hand, was the least likely day for an away from home meal to occur (10.54% of away from home meals). Yet another eating pattern was observed by the three or more person households. The elderly living in this household size classification ate a greater percentage of meals away from home on Friday (17.61%) and Saturday (16.98%) than they did on the other five days. The least number of away from home meals occurred on Wednesday, only 9.43 percent of the meals 77 mm.me em em.oe Pee em.me mm smeeseem em.se ww om.ee ewe mm.re hm assays Pm.me em om.ee ewe em.me ms assesses me.m me mm.me mom mm.ee we messenger mo.me em mm.ee 00m mm.me mm anemone mm.ee me we.me are em.ee we amazes ms.me mm me.ee emm mo.me or seesaw mxomnm mxomsm mxomsm mxomcm mxomsw mxomsm xow3 Ho Hmm \mamos \mHMma \mamos \mamoe \mamme \mamms mo mo Mo Ho Ho Mo ommpsooumm Hmpasz owmpcoonma smpesz mmmsnoonmm Hmpasz Arenas Aoomusu Ammaugv somnom whoa no mouse GO memH O33 somhom one QOAPQOHMfimmmHo uaonomsom .mufim vaozomsoz m9 doamammm mmmv sm>mm opp mo some Mom mac: 809% o haumcam mp xmo3 mm>nsm exp wsaszu mam Umeswcoo mxomsm\mHMoa Ho nonesz .ms magma 78 eaten outside of this sample's homes were for this day. Thus, as evident in the above detailed analyses, the elderly individuals living in one and two person households consistently ate meals/snacks more frequently than did the older members of three or more person households. This was shown for both daily and weekly meal consumption habits. The major difference in the eating frequencies of these three groups was the number of times food was consumed between meals. The one person household sample consumed a greater percentage of sncaks than did the three or more person household group. The two person household sample ate less often between meals than did the one person household group but more frequently than did the three or more person household sample. This may indicate a relationship with the sociological impact of food eating occurrences as suggested by previous researchers. If food and eating is considered to be a source of sociali- zation and emotional satisfaction as hypothesized, it would follow that individuals living in smaller sized households might eat more frequently. As shown above, this investiga- tion confirms this belief. Away from home meal consumption is an excellent means of socialization and recreation. Whether food is eaten at a restaurant or work or even a friend's home, it is clear that other people are involved. Again it would follow that elderly individuals living alone or with a spouse might eat meals more frequently away from home than elderly individ- uals living with families or several friends. The one and two person household samples investigated in this study 79 did eat away from home more frequently than did the three or more person household subjects. It is interesting to note which meals were actually consumed outside the home. The smaller household size subjects ate more breakfasts and dinners away from home than did the subjects living in the three or more person households. Thus, meals which are traditionally family eating occurances were consumed more frequently at home by those individuals wh0 N.P hm N.P mm¢ éee mm? mysz % mnwno o.m son m.m mmmr o.m «mm mpsomoon m.o we ¢.o mew ¢.o me . husoo oF.m mum ne.e ohms om.m wee moaaueomo> om.oe mm» n¢.rr m¢o¢ we.mr mm¢e mvfisnm m c we a e eon m a wee mqmuensom v.0 me v.0 emu 0.0 or mmuonsom m.r sea v.4 mam m.e mam omsom M¢.e 00? no.0 mum 90.? mo? eHmImEoPH Ham: mam: m.r mm e.w bmn N.e mmw mmlmaopH ado: mam: m>.m mm? no.m vmrb om.m mew maopH Ado: saw: or m ems now a Pmo pm P be: ggmnmpoo: om.> rpm po.> Mbem o>.m «mm mmIoHMo: oo.op mm» pm.m ¢mFm om.> mmm undo: m.m mmw m.m mums m.m bmm oHoonoo m.oe mes m.oe emmm. P.PF emu, reopened a eesm .eaeeo om.s om om.e 0mm we.m 0¢N muoxomno mm or mmu now or mbmm pm m mbov maximumonm N.F mm N.F Nee N.P mm? mmuocoosm o>.ew mmw pm.wr wroe n>.or meme ocoonm om.m row. pm.m mom pm.m emu omwm nom.vr moor mP.mF mmmm nm.mF bmmw meosuonm :HHmn were hm om.o mm? pm.o om oomono>om owaonooa< mm.mr mmmw pm.¢a mvmm p¢.mF mere mommnobom soap macaw soap snow» soap macaw macaw doom nsnauvsoo no>sompo nsnanpnoo Io>nomno aspasvnoo Im>nompo omopnoonom mo popes: owopzoosom Ho Hones: owopnoouomMo Homasz defines :oommwa Ammeuea nomnom ono: Ho oonse nomnom oza nomhom oco 20HvmoamwmmmHDmmwosomnom1 .ouwo uaonomson hp cofiwammofio masocao on» Ho opouu on» ow xoos mo>ssm opp moansv oaon pm nopoo non: masonw doom uovooaom no godpsnwnpnoo .mw oapoa 81 The most frequently consumed food items, regardless of preparation requirement, by all three household size classes were beverages, dairy products, fruits, pasta, rice & pota- toes and breads. Beverages was a diet component 15.4 percent of the time for the one person household sample; while dairy products were 13.9 percemt; fruit, 13.1 percent' pasta, rice & potatoes, 11.1 percent; and breads, 10.7 percent of the time. The percentage frequencies of the main food groups to the diets of the two person household sample were: dairy products, 15.1 percent; beverages, 14.9 percent; breads, 11.3 percent; fruits, 11.4 percent; and pasta, rice & pota- toes, 10.9 percent. Beverages were consumed most often in the three or more person household sample's diets, being consumed 16.8 percent of the food items. The other main food groups and their percentage contribution were; dairy products, 14.6 percent; breads, 11.7 percent; pasta, rice & potatoes, 10.3 percent; and fruits, 10.5 percent. \Meats was the next most frequently consumed food group for all three of the household size samples. This food group was consumed 7.3 percent of the time by the one person household sample, 8.8 percent by the two person household sample and 10.0 percent by the three or more person household sample. Thus, even though meats was in the same rank order for each of the household size samples, the percentage contribution to the diets increased as household size in- creased. The frequencies of the next food groups varied depending on household size. The percentage contribution of the next ranking food groups to the diets of 82 the one person household sample were: vitamin/mineral supple- ments, 5.6 percent; desserts, 5.0 percent; vegetables, 3.9 percent; cereals, 3.5 percent; eggs, 2.3 percent; main meal items, 2.3 percent; and soups, 1.9 percent. Those for the two person household sample were: desserts, 5.3 percent; vegetables, 4.4 percent; vitamin/mineral supplements, 4.0 percent; cereals, 3.6 percent; eggs, 2.5 percent; main meal items, 2.0 percent; crackers, 1.8 percent; and soups, 1.7 percent. The following food groups were the next largest contributors to the diets of the three or more person house- hold sample: vegetables, 5.1 percent; desserts, 5.0 percent; cereals, 3.5 percent; eggs, 2.8 percent; main meal items, 2.7 percent; vitamin/mineral supplements, 2.4 percent; soups, 1.6 percent; and crackers, 1.2 percent. The food groups which contributed the least to the diets of these household size samples were chips & nuts (one person household, 1.4%; two person household, 1.2%; three or more person household, 1.2%), alcoholic beverages (0.2%, 0.5%, and 0.4%, respectively) and candy (0.4%, 0.4% and 0.2%). As seen in the above analysis, the number or times a particular food group was consumed at home was influenced by household size. Definite patterns were observed for the rank order of several of the food groups as household size increased. The frequency of vegetables in the diets increased as household size got larger, while that for fruits and vitamin/mineral supplements decreased. Statistical analyses (one sample Chi square, Siegel, 1956) were performed to determine any significant differences 83 among the three household size tallies for each of the food groups. This analysis indicated that for some of the food groups there were significant differences observed. However, no significant differences were noted in the number of times a particular item was consumed to the total number of food items eaten for foods in the following food groups: breads - RP; pasta, rice & potatoes; cereals; main meal items-RP; soups - both soups-RP and soups-RLP; candy; desserts; and chips & nuts. Household size did, however, have an impact on the consumption frequency of the remaining food groups. Beverages, eggs, breads and main meal items-RLP contributed a significantly greater percentage of food items to the diets of the three or more person household samples' diets. The two and three or more person household samples obtained a significantly greater percentage of food items from alcoholic beverages than did the one person household sample. Dairy products contributed a significantly greater percentage of food items for the two person household sample than for the one person household sample. The three or more person household sample obtained a significantly greater percentage of food items from breads-RLP and meats-RLP than the one person household sample. There was a direct correlation with increasing household size observed for the consumption of crackers, fruits, vitamin/mineral supplements, meats, meats-RP and vegetables: 1) as household size progressively increased so did the percentage contribution of meats, meats-RP and vegetables; 2) the percentage contribution of crackers, fruits and vitamin/mineral supplements to the diets 84 decreased as household size increased. The results of this research on foods most frequently consumed at home during the survey week indicated that household size did indeed influence food choices by this elderly sample. Obvious trends were noted for the consump- tion frequencies of several food groups as household size increased. A further analysis of the at home food group consumption frequency was undertaken to determine the use of foods which required preparation or required little preparation. Those foods classified as requiring preparation were foods which traditionally take more time to cook or bake - such as casseroles, roasts, homemade soups and sweet breads. Those classified as requiring little preparation included canned soups, packaged main meal items, frozen dinners and toaster pastries. Significant differences were found in the consumption frequencies of meats-RP as household size increased - the percentage contribution of meats-RP signi- ficantly increased as household progressively increased. However, no significant differences were observed among household size groups in the consumption frequencies of breads-RP, main meal itemseRP and soups-RP. Significant differences were observed for three of the four food groups which required little preparation. The three or more person household sample consumed breads-RLP and meats-RLP signifi- cantly more often than the one person household sample plus they consumed a significantly greater percentage of food items from main meal items—RLP than did either the one or 85 two person household samples. No significant-difference was noted for the consumption frequency of soups-RLP among the three household samples. Away From Home Food Consumption Patterns. The contribu- tion to the elderly's diets of each of the 16 main food groups when consumed away from home are indicated in Table 17. Beverages were the most frequently consumed food group outside the home for each of three household size samples. Beverages were diet components 17.3 percent of the time by the one person household sample, 17.7 percent by two person household sample and 20.3 percent by the three or more person household sample. The next most frequently consumed food groups by the one person household sample were: pasta, rice & potatoes, 12.9 percent; meats, 10.2 percent; vegetables, 9.3 percent; desserts, 9.3 percent; breads, 9.2 percent; dairy products, 8.8 percent; fruits, 6.7 percent; main meal items, 6.2 percent; and chips & nuts, 2.0 percent. The percentage contribution of the main food groups to the away from home diets for the two person household samples were: dairy products, 11.8 percent; meats, 11.7 percent; breads, 11.1 percent; pasta, rice & potatoes, 10.5 percent; vegetables, 8.5 percent; desserts, 7.3 percent; main meal items, 5.8 percent; fruits, 5.8 percent; and vitamin/mineral supplements, 1.8 percent. Those for the three or more person household sample were: meats, 11.8 percent; dairy products, 11.3 percent; breads, 10.3 percent; desserts, 86 .Asmma .Hemeamv peenemmee hapsooawfiswflm pom Hoppoa oeom LPH3 momMpsoosom 30p 90 msoppoa psospfl3 momopsoonom 30mo mpaoaoamgsm 00.0 0 mw.a For no.3 em Hosesaz\sasopa> N.e s 0.? mm 0.m me 09:: a mmano nmr.m em pm.» Noe mm.m mom superman m.c N m.o ow 0.0 4: sense m.» we m.m Pee m.m mom meapepeme> 0.0 04 m.m mmm s.r sea messes o.m N: 0.3 mm 0.: mm mmsom m.m em o.m mmm m.m mm: meepH are: nae: w.ee cs s.ea sew m.oa mmm memes m.o a m.0 mm m.o we masonmo or.» me em.oe mom em.me arm reverses a mess .spmem se.m 0m mm.e es nw.e mm «noxemno nom.oe aw me.ee eeo nm.m row museum s.0 e m.: as m.e em mmmm mm.ee so em.aa mmm pm.w em, reassess spams 4.: m 9.3 mm m.o ma mommnoeem oaaosoeaa n.0m 0m: s.se mam m.sa men mommnoeom soap msoflp soap maoflp soap msoflp msosc 000m uznflnpsoo Io>hompo Isnfispnoo Im>nompo Issanpzoo Im>pompo omopzoomom mo Hones: omopsoosom m0 gonesz oMMpnooHom H0 Hones: Nosuev mormuea Ammeuev somnom oao: so oonne somhog 03s somnom opo aoflpmoflmflmmoao caosomsom .ouHm uaosomsos an uoflmwmmmfio :Huocao one H0 mpoac onp op xoo3 ho>nsm ozp msflnsv oaon Eonm :030 sopmo sos3 masonw 000w popooaom m0 soapspshpaoo .bp odnme 87 9.1 percent; vegetables, 7.8 percent; pasta, rice & potatoes, 7.6 percent; fruits, 6.8 percent; main meal items, 5.8 percent; and crackers, 3.4 percent. The food groups which were consumed infrequently by the three household size samples (one person, two person and three or more person households, respectively) were: soups (1.6%, 1.6%, 2.0%), eggs (1.2%, 1.3%, 0.7%), alcoholic beverages (0.9%. 1.1%, 1.4%), candy (0.6%, 0.5%, 0.3%) and cereals (0.5%, 0.5%, 0.2%). Vitamin/mineral supplements were not consumed away from home by the three or more person household sample. Thus, as seen in this analysis, the number of times a particular food group was consumed away from home was influenced by household size. Definite patterns were observed for the rank order of a couple of the food groups as household size increased. The occurrences of pasta, rice & potatoes and chips & nuts in the diets were less frequent as household size got larger, while the order in which eggs occurred remained the same. Statistical analyses (Chi square, Siegel, 1956) were perforemd to determine any significant differences among the three household size tallies for each of the food groups. These analyses indicated that for some of the food groups there were significant differences observed. The two and three or more person household samples consumed dairy products significantly more often away from home than did the one person household sample, while crackers were consumed signi- ficantly more often by the one and two person household 88 samples than by the three or more person household sample. Breads played a significantly greater role in the food choices of the two person household sample than in the one person household sample's; the Opposite was observed for desserts. The one person household consumed desserts signi- ficantly more often than did the two person household sample. Vitamin/mineral supplements were used significantly more often by the subjects living in one and two person households than by those living in three or more person households. There was a clearer correlation of food group consumption with household size for pasta, rice & potatoes than for the otehr food groups. As household size progressively increased, the number of times pasta, rice & potatoes were eaten com— pared to the total food items significantly decreased. However, no significant differences among household size groups were observed in the consumption frequencies of bever- ages, eggs, cereals, meats, main meal items, soups, fruits, vegetables, candy and chips & nuts. Thus, as seen in this analysis, household size had an impact on the percentage contribution of selected food groups to the total food items consumed away from home by the ' elderly. As household size increased, a definite correla- tion with decreasing consumption of pasta, rice & potatoes was observed. In concluding these analyses of the food consumption patterns of the elderly classified by household size, for both at home and away from home eating occasions, several 89 points should be reiterated. The size of the household in which the participants in this investigation lived influenced food consumption both at home and away from home. At home food choices varied significantly for a majority of the food groups depending on household size. The at home frequencies of food requiring preparation did not appear to be influenced by household size while the consump- tion of those requiring little preparation did; the larger household size sample consumed breads-RLP, meats-RLP and main meal items-RLP more frequently than did the smaller house- hold size sample. Away from home food frequencies, however, were not as dependent on household size as were the at home food consumption patterns. Dietary‘Component Intakes After having examined the food frequencies of this sample population, the data were analyzed to determine the average daily intakes and percentages NRC-RDA of 24 dietary components obtained by the sampel. The components examined were: calories, protein, total fat, total carbohydrate, total sugar, cholesterol, crude fiber, ascorbic acid, thiamin, niacin, riboflavin, vitamins B-6 and B-12, panto- thenic acid, vitamin A, vitamin E, iron, calcium, phosphorus, sodium, magnesium, potassium, copper and zinc. This analysis was performed for the total sample as well as for the three household size classifications. The impact of dietary supplement (vitamin/mineral) usage by this population was 90 also investigated. Dietary Component lptakes of theTgtal Elderly Sample The data were analyzed to determine the adequacy of dietary intakes for the 24 component, by the total sample regardless of household size. This investigation also examined the proportion of calories obtained from carbohydrate, protein and fat plus the percentage of subjects whose dietary intakes fell below 100 percent, 66 percent and 33 percent NRC-RDA for one to seven days during the survey week. Proportion of Calories. The proportion of calories obtained from total carbohydrate, complex carbohydrate, total sugar, protein and fat are indicated in Tables 18 and 19. It has been recommended that 50 to 55 percent of calories be obtained from carbohydrate, with 40 to 45 percent of energy intake coming from complex carbo- hydrate (National Research Council, 1980). The caloric contribution from fat has been suggested to be 30 to 35 percent of calories while protein should contribute 12 to 15 percent (National Research Council, 1980). For this sample population, 46 percent of the calories consumed were obtained from carbohydrate (Table 18); this proportion was slightly less than the recommended amount. The contribution of fat to the diets was higher than suggested; thirty-nine percent of the 91 calories were obtained from fat. Protein contributed 15 percent of the calories which was at the upper end of the recommended range. Table 18. Distribution of calories from carbohydrate, protein and fat in the diets of the elderly (n=561). Percentage of Macronutrient Total Calories Carbohydrate 46 Protein 15 Total Fat 39 The distribution of complex carbohydrate and total sugar to energy consumption was different from that recom- mended (Table 19). A much lower percentage of'energy intake was obtained from the consumption of complex carbo- hydrate (25%) than recommended (40 to 45%). Total sugar intake (21%) was greater than normally recommended (10 to 15%). Table 19. Proportion of calories obtained from complex carbohydrate and total sugar by the elderly (n=561). Percentage of Component Total Calories Complex Carbohydrate ’ 25 Total Sugar 21 Dietary Component intakes. The mean dietary component intakes and percentages NRC-RDA for the total sample are indicated in Table 20. Average figures indicated that 92 Table 20. Average daily nutrient intakes of the elderly (n=561). Total Sample Dietary Component Mean SD _%RDA Calories 1992 637 100 Protein,g 77 23 158 Total Fat,g 86 33 Total Carbohydrate,g 232 81 Total Sugar,g 108 48 Cholesterol,mg 369 168 Crude Fiber,g 4.5 1.9 Ascorbic Acid,mg 128 59 213 Thiamin,mg 1.43 2.11‘ 123' Riboflavin,mg 20.6 6.6 136 Vitamin B-6,mg 1360 502 65 Vitamin B-12,mg 6.20 6.30 207 Pantothenic Acid,mg 3932 1344 Vitamin A,IU1 8738 5360 200 Vitamin E,IU 15.8 4.7 179 Iron,mg 16.0 8.3 160 Calcium,mg 747 310 93 Phosphorus,mg 1227 396 155 Sodium,mg 2842 1007 Potassium,mg 2958 888 Magnesium,mg 282 134 88 Copper,1g 1296 634 Zinc,mg 11.1 5.2 74 1Vitamin E based on alpha tocopherol due to insufficiency of analytical data. 100.percent NRC-RDA was consumed by the total sample for calories, protein, ascorbic acid, thiamin, niacin, ribo- flavin, vitamins B—12, A and E, iron and phosphorus. Those dietary components which showed less than average intake levels of 100 percent NRC-RDA included vitamin B-6, calcium, magnesium and zinc. Vitamin B-6 was the only nutrient consumed, on the average, at a level less than two-thirds NRC-RDA by this sample population. The average calcium and magnesium intakes appeared to be adequate with 93 percent and 93 88 percent NRC-RDA met, respectively. The adequacy of the intake of zinc, on the other hand, was questionable since only approximately two-thirds NRC-RDA was met, on the average. In 1980, the National Research Council (1980) set estimated safe and adequate daily dietary intake ranges for several vitamins and minerals. These ranges are compared with the daily intakes of this sample for pantothenic acid, copper, sodium and potassium in Table 21. The intake of pantothenic acid appeared to be slightly low while that of copper was approximately 45 to 65 percent below the recom- mended range. The intake levels of sodium and potassium, however, fell within the recommended ranges. The intake level for sodium did not adequately reflect the true sodium level since table salt usage cannot be assured to have been accurately reported in this type of dietary survey method- ology. Thus, the average sodium intake reported throughout this investigation, basically, represented the sodium contained in food only. Table 21. Comparison of average daily intakes by the elderly of selected vitamins and minerals with their estimated safe and adequate daily intake ranges . Dietary Component Mean intake ESAADI Range Pantothenic Acid, g 3932 4,000 - 7,000 Copper, g 1296 2,000 - 3,000 Sodium,mg 2842 1,100 - 3,300 Potassium,mg 2958 1,875 - 5.625 National Reseach Council, 1980. 94 To further investigate the adequacy of the diets consumed by this elderly sample, regardless of household size, the data was analyzed to determine the proportion of the sample whose intakes were always above 100 percent, 66 percent and 33 percent NRC-RDA for all seven days survey- ed. This program also permitted the percentage of elderly whose nutrient intakes fell below 100, 66 and 33 percent NRC-RDA for 1 to 7 days to be calculated. This informa- tion is detailed in Tables 22 through 24. Very few of this total sample obtained 100 percent NRC-RDA for all seven survey days for the thirteen nutrients examined by this method (Table 22). Protein was consumed at the 100 percent NRC—RDA level by the greatest percentage of the sample, 48 percent. One hundred percent NRC-RDA of zinc for all seven days was consumed by only 0.36 percent of the sample. The largest percentage of subjects whose diets fell below 100 percent NRC-RDA for all seven days was exhibited in the intake of vitamin B-6; almost one-half of this sample had diets which provided less than 100 per- cent NRC-RDA for all seven days surveyed. When two-thirds NRC-RDA was used as the standard of dietary adequacy, the nutrient profile analyses appear to be improved (Table 23). However, large percentages of the sample had not met two-thirds NRC-RDA for several vitamins and minerals plus calories. Less than one-half of the sample consumed diets containing adequate amounts of vitamins B-6, B-12 and A, calcium, magnesium and zinc for all seven days. Only 5 percent of the sample consumed diets adequate 95 4.40 6.0 0.60 6.4 6.60 6.6 6.00 4.4 4.0 seam 0.06 6.64 0.66 4.6 P.60 4.6 0.60 0.6 0.6 sasnosmmz 4.4a 4.6 6.66 4.6 0.66 6.6: 6.66 4.36 6.64 masosanoam 6.46 0.04 4.60 6.64 6.66 6.0 0.60 4.6 4.6 ssfloamo 0.64 4.6 4.66 6.0 6.66 6.6: 6.06 6.66 6.06 sonw ”mamnosfi: 6.mm 6.6 0.44 4.mm 6.06 6.04 6.06 6.04 6.04 < :Heopa> 0.64 4.64 4.66 6.64 6.06 6.64 4.40 0.04 0.6 6416 sasmpa> 4.40 6.6 6.60 6.6 6.00 0.0 6.00 6.4 6.0 616 sasmpa> 6.66 6.0 4.04 4.44 6.66 4.64 6.66 6.04 0.46 sa>6auopam 6.6a 4.0 6.66 4.4? 6.46 0.46 0.66 s.am 4.4m saomaz 6.44 0.64 0.66 4.43 0.66 0.64 4.66 6.64 6.44 sasmage 0.64 6.6 6.46 6.6 0.06 4.44 0.46 0.46 6.06 usea oappoen< "msflsopfi> 0.6 0.6 6.44 6.6 6.06 0.64 6.46 0.06 6.64 esoponm 4.66 4.64 6.06 4.4a 6.06 «.04 0.60 6.64 0.6 noasoamo "chow: 1: ago x 1x 8:0 1:, 1x 590 x1 (X1600 1x «axiom: economsoo 4 6 m a 6004 pm: asepean «mmlomZixooe 30Hom thQ mo Hones: .mame 6 ea 4 new 406-062 xooe zeamp Haow moxopsfl psoauvss ooos3 manovao mo omopsoonoa one 66 HHo3 mo «axiom: $004 o>0nm 6:63am ono3 moxopaw psofinpss :Hwoc 060:3 A46musv :ahouao so omopsoonom .Nm oanoa Table 22 (cont'd.). Cum %_ %7 <1; CF 0:. I c; a: O O 30 o H a) m m a (U Q 4., o :4 mm .o E :3 2 >> H (6 .p CD «4 m Component m \1 MO ‘— Macro: Calories Protein Vitamins: 96 <1 N\L{‘.N\'§1' N C) .-- Ln 0 \‘1‘O‘\U\N\ q, k\'[‘!“LK\V-(\l:>:> Minerals: Iron Knows-M e e e e e FONT-ow “" MM LDFMOI‘ 00000 46406 xx uuo Nx-Nmm MSNOCI) (\Jr- VmOVN e e e e e mrml‘N Ln \OCU 04>4m mmmmm PF Phosphorus Magnesium Calcium Zinc 97 4.66 0.64 0.60 6.64 0.66 0.64 4.40 4.6 0.6 0066 0.46 6.04 6.64 4.64 0.06 4.44 0.40 6.64 6.66 50660066: 0.6 6.4 6.6 4.4 0.6 4.4 0.46 0.64 4.60 manozmmonm 6.06 6.04 6.04 6.04 6.06 4.64 6.40 4.04 0.66 asfloamo 6.6 6.4 6.4 6.6 6.04 6.6 6.66 6.64 6.40 sonH ”mamsosfl: 6.0 6.4 6.04 6.0 6.46 6.64 6.66 6.06 4.44 4 sasmpa> 4.04 6.44 6.66 4.44 6.66 6.04 6.60 0.46 6.46 6416 sHaopH> 6.66 4.04 6.00 0.64 6.66 6.44 6.60 4.6 6.4 616 0686460 4.4 6.6 6.6 0.4 4.64 6.6 6.06 6.64 0.06 sa>mawopwm 0.6 6.4 6.4 0.6 6.64 0.6 6.46 0.64 6.66 26066: 0.6 6.4 6.6 6.6 6.64 6.0 4.04 0.46 0.06 06866£0 0.0 4.6 6.64 4.6. 4.66 0.0 6.64 0.46 6.66 0604 069H006< “mswsmpfl> 4.4 4.4 6.6 6.4 0.6 6.6 4.44 6.6 0.66 swoponm 6.44 4.4 0.64 6.6 6.66 6.0 0.04 6.66 6.06 moflnoamo ”0906: 116 ago 16 (a E:0 6 a 5:0 x 61500 x 4061062 006000900 4 6 6 a 666 pm: sampeam 4661062 666 30Hom 6:66 90 Hones: .name 0 ea 4 new 406-062 666 zoaep Haom moxopsfi psoflups: 66063 :Hno0ao 60 ommpsoopog on» 60 Hao3 66 496106: 666 oponw 6:63am opo3 moxspsfl Psoanpss 06660 owon3 A466usv manocflo mo owopsoonom .66 oanme o/w [O %_ Cum %— of '0 4 Number of Days Below 66%3NRC-RDA Cum 6% Table 23 (cont'd.). Dietary Component Macro: VO F0 #0 MO 00 010 Calories Protein Vitamins 90' \ONLDkOv-CDO V‘MOV’LDFLR V (\H-Lnfid‘md' O mmoowmm F 0 H 6 2 0‘3? Hmm< o > "'1‘: (US$353 ro.,...g,_;.,_|.,.;.,_g HE-H‘HEEE 01.130066 (6 onDPPP wQHHHHH <11E-HZIIH>’.>:> Minerals -_ OOWO’d'l‘ OMOMCD <14“ #01- ONOON t—x—N 46464 e OCDOKOM v- 46444 0.... 1— NM 00046 0 00040 P‘— Phosphorus Magnesium Calcium Zinc Iron 0.m o.m 4.mP 0.0 m.mm m.mp r.mm m.mm m.m4 onHN m.s v.0 m.w _nas 0.m N.m -mass m.PF 4.Nm asammsmmz 0.0 0.0 4.0 4.0 4.0 0.0 m.¢ m.m 0.mm manosgmogm m.m m.m v.0 m.m m.mr m.m m.0m 0.mF 4.N0 aswoamo 0.0 0.0 0.0 .0.0 0.0 0.0 m.m N.m F.0m :oHH ”mamnonfiz 4.? m.o m.m P.P 0.0 m.m m.mm w.mr m.m0 4 na€¢va> m.m ¢.m v.0 w.m o.me m.PF F.m4 9.4m m.0m anm :HEMPfi0 w.w m.4 o.mr 4.0 0.wm 0.NP m.mm v.4? m.04 mum :fiampw> m.o 0.0 m.o m.o m.w r.e m.m 0.m 0.4m 2H>mawonwm 0.0 0.0 m.o m.o m.w 0.? m.m m.m m.4m :Homwz m.o m.o m.o 0.0 w.w m.o N.m 4.4 m.mm massage w.r m.o m.m 0.m m.0 m.m N.Pm 0.mp m.w0 cHo< ofimmoom< “mafiampw> 0.0 0.0 m.o m.o m.o m.o m.m 4.n «.mm naovonm 4.0 m.o m.o m.o w.¢ m.o w.0 Cum N.Nm mofinoamo "onus: R‘ezo x&i‘ Xmaso xx x 820 x amaze & 4mmnomz pnmnonsoo a m m anm pm: mumpmfin «axiomz xmm zoaom whoa Ho Hopesz .mmmu s op F new «mmuomz Xmm sodas Hamw mwxmpcfl pcmapps: omen: manmvao mo ommpqmonom was no Ham: mm onm massam mum; mmxmpnfl pzoflhps: maflmu woos: Apmmuav manmcam Ho owmunoonmm .4N magma 100 o o o Omoom o o OOOON O0Om4 C 00000 ONOOO 0 00000 OOWOLOV' C 00000 OV’OLOF O OFOON onam enammnmmz msnegmmonm asaoamo :oHH ”mamnmzfiz 0.0 0.0 0.0 m.o m.o < :aBMpfi0 0.0 m.o m.o 4.0 N.O mrlm nHampH> m.o o.r 4.? >.m P.N mum qaampfl> 0.0 0.0 0.0 m.o N.o ..GH>MHHonHm 0.0 0.0 0.0 0.0 0.0 :Homwz 0.0 0.0 0.0 0.0 0.0 GHEMHQB m.o 4.0 m.o 0.0 m.o cflo< ownuoom< umGHEMpfi> 0.0 0.0 0.0 0.0 0.0 :Hoponm 0.0 0.0 0.0 N.o N.O mmwhoamo "chow: & x 5:0 x x,sso xx pnmnomsoo 0 m mm znwpoan «pm-omzxmelsonm mmmmLMO nmpasa .A.a.pgoov 4N «Hams 101 in vitamin B—6 and only 6 percent adequate in zinc. Some of the sample failed to consume diets which provided 33 percent NRC-RDA for all seven days of ascorbic acid, vitamin B-6 and calcium (Table 24). In summary, even though the average daily dietary component intakes appeared to be adequate, several nutrients were consumed in levels less than desired by individual people. Protein intake did not seem to be a problem; however, the intakes of vitamins B—6 and B-12, calcium, magnesium and zinc appearred to be inadequate for a large preportion of this sample. DietaryComponentggntakes of the Elderly Classified By Household Size To learn the impact of household size on nutrient intake levels, the sample popilation was divided into the three previously described household classifications and the average daily intake levels for each group were calcu- lated. Proportion of Calories. - The proportion of calOries obtained for total carbohydrate, complex carbohydrate, total sugar, protein and fat are indicated in Table 25. As seen, the proportion of calories obtained from total carbohydrate for all three household size classifications fell below the recommended range of 50 to 55 percent of calories. As household size increased, the prOportion 102 of calories obtained from the consumption of carbohydrate decreased from 48 percent by the one person household sample to 46 percent by the two person household sample and 45 percent by the three or more person household sample. This decreased percentage of calories from total carbohydrate is due to a lesser proportion of carbohydrate being obtained from total sugar consumption. As household size increased, the percentage of calories from total sugar intake decreased while thr proportion of calories from complex carbohydrate remained constant. This might be expected since the fre- quency of pasta, rice & potatoes consumption was similar for all three household sizes while candy was eaten slightly less often by the three or more person household sample. This might not have been evident, thoughm due to the increased consumption frequency of breads as household size got larger. More than one-half of the proportion of calories from total carbohydrate was obtained from the intake of complex carbo- hydrate for all three household size classes. The proportion of calories obtained from the consumption of protein was at the upper end of the recommended range for protein intake (12 to 15% of calories). Little impact was observed in the percentage of calories from protein due to household size. The porportion of energy intake from protein did not neces- sarily follow the food frequency data where the consump- tion of meats occurred more frequently as household size got larger. A lower percentage of calories from fat was obtained by the one person household sample than by the two and three or more person household samples. However, 103 these caloric percentages from fat were greater than the recommended level (30 to 35%). Table 25. Proportion of calories obtained from total carbohydrate, complex carbohydrate, total sugar, protein and fat by elderly classified by house- hold size. Household Classification Three or One Person Two Person More Person Macronutrient Ln=12§) (n=360) (n=76) Total Carbohydrate 48a 46 45 Complex CHO 25 25 25 Total Sugar 23 21 20 Protein 15 15 16 Total Fat 37 39 39 3Percentage of total caloric intake. Dietary Component4§ntakes. The mean dietary component intakes and percentages NRC—RDA obtained from foods consumed for the elderly classified by household size are indicated in Table 26. Household size made a significant difference in the average intake levels of a majority of the dietary components. For most of the nutrients, the two person household sample obtained significantly greater quantities than had the one and three or more person household samples. The two person household sample had significantly greater amounts of calories, total fat, total carbohydrate, total sugar, niacin, riboflavin, vitamins B-6 and B—12, pantothenic acid, phosphorus, potassium, copper and zinc in their diets than had the one and three or more person household samples. The two person household sample, also, obtained significantly 104 greater quantities of protein, vitamin E, calcium and sodium than the one person household sample; while the two and three or more person household samples consumed significantly greater amounts of cholesterol than did the one person household sample. However, no significant differences were due to household size for the intakes of fiber, ascorbic acid, thiamin, vitamin A, iron and magnesium. The mean percentages NRC-RDA for the dietary component intakes are also given in Table 26. As shown, the majority of nutrients had been consumed at levels greater than 100 percent NRC-RDA with the exceptions of vitamin B-6, calcium, magnesium and zinc. The two person household sample obtained significantly greater percentages NRC-RDA of zinc and calcium than did the one person household sample, with the smaller household sample having obtained, on the average, less than two-thirds NRC-RDA of zinc. The diets of the two per- son household sample provided a significantly greater percent- age NRC-RDA of vitamin B-6 than did the diets of the three or more person household sample. Less than two=thirds NRC-RDA of vitamin B—6 was consumed, on the average, by the one and three or more person household samples while the two person household sample barely met two-thirds NRC-RDA for vitamin B-6. The two person household sample, also, obtained significantly greater percentages NRC-RDA of vitamin B-12 and phosphorus than did either the one or three or more person household samples. No significant differences, however, were noted in the percentage NRC-RDA due to house- hold size for calories, protein, ascorbic acid, thiamin, 105 vsmnowwflu zapszHHHzmHm no: Hopped .mpmu awowphaasm Ho hosmfiowmmzmsfi op one Hononmooop mnmam no woman m adampa>P .Asmmr .nmonsnv Amo.0v av mama as“: memos 30H cam mumppmfl,paonpa3 mamas 30mm pmNs s.e pme.oc «we m.m mm. as pmm ¢.¢ pm. m Ama.osaN owe name? mmm “some mNm mess? m:.nomaoo am moN nmsN mm was mmmN mm nN_ pmmN ma.esamonmmz mmm pmomN mam ammom ems pNosN wa.asammm»om mom pmNssN mmop mommN an nmmmN ma.a=aeom ass? men asses mama mos mmsNF noes mmm amass ma.msnonmmogm pmmm omN names Mum mNm “mes pom mmN mmmm ma.asaoamo was o.m m. as «no, m.s am. me name m.os n4.ma ma.nonH or? m. m as0. NF Fm? o.m mm. me owe N.m n¢.PF pH.m magmas» mes mamas mseom NoN mmmm oopm moN moms NNFm .4 aaampa> NNNF memm some mNsse a??? pssmm m:.uao« oacmspopnmm 9mm? mm.s nmo.m mmNN Nm.m Mm». 0 amps ms.m pmN. m m:.NF1m :Nam»a> mom one nemNF New arm “was. pans owe pmmNP mn.m-m naampa> pmsNF mm.o now. a mum? mN. a Mom. a paNF om.o pom. F ma.:N>mamonNm gamma m.m pm. me Moms 5. m Mm. FN nsNP 4.m pm.mF ma. causaz ma, F¢.o om.e mmNP Pm. N «am. 9 mos msso oN.P ma.:NSMana mm? mm was mFN mm mNF sFN em one ma.uao< oapuoom< F.N m.¢ m.a m.¢ m.s m.4 m.nmnam mango mm? «mom ass sown 0n? pawn ma.HonmpmoHono‘ ms pmeN mm MNeN so paaN m.mpmnusnopnmo Haves Nm ppmm an “Pm mN as» w.»mm Hmpoe owe mN «me can eN Jm mm? oN mam m.naoponm 009 Now fimmwr For osm MFNON cos ems menus acanoamo ammx mm scam: anmx mm saw: , anmx1 mm paws: pawnomaoo snapoan Assume Aommuqv NmNrmmv nomhmsw who: flown—”0R 039 Gomhmm 0G0 no mommfi sospmosmflmmmao caonomsom .msflm uaonmmsos mp umflmwmmmao manovam mo moprsw psmwupss hawmu ommno>< .mm canma 106 vitamin A, total tocopherol, iron and magnesium. In conclusion, the size of the household within which this elderly population lived did, indeed, have an impact on the dietary component intakes. For a majority of nutrients, the two person houseold sample obtained greater mean intakes. However, many of the average intakes were over 100 percent NRC-RDA for all three household size groups. The importance of the differences due to household size are diminished since the mean intakes were over 100 percent NRC-RDA. As long as an average 100 percent NRC—RDA was met, the differences in intake levels among the household groups would not appear to be as important as if the intake levels were below 100 percent NRC—RDA. Thus, more consideration should be given to those nutrients with mean intakes which did not meet 100 percent NRC-RDA; particularly for the mean intakes of vitamin B-6 and zinc, since at least one household size group obtain- ed inadequate amounts for both nutrients. A more complete analysis of the impact of household size on dietary component intakes should include the percentages of elderly for each household sample who did not meet 100, 66 and 33 percent NRC- RDA for 1 to 7 days, especially for those nutrients obtained in low amounts or with large variations in intake levels. -Impact of Dietary Supplements on Nutrient Intakes Approximately one-fourth of this elderly population used dietary supplements at least once during the survey week. Thus, the analyses described above was recalculated to include all dietary supplements taken by this elderly 107 sample population. These analyses were performed for both the total sample and the three household classifications. Analysis of Total Sample. The impact of dietary supple- ments on the nutrient intakes levels of this elderly popu- lation is indicated in Table 27. The use of the dietary supplements increased the average daily intakes for all vitamins and minerals with the exception of sodium, potas— ium, magnesium, copper and zinc (Tables 20 and 27). The average daily intake of vitamin B-6 increased from 65 percent NRC-RDA to 87 percent NRC-RDA when dietary supple- ments were considered in the calculations. The intake levels of magnesium and zinc were not increased to greater percentages NRC-RDA. However, with the addition of the dietary supplements, all nutrients were obtained at levels greater than two-thirds NRC-RDA. To further investigate the adequacy of the diets when dietary supplements were included, the data was re- analyzed to determine the proportion of subjects whose nutrient intakes were always above 100 percent, 66 percent and 33 percent NRC-RDA for all seven days surveyed (Tables 28 through 30). Very few of these elderly subjects consumed 100 percent NRC-RDA of the 13 nutrients examined for all seven days. However, comparison of this data with the analyses without dietary supplements (Tables 22 through 24) revealed that wen dietary supplements were considered in the diets the nutrient profiles of the 108 Table 27. Average daily nutrient intakes obtained from food and dietary supplement consumption by the elderly (n=561). Total Sample Dietary Component Mean SD %RDA Calories 1992 637 100 Protein,g 77 23 158 Total Fat,g 86 33 Total Carbohydrate,g 233 81 Total Sugar,g 108 48 Cholesterol,mg 369 168 Crude Fiber,g 4.5 1.9 Ascorbic Acid,mg 196 237 327 Thiamin,mg 2.68 14.87 236 Niacin,mg 26.1 22.6 174 Riboflavin,mg 2.35 2.20 170 Vitamin B-6,Lg 1813 1995 87 Vitamin-B—12,ug 7.32 7.80 244 Pantothenic Acid,1g 4946 4946 Vitamin A,IU 10194 8067 233 Iron,mg 17.0 10.6 170 Calcium,mg 786 425 98 Phosphorus,mg 1241 425 155 Sodium,mg 2844 1007 Potassium,mg 2963 895 Magnesium,mg 285 140 89 Copper,ug 1296 634 Zinc,mg 11.7, 8.7 78 subjects appeared to improve. Greater proportions of the sample met 100 percent NRC-RDA for ascorbic acid, thiamin niacin, riboflavin, vitamin B-6, vitamin B-12, vitamin A calcium and zinc. The dietary supplements appeared to improve the profile of vitamin intakes more than that of mineral intakes. However, less than one-third of the subjects still did not meet 100 percent NRC-RDA for thiamin, vitamin B—6, vitamin B—12 and vitamin A. 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N.ss m.mm swoponm m.rs v.4 o.wr m.m m.wm m.ow m.m4 F.Fm 4.0m mmfiuoamo noses: 1x,eso x1! 1x 850 x .XJESO -x AR 350 ,R «axiomz anonomsoo 4 1m N a see pm: suspoan «mmnomz me onmm mama Ho Honesz .uonocamsoo mm; mmmms pacemammsm mumpmwc son; mama 0 op F you 4mmnomz xmw sonn Hamw mmxmpzs psmanpss mmog3 manmvam mo mmmpsmosom on» as Ham: mm «mmlomz are mbopm mmmzam mum3 mmxmpsfl snowman: hasmu smog; Armmusv manmuao mo ommpsoonom .mm wands %’ Cum %’ %: Cum.% Number ongays Below 66% NRC-RDA %3 Table 29 (cont'd.). 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F.F m.4 m.m m.mm sabmamonam 0.0 0.0 m.o N.o m.o m.o o.m m.4 o.mm :fiomfiz m.o m.o 0.0 m.o 0.? m.o 0.m «.4 n.4m nasmwaa P.P m.o w.m m.m 4.w m.m 4.mr o.NP m.em vfio< ofinhoom< "msflsmpa0 0.0 0.0 m.o m.o m.o m.o m.m 4.m F.mm naoponm 4.0 m.o m.o m.o m.n. m.o @40. o.m N.Nm moanoamo "chow: R 550 $11, x 8:0 1%, 1x 650 1* x 550 x, «axiomz Pnonomaoo 4 m N 10‘ ann no: snapoan «extomz Xmm,3oamm mama Ho Hmnanz .conovamnoo mm: mmmmz psmemngsm 09mpmac cog: mhmc 0 op r you 4nmnomz an sedan Ham“ mmxmpsfi escapes: omens masmcam mo mmmpnmonma on» ad Ham: mm «mmuomz Ran esopm mmmsfim mum: mmxmpss escapes: haflmc smog: Awwmusv hflnmudo Ho owmpnoosom .on manna 114 0.0 4.0 4.0 >.N m.N onHN o.o m.o m.o m.o o.o asammnmmz 0.0 0.0 0.0 0.0 0.0 manonmmosm N.o m.o 5.0 4.. m.o ssaoamo 0.0 0.0 0.0 0.0 0.0 nomw u mHMHmQHZ 0.0 0.0 0.0 v.0 0.0 < nasmpa> o.o N.o N.o 4.0 N.o Naum swampa> o.o m.o m.o o.m F.N mum naempa> 0.0 0.0 0.0 N.o N.o sasmamonam 0.0 0.0 0.0 0.0 0.0 , :aomaz 0.0 0.0 0.0 0.0 0.0 massage N.o 4.0 N.o m.o F.o saoa cannooma u mQHEmPH> 0.0 0.0 0.0 0.0 0.0 namponm 0.0 0.0 0.0 N.o N.o mmanoamo "DRUMS ,R IN 550 x 1% 8:0 Mw1 pnosomaoo 10 m m asapown «mmuomzxmm onmm mhmm Ho Hmpazz A.e.p:oov on manna 115 I percentages of the sample met 100 percent NRC-RDA intakes of calcium (8%), magnesium (4%) and zinc (1%) for all seven days. When two-thirds NRC-RDA was used as the standard of dietary intake adequacy, the nutrient profile appeared to improve even more than the profiles did when vitamin/mineral supplements were not considered in the analyses. Again, this was mainly evident for the intakes of ascorbic acid, thiamin, niacin, riboflavin, vitamin B-6, vitamin B-12 and vitamin A. At least one-half of the sample consumed diets adequate in ascorbic acid, thiamin, niacin, riboflavin and vitamin A. Even though there were greater percentages of subjects whose intakes always met two-thirds NRC-RDA of vitamin B-6 and vitamin B-12 when vitamin/mineral supple- ments were considered, only small prOportions of the sample met this level of diet adequacy for vitamin B-6 (15%) and vitamin B-12 (33%) for all seven days surveyed. The mineral profile of these subjects improved very little when dietary supplements were included in the analyses. Less than one- third of the sample met this standard of diet adequacy for calcium (27%), magnesium (26%) and zinc (7%). Some of the sample did not meet 33 percent NRC-RDA for all seven days of vitamin B-6 (53%) and zinc (47%). Analyses of Sample Classified by Household Size. The impact of vitamin/mineral supplements on the nutrient intakes of this elderly papulation classified by household size is 116 indicated in Table 31. As previously discussed, household size had a definite impact on the intake of the macro— nutrients. This did not appreciably change, nor was it expected to, when dietary supplements were included in the analyses. However, the average intakes of vitamins and minerals were affected by the use of dietary supplements. The mean intakes of all vitamins were raised by the inclusion of dietary supplements in the calculations. The only vitamin whose mean percentage did not meet 100 percent NRC-RDA was vitamin B—6; as household size progressively increased, the percentage NRC-RDA obtained for vitamin B-6 slightly increased. No significant differences, though, were observed for the mean intake levels of most of the vitamins examined across the three household size classes. Extremely large variations in intake levels were observed for manu of the vitamins when dietary supplements were included in the analyses; this was particularly evident for the thiamin intake by the one person household sample. The one person household sample obtained a significantly greater average percentage NRC-RDA for thiamin than had the two person household sample. However, no significant differnece was noted among household size classes due to the wide variations in intakes for the other vitamins. The inclusion of dietary supplements in the analyses did not appreciably affect the average daily intakes of the minerals examined (Table 31). The intakes of calcium by the three household size samples were raised only slightly; 117 nmnpo mo meme Hmoapmdmsm Ho mosoNONMMsmsw op was Honmnaooop mnaam no woman m nHBmPH> .Asmm. .asossnv Amo.0v av .mussomsoo sense 4 psmnmwmas mapsmoawasmam no: nmppma mean 39H: memos 309 was mnoppoa psonpaz names 30mm pmm0 0.4 9mm.04 m4m m.m so. me 94m 0.m n0.m we.o:HN mm4 name. 6mm “Nome mNm peers m:.nmmaoo 4m moN msN mm NN. mNmN om ems pNsN ms.ssammnmmz 0mm somN mam mowom on pos0N ms.ssammmpom mmm o,mm40m mwor mmmmm mmm nm0mm ma.esacom ps4. men owes. News NN4 MmmNF 944? 444 meaa ms.msnosommosm pom mmm 0w0 m404 m04 mmom 9mm mmm ow0 we.aswoamo pm44 o m pm 44 mm04 a 44 mm. 04 pmmm4 4 44 mac or . ma.:onH O04 m.4m m.4m sww 0.40 4.mm ems w.m04 m.mm DH.M :«amvwb 4NN 4mmss m4mm mMN mews smmoa NmN NFNm smNm DH.< :Hsmpa> o4®04 wmmm 0mmm mmom m4mm mmm4 mn.cflo< oaswspopnmm 4mm 40.44 40.0 owm 4m.0 m0.0 mom Pm.m m4.m mn.menm :aEdpw> mm 4N44 mmoN em owns 4NN, 4N 4moa mN64 N;.mum sasmpa> mme sm.m m4.N our om.. .4.N mm? 4m.4 mo.N ms.n4>mamopam mm, 6.44 m.mN 404 m.s4 m.sN 084 p.44 m.NN me.aaoaaz smear 40.m mo.m pmw4 4o.m oo.m mmm4 4m.om mo.m . ma.aaamfine mmN mos mm. omm FFN was 44mm mNm mFN Na.sao4 oanuooma 4.m m.4 m.4 v.4 m.4 m.4 m.nmnwm dunno mos mom 404 mmmm 0M4 pram ms.aonmpmmaono 84 new Fm smas mm pNoF m.nmmsm Hmpoa m0 mm4m mm mm4m no pm4m m.mvmnuznonnmo Haves mm nmm 4m mrm mm n40 m.pmm Hmpoa 4m. mN Dams om. 4N Mam em. 0N paw m.namponm 4m moo pmmms 404 00m m0wom 004 mw4 p@004 mmfinoamo 4 .Pm manma 118 however, the significant difference which had been observed between the one and two person household=samples was allevi- ated. The two person household sample, on the other hand, obtained a significantly greater percentage NRC-RDA of iron than did the three or more person household sample plus a significantly greater percentage NRC-RDA of zinc than did the one person household sample. This two person household sample, also, obtained significantly greater oercentages NRC-RDA of potassium, phosphorus and copper than did either the one or three or more person household samples. The inclusion of dietary supplements in the analyses did not appear to raise the intake levels of zinc to an adequate (66% NRC-RDA) amount, particularly for the one person house- hold sample. Thus, when dietary supplements were taken into consider- ation, differences due to household size for the intakes of vitamins were erased. However, the dietary supplements did not appreciably affect the intakes of minerals. Signi- ficant differences were observed for most of the minerals between the two person household sample and the other two household size classes. 119 Dietary Component Intakes of Elderly Classified by Household Size and Dietary Supplement Usage Since dietary supplements (vitamin/mineral/protein) were used by at least one-fourth of the elderly population sample, it was important to consider the impact they made on dietary component intakes of those elderly who used such supplements compared to those who did not. Each household size classification was divided into two groups: those individuals who consumed dietary supplements and those who did not. Nutrient analyses, as previously described, were completed for the two groups fro each of the household sizes. To obtain a better understanding of the impact dietary supplement usage on nutrient intake levels, the usage of specific supplements was examined. Statistical analyses were then performed to determine if any significant differences cue to supplement usage occurred by the threeehousehold size classes. Dietary Supplement Usage The use of dietary supplements by these sample popu- lation groups are indicated in Table 32. Of the total elderly sample, 28 percent took dietary supplements at least once during the seven days. Approximately 25 percent of the one person household group used dietary supple- ments during the survey week while 30 percent of the subjects in the two person household group consumed dietary supplements. The least number of dietary supplement 120 tablet users belonged to the three or more person household group - only 22 percent of this sample took dietary supple- ments during the survey week. However, no significant differences were observed in the percentages of supplement consumers for the three household classes. On the other hand, the food frequency data previously discussed noted that dietary supplement usage, in comparison to the total number of food items eaten, significantly decreased as the household size increased. Thus, the one person household sample used dietary supplements more frequently than did the three or more person household sample. Table 32. Proportion of elderly, classified by household size, who consumed dietary supplements at least once during the survey week. Household Classification Three or One Person Two Person More Person Supplement Usage (n=125)_, (n=360) an=16) Number of Subjects 31 109 17 Percentage of Sample 24.8 30.3 28.0 Specific Dietary Supplement Usage. The investigation of which dietary supplements were used included tallies of the number of subjects who took the specific supple- ments plus the number of tablets which were consumed. These analyses were performed for both the total sample and the three household size classifications. The usage of the general types of dietary supplements 121 are indicated in Table 33. Almost one-half (48%) of the dietary supplements used by this elderly pOpulation were of the single vitamin type, while 30 percent were multiple vitamin tablets, 5 percent single mineral, 5 percent multiple mineral, 4 percent vitamin and mineral plus 8 percent contained macro-/micronutrients. Thus the most frequently used dietary supplements were of the single vitamin type. Table 33. Types of dietary supplements used by elderly (n=157) during the survey week. Number of Percentage of Supplement Type Supplements Supplements Single Vitamin 1551a 47.6 Multiple Vitamin 987b 30.3 Single Mineral 163d 5.0 Multiple Mineral 17od 5.2 Vitamin & Mineral 140d 4.3 Macro/micro Nutrients 250c 7.7 aColumn frequencies with same letter not significantly different (p< 0.05) (Seigel, 1956). A more detailed examination of the dietary supplements used are presented in Table 34. A significantly greater number of vitamin E and multiple vitamin tablets were consumed than were the other supplements. A significantly greater percentage of supplement consumers, however, used multiple vitamin tablets than took vitamin E capsules. The next most frequently used dietary supplements, in descending order of significance, were: vitamin C; B complexgoand bone meal, Table 34. Dietary supplement usa e by elderly during the survey week (n=157 . Number of Percentage Supplement Supplements of Sample Vitamin E 682a 30.6: Multiple Vitamin 681: 47.8ab Vitamin C 536 43.90 B Complex 1453 11.5def Bone Meal 101de 3.8def Niacinamide 96de Z'Sef Protein-Amino Acid 91def 1.96f Calcium plus Vitamin D 84ef 1'9cd Lecithin 74efg 6.4f Whey 73efg 0.6de Vitamin A 72f g 4.5de Vitamin B-12 63fg 4osdef Brewer's Yeast 63fg Z'Sdef Vitamin D 62 % 3.8cd Multiple Vitamin plus Iron 56gh 7.0def Zinc 54%1 2.5de Iron 39hi 4‘5ef Dolomite 38.. 1.3ef Kelp 33%? 1.9def Multiple Mineral 31:4 3.2def B Complex with C 3113 3.261‘ Wheat Germ 30iq 1098f Thiamin 29.fl 1.3f Selenium 21:!k1 0.6def Cod Liver Oil 1913,1m 3.2def Alfilfa Tablets 14klm 3.8f Riboflavin 111m 0.6f Fluoride 9 n 0.6de Calcium 7mn 4.5f Natural Rutin 7mn 0.6ef Geritol 5n 1.3f Dandelion Juice 4n 0.6 aColumn frequencies and percentages with same letter not significantly different (p <0.05) (Siegel, 1956). 123 niacinamide, protein-amino acid and calcium plus vitamin D. Forty-four percent of the subjects used vitamin C tablets while only 11.5 percent took B complex, 4 percent bone meal, 2.5 percent niacinamide, 2 percent protein-amino acid and 2 percent calcium plus vitamin D. Thus, even though some of these dietary supplements were used in significant amounts, they were taken by a relatively low percentage of the subjects, e.g., protein-amino acid, whey and niacinamide tablets. This would account for the large standard deviations in nutrient intake levels observed in the previous section. The frequency with which this supplement user sample took dietary supplements is indicated in Table 35. Five of the subjects used over 100 supplements during the survey week, onevone whom took 349 tablets! One-half of the supple- ment users, on the other hand, used 7 or fewer dietary supplements, while 16 percent used 8 to 14 tablets. Table 35. Proportion of elderly who took specified amounts of dietary supplements during the survey week. Number of Percentage Number of Supplements Subjects of Sample 1 - 7 79 5003 15 - 21 3 10 6.4 22 - 28 17 10.8 29 " 35 7 405 36 - 42 4 205 43 "' 49 4 205 136 1 0.6 182 1 0.6 189 1 0.6 238 1 0.6 342 1 0.6 124 The frequency with which the general types of dietary supplements were used by the elderly supplement consumers, classified by household size, are indicated in Table 36. As household size got progressively larger, the use of multiple vitamin type supplements significantly increased. The two person household sample used significantly more single vitamin, multiple mineral and combination vitamin/ mineral type supplements than had the one person household sample; the one person household sample, in turn, took significantly more of these three dietary supplement types than did the three or more person household sample. Signi- ficantly more single mineral supplements were taken by the one and two person household samples than by the three or more person household sample. The one person household sample used significantly more supplements containing macro and micro nutrients than did the two and three or more person household samples. Further analyses of the dietary supplements used by this supplement consumer sample are indicated in Table 37. Various effects due to household size on the use on dietary supplements were observed. The one and two person household samples used vitamin A, vitamin B—12, vitamin D and niacin- amide tablets while the three or more person household sample did not. As household size progressively increased, the use of multiple vitamin supplements significantly increased and the use of bone meal significantly decrease. The three or more person household sample used significantly more 125 Table 36. Frequency of vitamin/mineral supplements used by elderly classified by household size. Household Classification Three or Supplement Cne Person Two Person More Person Type (n=31) (n=109) (n=1Z) Single Vitamin 399b 11013 51C Multiple Vitamin 161C 596b 230a Single Mineral 47a 1153 1b Multiple Mineral 107a 61b 2C Vitamin & Mineral 19b 121a oC Macro/micro Nutrients 170a 68b 12b aRow means with same letter not significantly different (p <0.05) (Siegel, 1956). B complex with vitamin C tablets and alfalfa tablets than did the one and two person household samples. The two person household sample used significantly more vitamin C and vitamin E tablets than did the one person household sample which, in turn, used significantly more of these supplements than did the three or more person household sample. The two person household sample took significantly more zinc tablets, brewer's yeast and kelp tablets than did the three or more person household sample. The one person household sample consumed significantly more protein-« amino acid tablets and total dietary supplements than did either the two and three or more person household samples. Two household size classes took dietary supplements which had not been used by the other samples: the one 126 Table 37. Frequency of various dietary supplement usage by elderly classified by household size. Household Classification Three or One Person Two Person More Person Supplement Ln=31) (n=109) (n=171 Vitamin A 2013 52a ob B Complex 32b 99b14a B Complex with C 7a1727b Vitamin B-12 21b 42: 0c Vitamin C 1283 388: 20b Vitamin D 20b 42: 00 Vitamin E 146c 505% 31a Multiple Vitamin 114: 3642 203b Niacinamide 24: 72% Oab Riboflavin 11: 0b 0b Thiamin 29a 0 0 Multiple Vitamin + Iron 19b 37a Ob Calcium + Vitamin D 0 84a 0 Calcium 0a 6b 1b Dolomite 38: 0b Oab Fluoride 9b 0a 0b Iron 0 39 0 Multiple Mineral 10 10b 2b Selenium 21ab 0a 0b Zinc 12b 42b 08 Alfalfa Tablets 0 8b 6 Bone Meal 59% 42 0% Brewer's Yeast 1 62a 0 Cod Liver Oil 7 12 O Dandelion Juice 0 4 O Geritol O 5 O Kelp 5ab 28a ob Lecithin 2O 42 12 Natural Rutin O 7b 0b Protein-Amino Acid 77% 148 0b Wheat Germ Oa 3Ob Ob Whey 73 0 0 Total 903a 2062b 296b *1 Number of supplements. aRow means without letters and row means with same letter not signifcantly different (p‘<0.05) (Siegel, 127 person household sample took calcium plus vitamin D, iron and wheat germ which were not used by either the one or three or more person household sample. As shown in Table 38, the percentages of subjects who used the various dietary supplements varied dependeing on household size. More than one-half of the one person household sample took at least one multiple vitamin supple- ment and/or one vitamin C tablet while the greatest percent- ages of the two person household sample used multiple vitamin (42.2%), vitamin E (35.8%) and vitamin c (27.5%). Almost three-fourths of the three or more person household sample took nultiple vitamin tablets with the next most widely consumed dietary supplement being vitamin E (23.5% of sample). The frequency of dietary supplements during the survey week by the three household size samples are presented in Table 39. A majority of the subjects consumed between 1 and 14 tablets per week. Two members of each of the one and two person household samples and one member of the three or more person household sample consumed more than 100 dietary supplements during the survey week. One Subject in the one person household sample took 349 dietary supple- ments - from 1 to 77 tablets of 15 different supplements. The greatest number of dietary supplements taken by the two person household sample was 238 tablets and that by the three or more person household group was 136 tablets. 128 Table 38. Percentage of elderly classified by household size who used dietary supplements at least once during the survey week. Household Classification Three or Two Person More Person in=109l (n=17l One Person Supplement (n=31) Vitamin A B Complex B Complex with C Vitamin B-12 Vitamin C Vitamin D Vitamin E Multiple Vitamin Niacinamide Riboflavin Thiamin Multiple Vitamin + Iron Calcium + Vitamin D Calcium Dolomite Fluoride Iron Multiple Mineral Selenium Alfalfa Tablets Bone Meal Brewer's Yeast Cod Liver Oil Dandelion Juice Geritol Kelp Lecithin Natural Rutin Protein-Amino Acid Wheat Germ Whey .i m e \11 U'I WOWOQWOOWUQOWWOWGOOmew-§O\O\-IO\\N|\) O NOMOQNOONMQONMONWOOQWNMCD—b\n0\\n1\)\0 e‘o U14 1 A N #W ON—tO-F-l-‘OWNNWOAGOOU'INmOONNUlWQ-hrUO-h o e o o o e o o e e e e ommmmmmmflmmqom#oomm#oomNm'QU'ICNmJON ~ano .4 .4 O O O O O O O O O I O I O u—b OPPOAOOOOOO-‘OAOOOWOOOOOOKNONOWQO O O O OOOOQOOOOOO®OCDOOONOOOOOmmomOQONO 1Percentage of subjects within each household classification. 129 o o o o m 4 m¢m o o 4 4 o o mmm o o o o m 4 mm4 o o 4 4 o o mm4 m 4 o o o o mm4 o o m m o o 004 I 0m 0 o m m m 4 me I m4 0 o m m m 4 N4 I on o o m m m 4 mm I mm N4 N 44 N4 04 m mm I NN N4 N m m 04 m 4m I m4 >4 m 44 m4 04 m 44 I m mm m m4 mm mm >4 4 I 4 4 mamamm mvoowpsm odflfidm mpomfinzm maaamm mpoofinsm mpaoaoaamsm Mo Hopasz no mo mo Ho Ho we mmmpsooaom Hopasz mmmpaooaom Honasz owmpsooaom Hopasz A44uev Nmo4uev A4muqv somaom who: no means somsom 039 nomnom ego neweeeaaammmao eaoemmamm .%o>nsm esp mswasc manoaoaaasm manpowo Mo mangoes omawaomam xoop on: omfim uaonomson an oowmflmmmao maaouao Ho soapnomonm .mn canoe 130 Dietary Component Intakes of Supplement Consumers. The impact that these consumption habits had on dietary nutrient intakes for the household size samples are indicated in Table 40. Significant differences between the three house- hold size samples for almost one-half the dietary components were noted. The two person household sample obtained significantly greater amounts of calories, protein, fat and sodium than did the one person household sample, even though the one person household sample used significantly more supplements containing macro nutrients. On the other hand, the individuals living in one person households consumed a significantly greater amount of thiamin tha did the two person household sample subjects; this is in accord- ance with the use of thiamin tablets by the one person householdssample and not by the other two household size groups. The one person household sample, also, obtained significantly greater quantities of calcium than did the three or more person household group. However, for niacin, vitamin B-6 and pantothenic acid, the three or more person household sample obtained significantly greater amounts than did the one and two person household samples even though the three or more person household sample did not use supplements containing these three dietary components. No significant differences were observed for the intakes of ascorbic acid, riboflavin, vitamins B-12 and A, total tocopherol, iron, phosphorus, potassium, magnesium, copper and zinc, despite the fact that supplements containing some of these components .Asmm4 .emoesav AmOoOv «My PfimhmHMHU hHPEwOHHHQmHm FOG .HQPPOH @Ewm SPfl3 .HO mH¢P90H P508Pfi3 and: 30mm m4, m.m 0.44 mm, 1w.m4 N.44 m4 n.o4 ~.44 mauoeHN m04 mN44 44m 4mm4 nmm NNN4 ma.neaaoo 4m N44 44N 4m mN4 mom 4m mm4 NmN ma.eeameemmz m4m 44mN mom 40Nm mmm 44mN ma.eeammmeoaa. 0444 pmmomN 4mm mm4om m4m 94mmN wa.as«vom 444 mm4 m444 444 004 m4mn4 mm4 m4m N4m4 we.manonanosm e4m mNN N48 pmm44 4mm mNm m4m4 mmm m4o4 ma.aeaoamo nmm4 m.m m.m4 m4N 0.44 m.4N m4m4 o.N4 4.m4 ma.eoeH mom momNN mNmm4 4cm 0mmo4 Nm>n4 Nmm 44mm mst4 DH.4 aaam44> mmm4N mmOmN4 NmOm me4> wNmm pONmm m:.uwo< oaaonpovsmm mO4 m4. NN mm4. N4 4mm m4.m pmo. m 4Nm 4N.4 Nm.m ma.N4Im eaam44> mmmN 04mm m4om4 D.N4\.4 4mm4 nmth Qmm? >444 94>>N wa.mIm :Hampa> mam 44.4 N4. m NMN wN.N 9mm. m NPN 44.m mm.n ma.s4>mamonam m4N4 m.mm mm. mm nmmN w.mN N. mm pmomN 4.NN pm. mm ma.saomfiz eM43 Nm.4 emmm.4 pO4N mm.N e.Nm N m40m4 44.4m M4m. m4 ma.e4amasa mm4 me mmN mom ONM nmmm mmmw mmm mm>4 ma.uao< oaphoom< 1 m.N N.4 4.4 4.4 N.N m.4 m.nopum ouano flu mMN mom mm4 4mm om4 04m me.aoem4meaoeo mm nmm m4 mm44 m4 pm4o4 m.nmmam Hmeoa m4 m4N m4 mm4N m4 w4N m.m4mncasopumo Hmpoa 44 nmww on mNm 4N 9mm w.pmm Hmpoa 0m4 bN mm» >m4 MN M4m 404 mN 94> meaaopohm mm mom mmm4m4 mo4 44m MN44N No4 mum a.mom4 moaaoamo 4ucv Amo4unv 4mncv nomnom who: no mouse nomnom 039 :oflpmoflmwmmmwo uaopomsom sonnem oao mpamsmammsm mumpoau pom: on: .ouflm oaonmmso: mp coHHHmmmHo .hanooflo 0:4 He coavaesmsoo pamEmHamsm hampmav cam doom Bonn moxmpsw paownpss haamc owmse>< .xoo3 moensm on» msansc mono Posed no .04 canoe 132 were used in varying amounts by the three household size samples. The percentages NRC-RDA for dietary component intakes of vitamin/mineral supplement takers, according to household size, are given in Table 40. 'As shown, all nutrients which have recommended allowances were consumed at least at the two-thirds NRC-RDA level. Extremely large intakes of ascor- bic acid (788% NRC-RDA) and thiamin (1507%) were observed in the analyses for the one person household sample. Wide varia- tions were, also noted for the intakes of all nutrients by all three household samples. This would indicate that some of the elderly in each household group had consumed large doses of some vitamins and minerals; this was evident in the previous section (Tables 37 and 38). However, two minerals, magnesium and zinc, had not been consumed in amounts greater than 100 percent NRC-RDA for all three household size samples. Thus, these two mineral should receive more consideration from those elderly individuals, regardless of household size, who believe in consuming vitamin/mineral supplements. On the other hand, the average amount of pantothenic acid which was consumed by the two and three or more person household samples was greater than the recommended safe and adequate daily dietary intakes. No Dietary#Supplement Usage The pr0portion of this elderly sample who did not use vitamin/mineral supplements are indicated in Table 41. Seventy-two percent of this elderly sample, regardless of 133 household size, did not use dietary supplements during the survey week. A greater percentage of the three or more person household sample (77.6%) were in this category than were in either the one person (75.2%) or two person (69.7%) household samples. However, no statistiacally significant differences were observed between the percent- ages of non-supplement takers of the three household size groups. Table 41. Proportion of elderly classified by household size, who did not consume dietary supplements during the survey week. Household Classification Non-Supplement Three or ‘ usage One Person Two Person More Person Number of Subjects 94 251 59 Percentage of Subjects 75.2 69.7 77.6 The mean daily nutrient intakes by the non-supplement takers are indicated in Table 42. Significant differences were observed between household size classifications for a majority of dietary components. The two person household sample consumed significantly greater amounts of calories, protein, fat, total carbohydrate, cholesterol, riboflavin, vitamin B-12, vitamin E, calcium, phosphorus, sodium, potassium, copper and zinc than did the one person household sample. The subjects in the two person household sample, also, had significantly greater intakes of niacin, vitamin B-6 and pantothenic acid than did either the one and three or more 134 .44mm4 .sNossnv 4m0.0 vnv psmnmwmfiv 4H4CNOHHHSNNN 40: umppwa mENm £443 NQNNE 309 sz mumppca psonpaz mamas 3omN pN44 m.4 pN4.04 No4 0.m No. 44 now m.N no. N wa.0nss m4m n4N4m44 444 M44m4 N44 mm044 m4enmmm00 4N omN N4N 4N N44 NNNN NN 0m4 pmmN Na.ssammnmmz 004 0N40NN N00 N4mmN mN4 p444N ma.as4mmNpoN N4N 0N4N4N mm44 MmmmN 40N nNmmN ma.asauom N444 mom 0NN444 N0m4 004 MomN4 00m4 m4m 0$04 ms.msuonmmonm 04MNm mom 0N4m4 Mmm NNm MNm4 pmN mNN ammo Na.assoHN0 m44 4.4 m.44 NmN4 4.N Nm. N4 044 0.44 pm. 44 me.nonH mN4 04Nm NNNN 40N m4mm mm4m N04 0004 4444 04.4 nHaN44> 00N4 pmmmm 0Nm4 N4N04 omm 0m4mm N444404 04:43404sNN 0,N4m4 m4.m nNmm.m NmNN m4.w Mmm. w 0,4w4 4m.4 0,4o.m mi.N4nm QNENPH> 094m mm4 0N4N4 N4N N4m Nm444 me0 N44 0NmN4 mn.mum 045N444 4N4 om.o me4. 4 N044 mm.4 Mmm. 4 4N4 mm.o 9mm. 4 ma.sN>NHuonHm 0.N4m4 w.m 4. m4 Nmm4 m.w M4. 4N 0,mN4 m.m mm. m4 ma.cfioNHz m44 44.0 pom. 4 NNm4 44.m N40. 4 404 N4.0 004. 4 we.N4aNage N04 N4 044 44N mm 0N4 44N 4m 4N4 Na.0404 ospgoom4 4.N m.4 o.N m.4 m.4 4.4 m.nmpHm ccsno 444 0N4Nm 404 NmNm 0N4 p44n ms.aonopmoaono N4 404 mm 444 mm N04 m.nNm:m HNpoe 44 me4N mm N04N 4m n444N m.mpN904nonuN0 HNpoa mN pN4m mm Nom mN 0.44 m.4Nm Hmvoe 4m4 NN MNm4 4m4 4N Nm4 mm4 m4 9mm m.:Hcpon 4m 44m Nwmm4 004 mmw NmmoN 004 mm4 p4m44 mcwuoamo 40NN1, 0m :N02 4044 0m :Nmz «mmx 0m ch02 newcomeoo NNN4040 4mmuNN ~4mNu00 44mmmq. somnmm 0H0: no mcuse comnmm 039 somncm mac QOHpNoamflmmNHo Naonmmsom .xmoz 4m>nsm opp msfinsu mpsmaoamasm hszmav 0cm: #0: UN: 0:3 NNHN Naosmmson mp NNHMNNNNHO zanmuao Ho mmepsfl vsmauvs: hHaNN omNHo>< .N4 cHnNB 135 person household samples. The percentages NRC-RDA for all nutrients, except vitamin B-6, calcium, magnesium, zinc and calories, were above 100 percent of the standard for all three of the household size groups. The adequacy of the average daily intake of vitamin B-6 and zinc, according to percentages NRC-RDA, were suspect for all three household sizes. The two person household sample obtained approximately two- thirds NRC-RDA for vitamin B-6, while the three or more person household sample obtained significantly less, only 59 percent of the standard. The two person household sample consumed 79 percent NRC-RDA for zinc, while the one person household sample obtained significantly less, below two-thirds NRC-RDA for zinc. Comparison of Nutrientplntakes py Dietary Supplement Consumers and Non-Consumers. As seen in the above analyses, Tables 40 and 42 and in Table 43, the individuals who took dietary supplements durin the survey week obtained greater average quantities of vitamins and minerals than did the subjects who did not take supplements. The intakes of the vitamins and minerals which appeared to be inadequate in the diets of the non-consumers were improved in the diets of the supplement consumers. The intakes of vitamin B-6 for all three household size classes were above 100 percent NRC-RDA for the supplement consumers but below two-thirds NRC-RDA for non-consumers. The supplement consumers, also 136 .maso H0H0:90004 N:QHN :0 000Nm N .msoflpNascfiNo :4 Ncusacsfl mpsmsmammsm 4HNpodn4 44 4.N 0.44 mm N.m4 4.m4 N5.004N m4m mmN4 mom mmN4 mn.nommoo 4N M44 m4N mm N44 40m N0.0:4000NN2 0mm N04N 0mm m44m ms.s04mNN40N 0m04 4NNN 44m momN Na.as4eom 0m4 NNm N0N4 404 40m 04m4 Ne.m:N02000nN Nm 40m mm4 m44 4Nw NNm we.sswoaNo 4m4 4.4 4.m4 mON m.m4 m.oN ma.:09H 444 4.4 0.m4 4N4 0.4 m.04 N04.m 045N444 00N 04mm 404m 44m 44044 0NNm4 04.4 :48N4H4 me4 4mmm N4mm mwm4 m:.040< 04:0:4093Nm NON no.0 mN.0 4mm 4.04 4.04 m:.N4um :45N444 mm mm4 mmm4 m44 m44m mmmN m:.mnm :HBN44> 4m4 44.4 mm.4 mmN 44.m 4o.m ma.:fl>NH40:Hm mm4 4.0 4.0N 44N m.4m 0.44 ms.:40Nflz mN4 44.N m4.4 m4m No.4N 44.m ms.sssNN:a 44N om 4N4 4N0 mmm 44m ma.040< 04:H000< o.N m.4 m.4 0.4 m.H0:fim cvzno mm4 mom 404 00m Ne.40umpmoaon0 m4 404 m4 444 N.NNmsm HNpoe 4m 4MN om 4mN m.04N904:0:HNo HNpoe mm mm Nm mm m.4Nm HNpoe wm4 mN m4 404 4N 4m w.cflmponm mm one mmm4 No4 mNm 4mON mmflsoaNo «mmx mm :Nmz «Qmw am :ch 420209800 hHNpNHQ 4404usv A4m4usv museumsoo encamammsmnzoz museumsoo psmswaamsm NMNND pscacammsm .mpsmacanmsm mHNpmwc mm: 40: 040 0:3 0m0:p NsN x003 40>Hsm 0:4 msflnsv 00:0 pmNma 4N mvsmsmammsm aanmflc umssmnoo 0:3 masmvac 40 mmepsa psmahpss mHNNu NNNH0>< .m4 mapNe 137 had greater intakes of zinc than did the non-consumers. The level of intake for zinc by the one person households sample was above two-thirds NRC-RDA for the supplement consumers but below two-thirds NRC-RDA for the non-supple- ment consumers. There was little difference in the intake level by either group in the three or more person household size category. Greater percentages NRC-RDA were, also, observed for the intake of magnesium by the one person and two person household supplement consumers than by the non- supplement consumers in these household size classes, while no difference was observed between either of the supplement usage groups in the three or more person household size category. A similar pattern was observed for calcium intakes. Greater percentages NRC-RDA for calcium were obtained from the diets of the supplement consumers in the one and two person household samples than in the non-supplement consumer groups for these two household size classes. However, for the three or more person household samples, tje individuals who did not use dietary supplements during the survey week obtained a greater percentage NRC—RDA for calcium than did the supplement consumers. Also noted in the above analyses was the overconsumption of several dietary components. The subjects who did not use dietary supplements appeared to have adequate intakes of calories, protein, ascorbic acid, thiamin, niacin, riboflavin, vitamins B-12 and A, total tocopherol, iron and phosphorus while those subjects who did use dietary 138 supplements apparently had intakes of ascorbic acid, thiamin, niacin, riboflavin and vitamins B-12 and A greater than 200 percent NRC—RDA. Greater amounts of iron and phosphorus were obtained by supplement consumers than by non-consumers. Dietary Component Intakes of Elderly Classified By Household Size and Age The average daily nutrient composition of food intakes by the elderly were calculated for each of four age classi- fications: 62 to 64 years; 65 to 69 years; 70 to 74 years; and 75 years and older. An additional computer program was run to assess the impact of household size for each of the age classifications. PrOportion of Calories. The proportion of calories obtained from total carbohydrate, complex carbohydrate, total sugar, protein and fat are indicated in Table 44. A greater percentage of calories were obtained from total carbohydrate than from protein and fat intakes. The propor- tion of calories obtained by all ages of this sample was lower than the recommended"level. The percentage of calories obtained from complex carbohydrate was well below the recommended percentage. Approximately one-half of the carbohydrate intake was from total sugar consumption by all age groups. The individuals aged 75 years and older most nearly met the suggested proportion of calories for the macro 139 nutrients with only the percentage of fat consumption slightly high. This level, however, was only a little above the recommended amount. Fat contributed a greater percentage of calories than recommended for individuals aged 62 to 74 years. The subjects 75 years and older more approximately followed the suggested prOportion of calories from fat than did the younger age groups. For all age groups, the pr0portion of calories obtained from protein was at the upper end of the recommended range. Table 44. Proportion of calories obtained from carbohydrate, protein and fat by four age classifications of the elderly. Age Classification 62 to 64 65 to 69 70 to 74 75 Years Years Years Years and Older Macro Nutrients (n=123) (n=195) (n=132) ‘(n=111)g Total Carbohydrate 461 46 46 49 Complex CHO 24 25 25 26 Total Sugar 22 21 21 23 Protein 15 15 15 15 Total Fat 39 39 39 36 TPercnetage of total caloric intake. For the subjects aged 62 to 65 years, the size of house- hold made very little impact on the proportion of calories obtained from the energy nutrients (Table 45). Individuals living in the two person households consumed only a slightly greater percentage of their calories from carbohydrate and a slightly lower percentage from protein than did the other two household size samples. The difference in carbohydrate 140 Table 45. Fraportion of calories obtained from carbohydrate, protein and fat by the elderly classified by household size and age. Household Classification Three or Age Classification One Person Two Person More Person 62 to 64 Years n=11 n-95 n=17 Total Carbohydrate 45a 46 45 Complex CHO 24 24 24 Total Sugar 21 22 21 Protein 16 15 16 Total Fat 39 39 39 65 to 69 Years n=49 n=124 n=22 Total Carbohydrate 47 45 44 Complex GHQ 25 24 25 Total Sugar 22 21 19 Protein 16 15 15 Total Fat 37 4O 41 10 to 74 Years n=37 n=79 n=16 Total Carbohydrate 46 46 44 Complex GHQ 24 25 24 Total Sugar 22 21 20 Protein 15 15 16 Total Fat 39 39 4O 75 Years and Older n=28 n=62 n=21 Total Carbohydrate 50 47 49 Complex CHO 26 25 28 Total Sugar 24 22 21 Protein 15 15 16 Total Fat 35 38 35 aPercentage of total caloric intake. 141 contribution was due to a few more calories obtained from the consumption of total sugar by the two person household sample than by the other two samples. The percentage of calories obtained from fat was the same for each household group. Individuals aged 65 to 69 years had different consump- tion patterns depending on the size of the household in which they lived. The one person household sample consumed, on the average, a greater pr0portion of calories from carbohydrate and protein than did the two person or the three or more person household subjects. The three or more person household sample had the lowest percentage of calories from carbohydrate, which was reflected in a lower proportion of calories contributed from total sugar consumption. The percentage of calories obtained from protein was similar for individuals of each household size sample in this age group. The one person household sample obtained a lower proportion of calories from fat than did the other household size groups. This percentage of calories was close to the recommended intake level. For the subjects aged 70 to 74 years, there was little impact of household size on the proportion of calories obtained from energy nutrients. The three or more person household sample consumed a lower percentage of calories from carbohydrate and a greater prOportion from fat than did the one or two person household samples. The lower percent- age of carbohydrate contribution is due to a smaller 142 proportion of calories coming from total sugar consumption. The age group which more closely approximated the recommended proportion of calories from the macro nutrients was the 75 years of age and older sample. This was particu- larly true for the one person and three or more person household samples. The main difference was that as household size increased the pr0portion of calories obtained from complex carbohydrate increased. The two person household sample obtained a greater pr0portion of calories from fat than did the other two household groups. Dietary Component Intakes. The mean dietary component intakes and percentages NRC-RDA for individuals in each household size classification within each age group are indicated in Tables 46-50. For the subjects aged 62 to 64 years there were no significant differences found among the household size classes for any of the dietary components (Table 46). At least two-thirds NRC—RDA for all nutrients was obtained with the exception of zinc. The one person household sample consumed less than two-thirds NRC-RDA for zinc while the two larger household size samples obtained slightly more than two-thirds NRC-RDA. Among the subjects in the 65 to 69 year old age group, significant differences were observed for several of the dietary component intake levels for the various sizes of households (Table 47). The two person household sample consumed significantly greater amounts of calories, protein, 143 .A4mm4 .nmcnsnv Am0.0v my vnmnmmmau 5H92004HHGw40 won 0404404 400:443 00008 30mN 04 0.N 0.04 40 4.44 0.04 40 0.0 0.0 00.0040 404 0Nm4 000 0404 N04 0404 00.000000 044 004 440 00 444 000 004 004 4N0 00.00400000: 004 440N N00 0040 000 N0Nm 00.004000400 000 4040 000 000N 4NN4 0m0N 00.004000 004 040 0N4 004 0N4 00N4 044 000 4004 00.0000000000 004 04N N00 00 0N0 004 044 44 040 00.0040400 004 0.4 0.04 004 0.04 0.04 004 0.4 0.04 00.0004 44N 4040 0440 04N 0400 00444 00N N400 44044 04.4 0400444 44N 00.4 4N.4 00N 00.0 00.4 40N 44.0 40.4 0;.N4um 0400444 00 000 N044 N0 4N04 0004 00 4444 4004 00.0-0 0400444 004 00.0 0N.N 404 00.4 00.N 004 04.4 N4.N 00.0440440040 004 0.04 4.0N N04 4.44 4.0N 444 N.44 0.0N 00.040042 044 04.0 44.4 004 4N.4 N0.4 004 00.0 00.4 00.0400400 N4N N0 044 00m 04m 4mN 0N4 404 40N 00.0404 04000004 0.4 N.4 0.4 0.4 0.4 4.0 0.00040 00000 404 000 444 040 404 000 00.40004004000 04 444 00 044 N4 004 0.00000 40400 00 N4N 00 04N 40 mNN 0.040004000000 40400 00 00 00 00 0N 00 0.400 40400 004 0N 40 N04 0N 40 044 0N 04 0.0404000 N04 440 0N4N 404 400 044N 004 0N0 N404. 00400400 4000 00 10000 40001, 00 000: 40004w 00 000: 400000000 4004040 “Prflgv Ammflgv APPHSV GomhmnH who: .HO @mHSB 00040m 03a 00040m 000 00440049400040 040:0000m .0040 040:0000: 4: 0044400040 .0400» 40 04 N0 00NN 4440040 Mo 00x0404 4n044400 0wNHO>< .04 canme 144 .44004 .0000000 4.0.0.0v 00 440404440 4444004444040 404 404404 0800 4443 04008 304 040 0404404 4304443 04008 30mm 0000 0.4 004. 04 000 4.N4 04. m4 0.N0 0.N 00. 0 00.0040 444 0N44 04m 00404 400 00044 00.400000 00 mm 4mm mm mo4 mum 4m 404 mum - ms.804mm:wmz 0004 00004N 4N0 0N400 000 0000N 00.004000400 mom 40m4>m mm44 Mommm m44 440mm wa.as400m 00444 N44 000N44 0004 044 000N4 0044 000 0mN44 00.0040000000 mm own 400 0404 mm4 044m 4mm 044 pwmh ms.a:4o4mo 444 0.4 4.44 444 0.0 4. 44 404 0.44 4.04 00.0044 40N 0040N 40004 NMN N044 00404 40N 0040 N400 04.4 0400440 44404 00400 N04N 00004 00Nm 04044 00.0404 04000404000 400 00.0N 000. 0 00N 00.0 40.4 00N 44.0 04.4 00.N4-0 0400444 mmm4 omom 0mm4m 40m bow 4>mw4 40mm 4mm4 40mm>4 m:.mlm 4480444 mmm m4.0 4m.m 004 04.4 4mm. m 044 04.4 mm.m we.s4>044044m 40N 0.00 4.00 444 4.04 0. 0N 444 N.44 4.0N 00.040042 4mm No.0 >0.m Om4 m>.4 om.4 00m 4m.44 mm.m we.:4em4na 04m 04N 40N 04m 004 .004 044 044 40N 00.0404 04040004 0.4 0.4 m.4 m.4 0.4 m.4 m.40444 00:40 mom 0wmm 404 00mm mm4 400.0. wa.4o404004ono m4 0mm Om 0m0m mm 400 0.4mmsm 40400 00 0004N 00 04mN N0 0000 0.040404000400 40400 mm 0mm mm “mm 4m ”04 0.404 40400 4444 mm 4Mm> 0m04 mm 04m 40Nm4 m4 Who m.:404044 nwm mow 04mw4 0mm mbw 0040N 4m m04 mwmo4 00440400 4000 00 0000: 4000 00 0002 4000 00 00002 40000000044404040 Ammuzv 4¢m4n4v 4m4u44 440$th @902 .H0 @9548 400404 030 404400444000Ho 04onmmsom 400404 040 .0040 040800504 44 0044400040 .04004 mm 04 mm 0000 4440040 40 00x0444 4404445: 44400 mm04o>4 .44 04404 145 total carbohydrate, phosphorus, sodium potassium and zinc than did the one person household sample. The two and three or more person household groups obtained significantly greater quantities of total fat and cholesterol than did the one person household group. The mean intake of vitamin B—6 was significantly greater in the three or more person household sample. The one and two person household groups obtained significantly lower amounts of pantothenic acid from their diets than did the three or more person household group. Thus, as the household size within which the 65 to 69 year old subjects lived increased, significantly greater quantities of several nutrients were obtained from their diets. However, the size of household made no significant impact on the dietary intakes of total sugar, fiber, ascorbic acid, thiamin, niacin, riboflavin, vitamins B-12 and A, iron, calcium, magnesium and copper. At least two-thirds NRC-RDA was obtained from the diets of this age group for all nutrients except zinc. However, only the one person household sample consumed less than two—thirds NRC-RDA of zinc. Significant differences were also observed among the dietary component intakes of each household sample for the subjects 70 to 74 years of age (Table 48). In this age group, all of the differences occurred between the mean intakes obtained by the one person and the two person household samples. The three or more person household sample did not obtain any significantly different quantities of dietary components from the smaller household samples, 146 A39 £8.55 $0.01: pcmnmmmflc mapnmofimwsmwm p0: Hoppmfl oemm Spa: momma 30H cam mumppoa Psonpwz msmoe 30mm Pm o.w F.NF Fm v.0 P.NF so m.m m.m me.oefim mom «mm? mmm mmer mmm mmrs mn.nmmgoo am so? mom mm mm? whom om mm msm we.essmmnmmz mmm nmomom msm oerm Nmm nsmmm ma.asammapom mmm pm mum omow mwmom A mmm msmmm wa.asssom em? mes p mmwl muss mom sen. pens mam asses ma.msnonmmosm ammo EN 9mm? an? mg mg a: SN an; 3.9338 gnome m.m nmo.mf or? 0.0 0.»? pm? m.m >.mr ms.nonH om, moan wsem New smmo mmmmor so? omse Poms 2H.< gasses> Rmm ammo: om? 3m 3? pain 9:32 oseofiopzmm mm? mm.r n sP.s mom m©.> sm.s ms? ma.m pmm.m mqemrum :Hsmpa> #5 0mm mwms em smor moms ms was Mmsa mm.wum asamps> msr em.m m.m ow F .m -m.m ms mm.o m.r a afi>mamonfim snot v.8 nmmém mm? v.5 mmgm p9: Nam eta 3.532 NFN Fm.m mm.m mew >>.m mm.m om? mm.o vm._ . ma.nfiamane pmmsm For paws? mmem as? dmom nsmm em owe, me sfioa ofipnoom< F.m F.m m._ m.¢ >.F ¢.¢ m.nopflm mango om? nasmm our mmos ms? own ms.HonmpmmHopo cm om ms PF? Os 0? m.nmmsm Hmpoe mm mwm mm New mm mam m.mpmnssnonuwo Hmpoe mm pm an mm mm as m.pmm Hmpoa mm? mm pass so? mm mmm pm? Fm mm m.nampond mm mmm sawmmr mm sow .worm For on mamm. manuoamo < .ouwm vaozomson .m¢ manna 147 thus a clear correlation of this age classification with increasing household size can not be drawn, as done for the previous age group. However, the two person household sample did obtain significantly greater amounts of calories, protein, cholesterol, ascorbic acid, riboflavin, pantothenic acid, vitamin A, calcium, phosphorus, sodium, potassium and magnesium than did the one person household sample. As evidenced in the prior age group analyses, at least two-thirds of the NRC-RDA was obtained for all the dietary components except zinc. Again, only the one person household sample consumed less than two-thirds NRC-RDA for zinc. There was very little household size impact observed for the mean dietary component intakes among the subjects at least 75 years of age (Table 49). Significantly greater amounts of calories, total sugar and copper were consumed by the two person household sample than by the three or more person household sample. The two person household sample also obtained significantly greater quantities of total fat from their diets than did either the one person or three or more person household samples. Thus, almost no correlation can be made regarding household size with nutrient intake levels for this age group. The mean dietary component intakes, irrespective of household size, for each of the four age groups are indicated in Table 50. For the majority of dietary components, there was a trend of decreased consumption levels as the age of the subjects increased. This was observed for calories, protein, total fat, total carbohydrate, ascorbic acid, 148 .Asmmw .emonsnv Amo.0y my econommav mavnmowmwnmam won Hmppma mama spa: mamas son was muopvofl 930:9“: muses 30mm mm 0.0 ¢.op es m.m o... o» m.oe m.oF wa.onHN was psmoe Nam mmmea mus gamma? ma.umamoo pm» mm smm swam «NF smm mam mm? mmw ma.sswmmgmmz arm mmmm Nam mmmm mmoa mmmm ma.asammmpom new mssm mmos mmmm cam memm ms.asacom mm? mam mmor .0. mos mama mm? umm sews ma.msnonmmosm mm mmm omo no? wme omm or. mmm mmm ms.asaoamo mm? F.¢ m.ma mm? m.m m.m. mm? N.¢P m.ma ma.nonH For omsm smmm mow swam mama mmm msmm spoof DH.< :Hampa> mmmm meme msmm mmwa mmrm eons m;.uao< ospospopemm so, Fm.¢ mm.m mew FP.m mm.» Far am.m ma.m mn.mrum naampfi> ms mom. Pomp Fm smor was? as 0mm mama m:.mum :Hempa> mm, ¢F.F mm.. ems eF.F ma.m ms? mm.m mm.m ma.:a>mamopam has ¢.¢P F.NN cm? m.FF v.mm mm? N.Fm m.mm ma.:flomaz use em.o mm.r on? mm.o em." were >.mm ¢F.ma ms.naamana mom am mm? mam 00? mar mmm smm oom ma.sso< cannoom< m.F m.n N.m >.¢ >.N m.¢ m.nmnam mango mas ham mam mmm we? won ma.aoumvmmaono ms . arm Fm was? on pace? m.nwmam Haves mm mom em mam so anm m.opmnssnonnwo Haves ow pmm an mam mm nos m.pmm saves me, as mm as? mm sh mm? mm mm m.eaopoum mm pom nee»? mo? mms «meow For mme nmrmsp meanoamo «mmwl, mm cam: «mm mm as»: «max mm 2mm: passengeo sumpaan flamuza manna Ammuna nomnom one: no mouse uofimfimmmao .nmuao can munch mp comm hflnovao Ho moxwpnfi pcowhpsn hHHmu ommno>< somnom 039 cowprfimfimmmwmchonomsom nomhom one .ouwm uaosomsos up .m¢ manna 149 niacin, vitamins B-6, B-fz and A, pantothenic acid, iron, sodium, potassium, magnesium and zinc. There was an increased consumption of thiamin observed, on the other hand, as the age of the subjects increased. The intakes of total sugar, crude fiber, calcium, phosphorus and copper fluctu- ated from a decreased to increased consumption level while cholesterol and riboflavin increased then decreased as the age of the groups increased. Thus, as shown in the above analyses, age had a definite impact on dietary component intakes. However, household size was only a significant factor in the varying intakes for individuals age 65 to 74 years. There was a clear correlation of greater intake levels with increased household size observed for the subject aged 65 to 69 years. The two person household sample for the subjects 70 to 74 years of age had more adequate intakes for many of the dietary components than did the one person household subjects. Dietary Component_;ntakes of Elderly Men and Women Classified By Household Size The average daily intakes of the dietary components were also calculated for the sex classifications. Addition- ally assessments were done to determine the impact of house- hold size for each of the sex variables. Proportion Of Calories. The proportion of calories obtained from total carbohydrate, total sugar, protein and fat are indicated in Table 51. Females consumed 150 om n.oF o.NF mm m.op n.mr ma.onso omm mmma one own? o=.nnmooo mm or. new no om. men ma.a=annnmnz mom mono mom scam oa.asannnpom loos ammo pom mmmm ma.asaoom mm? moo now? owe .me omm. ma.nsuonmnonm mm mes Pop 00? won mom os.asaoano no, o.oF o.oF om? N.me o.mr soa.nonH oem memo snoop new mmom ammo, oH.< naanpa> snob moam moon mmom on.oao< osnmspopnnm mom mm.m mm.o mmm Pm.o on.» oz.meum enanpa> om mono moms mm owe? mama o:.oum naanpa> mos mo.m mm.m mo? m¢.F mm.m ma.nfi>namonam om? >.Pm ¢.om one m.mF o.o~ ma.:son«z m.m >o.o N¢.m mm? mF.P Fm.r ms.naanasa 0mm mom cam mom Pom sow oe.oao< cannoon< >.F ¢.¢ m.r o.¢ m.nnnam nosno one can mm? mom oa.aonmpnnaono no so? Pm or, o.nnmso Hopes Pm mom Fm new o.npnnomnopnno anoe em on on mm m.pnm Hmpoe ems no no mo? mm Pm m.:aoponm om emo mmme Noe mam mmom noHnoHno «QmXI am now: < .om manna 151 mo m.m m.oF mo m.m ¢.FF . 3 an no a, minnow mm #Nw OPN mm New Nmm mB.BSHmvfimmE bmm Nwmm wmw mmmm wfiofifiwmmwvom mfim mmmm bro? mmwm maoESHfiom man was smme on. man mmme ma.nnnonnnono For mwm Fwo mo omm oms ma.annoano bmw m m b mw mme w b m or mansoHH new mmmo Noam mom moan omom DH.< eaanpa> mmom meme omen poms o:.oso< nannnpOPnnm mam om.m sm.o emm oo.o m>.o m;.menm naanpa> ms moor smoe mo owe, nose m:.oum casnpa> om? on.F oe.m we? mm.m se.m oe.na>namopam one m.¢. o.mm one m.me ¢.mm ma.:aonaz omm o¢.nm oo.¢ sow Fo.¢ mm.m ma.naenase mom was om? son Mme one ma.oao< ospuoona m.m o.¢ o.m o.¢ m.nmpam nosuo mom emm mo, mom ma.aounpnoaoso so OFF so so? m.nnmsm anoe no mom or me m.npnuohnonuno anoe mm on mm mm m.pnm Hopes cm? no no Foe no mo m.:aoponm mos omo meme mm moo ooom nmanoano «mmx mm coo: «mmx mm goo: pnosomaoo hwmpmwn Aldperuqq “omeunv nooao mum whom» mb mnmow #m op om nowpmoamwmmmao om< .Ao.pnoov om manna 152 approximately the same proportion of their calories from carbohydrate and fat as did the males. Neither the males nor the females obtained the recommended proportion of calories from carbohydrate (SO-55%) and fat (30-35%). Both sexes consumed a level at the tOp of the range for protein contribution (15% of calories, each), while obtaining less than the recommended level for carbohydrate (46% and 47% by males and females, respectively) and more than the appropriate amount of fat (39% by males and 38% by females). Table 51. Proportion of calories obtained from carbohydrate, protein and fat by elderly males and females. Sex Classification M3193 Females Macro Nutrient (n=228) (n=333) Total Carbohydrate 461 47 Complex CHO 25 25 Total Sugar 21 22 Protein 15 15 Total Fat 39 38 1Percentage of total caloric intake. The size of the household within which the male subjects lived had an impact on the proportion of calories obtained from the macro nutrients (Table 52). The size of the male one person household sample (1 subject) made it impossible to accurately draw any conclusions based on the three house- hold sizes. However, the contribution of complex carbohydrate was similar for the two person and three or more person 155 household samples. The three or more person sample consumed approximately the same percentage of calories from total sugar than did the two person household sample. The propor- tion of calories obtained from the consumption of protein was fairly constant for the two and three or more person household samples. This was also observed for the prOpor- tion of calories obtained from the intake of fat. Table 52. Proportion of calories obtained from carbohydrate, protein and fat by elderly males and females classified by household size. Household Classification Three or Sex One Person Two Person More Person Males n=1 n=190 n=37 Total Carbohydrate 39a 46 45 Complex CHO 25 25 25 Total Sugar 14 21 20 Protein 18 15 16 Total Fat 43 39 39 Females n=124 n=17O n=39 Total Carbohydrate 48 46 46 Complex CHO 25 24 25 Total Sugar 23 22 21 Protein 15 15 15 Total Fat 37 39 39 3Percentage of total caloric intake. For the female subjects there was little impact observed due to the size of household within which the subjects lived (Table 52). The one person household sample obtained a greater percentage of their calories from carbohydrate than did the two and three or more person household samples. 154 This was due to a slightly larger proportion of calories obtained from total sugar consumption by the one person household sample. The proportion of calories obtained from protein was constant for the three household size groups. The one person household sample, on the other hand, obtained a lower percentage of calories from fat than did the two and three or more person household samples. Thus, neither the males nor the females obtained the appropriate proportions of calories from carbohydrate or fat. It appeared that the two and three or more person household size male and female samples deviated from the recommended proportion of calories for the macro nutrients more than did the one person household female sample. Due to the small sample size of the one person household male sample it was impossible to draw more complete con- clusions. Dietary Component Intakes. The mean dietary compoenet intakes and percentages NRC-RDA for the household size classes within the male and female sub-groupings are given in Tables 53 and 54. For the male subjects, there were no significant differences found in intake levels amoungl the three household size classes (Table 53). At least two-thirds NRC-RDA, on the average, was met for all nutrients by the two and three or more person household samples. Again, due to the small ample size of the male one person households it would be inappropriate to draw conclusions 15‘) .Aemmr .smossmv Amo.ouvmv pumpmwmfiu mapsmowmflcwwm p0: mnoppca vsosvflz wanes 30mm mm <.¢ m.me mm 0.0? m.¢~ N» I m.or manocflw emm mmma mes ommr . moor ma.nmaaoo so law who mm mm, own mm . sow oa.ssannnmnz moo mean mam mmmm . seam ma.snannnpom mom moon or.. ommm . some ms.EsHoom one mom ammo ewe ems mev_ see 1 com we.nsnosanosm mol mom now New emm Pom em . mme ma.assoano b,a m.m o.wa "Om w.mm v.0m mma I m.mw ms.noHH moi swam ream mm ammo moose no a amen oH.< naenpa> meow warm mono comm . ooom m;.oao« nannnpopnmm omm oa.o oo.o mom no.“ om.m mos u mm.m mi.m.-m :Hsnps> mm ewes woos ow moor oema me 1 www mn.mnm :flsmpfl> mww om.” mm.m be so.r om.m mm 1 mo.r ms.sfi>mayopfim so“ m.sa o.oe one o.mr m.me «or . m.ma oa.naonaz mm? ow.m qa.w mow mm.m mo.m mm 1 mm.o ms.:flemfl£e vow one son 44m 44m oom New 1 no, ms.oaoa afinnoona o.m m.e 4.N o.m . P.m m.nnnaa nonno own am now was . mam we.Houopanono m nos em em. a om m.nnmsm Hapoe or New mm com I Pm? w.opmnomnonnmo Hmpoa mm mm mm MOP u Pm m.pmm Haves mm? em mm mm? am am rm? 1 er m.:floponm rm owe mmpm For ewe Ommm or I owe? moauoamo smmxv am now: «mmxv mm ammz < .mm manna 156 psonmmmwo hapcmofiuanmflm you .Aemme .enonnov Amo.ov av nmppma 080m SPH3 msmos 309 was mnovpofl psonpfiz memos 30mm mo m.e m.m mo m.o m.oe 4o m.m >.m we.onao 4mm omm son more omm were m=.nomaoo non no perm ammo we pnemm new ems swam oa.ssannnmnz moo mmem mom anew mom mono ma.s=annnpom mos mmem mom memo omm comm oa.anaoom some 4mm pooch gnome 0mm anooae was? mes meme? ma.nsnosanosm me emm moo on mom was mm smm no» ma.asaoamo _ma 2.4 e.me mme m.m N.me one 4.PF o.oe ma.:onH mam omsme wmmm mom oomo whom mom memo memo oH.< essnpa> woos? meow moon meme mmmm moms o;.oao¢ oscnnpopnmm emm Fm.m2 em.o 2mm No.0 mm.o mow mm.m >F.o ma.maum swampa> or? more ommm on some nose on omoe some m:.oum swanpa> so. as.m me.m mos mo.e om.m one 00.? mo.m ms.sa>naoopam mew o.oo m.mm mes 0.0F m.sm Poe >.ea m.mm os.nsonaz ooa mm.e mo.m our ee.m om.e mme no.2m oe.m os.naenase mm“ mm, Fme mam no? one mmm mmm new oe.oao< ospuoona 4.? pe.m o.e pnm.e >.F mm.¢ m.nmnaa mosuo one wen ems 0mm one arm ma.aonnpnoflono on em me mm on No? m.nnmsm anoa mo so? as oam no mam m.npnnoanonnno anoe mm as om we om so m.vnm anoe was or mm mm? we 0o om? Fm mo w.:smponm so woo one? For mam more For one one? nnanoano «man go some «max on can: ages] on can: economsoo swnpnam ammunw1 Aoowuev Hemwnnv QOmem 0H0: .HO mmHSE nomnmm 039 sofipmoamwmmmao oaonomsom oaosomson an omHMHmmmao mmamamw hanmoam H0 mmePSfl psonflvss haddu owmho>< somnmm 0:0 .muam .vm manna 157 for this household size. Among the female subjects, there were significant differences observed in the intakes for a few dietary components as the size of the household increased (Table 54). Analysis of the female One person household sample showed significantly greater mean intakes of crude fiber, phosphorus and magnesium than did the such analyses for the three or more person household sample. At least two-thirds NRC-RDA was obtained for all nutrients by the females except zinc. The one and three or more person household female samples obtained, on the average, a lower percent- age of the recommended intake than did the two person house- hold female sample. The mean dietary component intakes, irrespective of household size, for males and females are indicated in Table 55. For the majority of dietary components there was a trend of lower average consumption levels for females than for males. For most of the nutrients, however, this was acceptable since lower intake standards are generally recommended for women (National Research Council, 1980). The male sample obtained greater mean intakes for calories, protein, total fat, total carbohydrate, total sugar, choles- terol, crude fiber, vitamins B-6 and B-12, pantothenic acid, vitamin A, iron, calcium, phosphorus, sodium, potassium, magnesium, copper and zinc than did the female subjects. The women, however, obtained, on the average, a greater intake of thiamin than did the men. Many of the mean intake differences were diminished when the dietary component 158 no a.» m.oe mm m.oe m.ma ms.onao mmm cm?” who can, mn.nnaaoo mm mop smm so For mom ms.asannnmnz one mmnm me moon oa.a=annmpom mam ammo moor moon oa.asaoom one son was? me? Poe woe? ms.nnnosanosm om ms are are new mom ma.asaoano mme m.m m.me mm, m.er m.ma ms.:onH _em amen seom com ammo ommoe 0H.< naempa> swam some mwsm mrmm m:.oao< canmSPopnnm mom oo.m mo.o new Fe.> om.m m:.maum mannaa> no mmsm nose om moor some m:.onm nasnpa> one se.m oe.m Nee so.e om.m we.nH>nHwonam mo? m.oo p.4m New m.me N.mm ma.:aonaz mom oe.me mo.m woe so.m mo.m oa.naanane mom new so? mmm mmm om? ms.oso< cannoon< o.e m.e m.m m.e m.pnpaa mango ems 0mm 0m? one ms.HosmpnnHoso as om em For m.nnmsm anoa so cam on mom o.mpnnosnonnno anoo mm oh mm F0. o.vma Hayes of mm am om w.naovonm ooh mOm our? mm mom oemm mownoamo ¢ .mm canoe 159 intakes were examined based on the percentage NRC-RDA. The male sample consumed a greater percentage NRC-RDA for ascorbic acid, vitamin B-12, iron, calcium, phosphorus and zinc than did the female sample. The women. though, obtained a greater percentage NRC-RDA for thiamin and vitamin A than did the men. Thus, as indicated above, the sex of the subject directly affected the intake of various dietary components. In general, males had greater mean intakes for a majority of the dietary components, which was partially negated when examined on a recommended intake level basis (NRC-RDA) for each sex. However, household size did not appear to have any impact on the consumption of the dietary compon- ents, particularly for the males. When significant differ- ences of intake levels did occur in the female sample, the smallest household size group had greater intakes than did the largest household size sample. DISCUSSION The increasing number of elderly in the United States population has brought some of the problems encountered by older people into the forefront; one of which is diet adequacy. The major purpose of this investigation was to examine one of the sociological factors which might affect dietary component intakes. That is, whether living alone, with another person or in a more communal situation influences food consumption habits of the elderly. The absence of 1 socialization during meal periods has been thought to be an inhibitor of pr0per dietary habits (Weinmerg, 1972). It also has been reported that many older people living by themselves find it inconvenient to prepare food for just one person (Pelcovits, 1972). This has led to the suspicion that elderly individuals living alone may have inadequate dietary component intakes (Anon, 1977). Thus, this investi- gation was undertaken to determine the validity of the above hypothesis. There were a total of 16,072 meals/snacks eaten (68% of possible meals) during the survey week by the total sample. The greatest percentage of meals/snacks was consumed by the one person household sample (70%) while the three or 160 161 more person household sample consumed the lowest percentage of meals/snacks (64%). The one and two person household samples consumed significantly more meals/snacks per week (29 meals) than did the three or more person household sample (27 meals). At least 90 percent of all three main meals were eaten by the one and two person household samples while less than 90 percent of the mid-day meals and more than 90 percent of the morning and evening meals were con- sumed by the three or more person household sample. The one person household sample consumed a greater percentage of snacks than did the three or more person household group. Thus, if the elderly living alone did find it inconvenient to prepare food for just themselves as reported in earlier research (Pelcovits, 1972), this sample of elderly living alone did make meals for themselves whether it was convenient or not. The meal frequency patterns revealed in this investigation also indicated a relationship with the sociological impact of food eating occurrences as suggested by previous researchers (Weinberg, 1972; Sherwood, 1973; Howell and Loeb, 1969). If food and eating is considered to be a source of emotional satisfaction, it would be logical to assume that individuals living alone or in smaller size households might eat more frequently. The fact that the one and two person household samples, in this investigation, ate more meals, on the average, than did the three or more person household sample confirmed this hypothesis. Thus, those elderly living in small size households obtain"some of the socialization missing due to the lack of others in 162 the home from eating more frequently. The three meals per day eating frequency pattern reported from previous research (Pelcovits, 1972; Davidson et al, 1962; Lyons and Trulson, 1956) also was substantiated by this investigation. However, from the percentages of the main meals eaten by this sample, it would indicate that the frequency of meals in the daily regimen was more prevalent than earlier thought. This sample consumed twice as many meals as did the elderly sample studied by Hunter and Linn (1979). The frequency of the snack consumption by this sample (26 to 55% of possible snacks) correlated with the percentage of subjects who had eaten between meals reported by Lyons and Trulson (1956) and Reid and Miles (1977) where 52 to 60 percent of their sample had consumed at least one snack per day. Thus, the increased meal consumption observed in this investigation appeared to be due to the increased frequency of eating the three main meals during the day rather than from between meal food consumption. The consumption of food away from home also is an excellecnt medium for socialization in the elderly popula- tion - more so than just aneexamination of the daily eating frequencies. Whether the eating occurrence took place in a restaurant, at work or even in a friend's home, it is evident that other people will generally be involved. Thus, if elderly individuals used "eating out" as a means of involvement with other people, it would seem that those living alone or with one other person might eat more meals 163 away from home during a given time period than those elderly individuals living with families or with several friends. The smaller size household samples investigated in this study did eat away from home more frequently than did the larger household size sample. A total of 431 subjects in this investigation ate at least one meal away from home during the survey week. The one person household sample had the greates percentage of individuals (85%) who ate a minimum of one meal outside their home. The one and two person household sample consumed more meals away from home (14% and 13% of meals eaten, respectively) than did the three or more person household sample (8%). It is interesting to note which meals were actually consumed outside the homes of this population. The two smaller sized household groups more frequently ate breakfast and dinner away from home than did the larger size household group. Thus, meals which are traditionally family eating occasions were more frequently consumed away from home by the surveyed elderly living in small households than those living with families or acquaintances. These meal patterns may account for the variation in the reported number of total meals by this sample than would have been expected due to the inconvenience of preparing food for just one person. Rather than making all of their meals, the smaller household samples consumed some of them outside their home. Previous research, also, reported only the prOportion of subjects wholconsumed most of their meals away from home (Lyons and Trulson, 1956; Kaplan, 1955) 164 rather than those who ate at least a meal or snack outside the home. Thus, the percentage of this sample which consumed at least one meal away from home was found to be, and was expected to be, greater than that previously reported. The examination of the at home food consumption patterns indicated that the food groups of beverages, eggs and main meal items were consumed significantly more often by the three or more person household sample than by the other two household size samples. Dairy products were consumed significantly more often in the diets of the two person household sample than in the diets of the one person household sample. There was a slight increase in the percentage con- tribution of breads and significant increases in the contri- butions of meats and vegetables as household size got larger. The Opposite occurred for the frequency consumption of crackers, fruits and dietary supplements as household size got larger: significant decreases in the consumption frequencies of these food groups were observed. No signifi- cant differences due to household size were noted in the contributions of cereals, soups, pasta, rice and potatoes, candy, desserts and chips and nuts. The at home frequency of food requiring preparation did not appear to be influenced by household size while the consumption of food requiring little preparation did; the larger household sample consumed breads-RLP, meats-RLP and main meal items-RLP more frequently than the smaller household size sample. The data reported by this sample pertaining to the consumption of the food groups designated RP and RLP seemed 165 to refute the notion that elderly individuals living alone may not prepare foods which required increased preparation for just themselves (Pelcovits, 1972). The samllest house- hold size sample used food items which required increased preparation more often than did the largest household size sample, while the largest household size sample used signifi- cantly more items which required little preparation than did the smallest household size sample. Thus, the earlier hypothesis was not found to be valid for this elderly sample. Also, many of these elderly individuals were raised during a period when the majority of food was prepared in the home rather than purchased already made and then brought into the home. Another factor which may have affected this evaluation was that over three—fourths of the elderly living in three or more person households lived with younger members who were most probably responsible for food preparation as well as other household responsilities and perhaps worked outside the home. Away from home food consumption frequencies were not as dependent on household size as were the at home consump- tion frequencies. The two and three or more person house- hold sample consumed dairy products significantly more often than did the one person household sample while the two person household sample included breads significantly more often in their diets than did the one person household sample. The three or more person household sample consumed crackers significantly more often than did the one and two person household samples while just the reverse occurred 166 for dietary supplements. As household size increased, the inclusion in the diets of pasta, rice and potatoes significantly decreased. Thus, many of the differences in the at home food consumption frequency patterns were not ‘evident in the away from home food consumption patterns. These findings would indicate that food choices of the elderly may not be as affected by household size as the at home con- sumption frequencies revealed since away from home food choices may indicate food preferences more accurately than i the foods eaten at home showed. Howeverm this investigation dealt with the food items which were consumed by the elderly individuals, not those which were preferred. The correlation of these food consumption patterns to previous research are difficult to make due to the vastly different methods used to examine the frequency of eating various food items. Earlier studies had shown discrepancies in the adequacy of fruit and vegetable con— sumption by the elderly population (Kohrs et al, 1978; Lyons and Trulson, 1956; Pelcovits, 1972; Van Syckle, 1957; Anon, 1966; Macleod et al, 1974). This investigation would indicate that fruits were probably consumed an appropriate number of times (approximately 12% of food items) while vegetable consumption may not have been (4%). This would tend to agree with results presented by Lyons and Trulson (1956) and Macleod and co-workers (1974). The predominance of dairy products in the food choices of this elderly sample substantiated that reported by Marr (1978) while the fre- quency of bread consumption by this sample agreed with that 167 of the sample investigated by Lyons and Trulson (1956). Dietary supplement usage by this sample was not reported by as large a percentage as previously discussed (Van Syckle, 1957; Davidson et al, 1962; Steinkamp et al, 1965; McGandy et al, 1966; LeBovit, 1965; Dibble et al, 1967; Kohrs et a1, 1978). Approximately 28 percent of the subjects in this sample used dietary supplements, which corresponded with the percentage of subjects investigated by Reid and Miles (1977) who used dietary supplements. The consensus of the afore- mentioned investigations was that the appropriateness of dietary supplements was suspect since many of the elderly who took the tablets already had an adequate consumption of nutrient from their food choices. Results reported in this study confirmed this theory; dietary supplements tended to increase the average daily nutrient intakes of those dietary components already at an adequate level while contributing little to the nutrients obtained in inadequate amounts. Household size did have an impact on the usage of dietary supplements by this elderly population. The one person household sample used dietary supplements more fre- quently and used a greater number of supplements than did the three or more person household sample. Differences were also noted in the typ of dietary supplements used by the three household size samples. As household size got progressively larger, the use of multiple vitamin type supplements increased. The two person household sample used more single vitamins, multiple mineral and combination vitamin/mineral tablets than did the other household size 168 samples. The one person household sample took supplements more often than did the two and three or more person household samples. The one and two person household samples used single mineral tablets more often than did the three or more person household sample. Thus, the number of pe0ple with which this elderly sample lived affected not only the number of supplements used but also which supplements were taken. The food consumption data were analyzed to determine any differences in dietary component intakes by the three household size classifications. The two person household sample obtained significantly greater amounts of calories, cholesterol, fat, protein, total carbohydrate, total sugar, thiamin, riboflavin, vitamin B-12, iron, calcium, zinc phosphorus, sodium, potassium and copper than did the one and three or more person household samples. Both the one and two person household samples consumed significantly greater percentages NRC-RDA of ascorbic acid, vitamin A and vitamin E than did the three or more person household sample. No significant differences were observed for the intakes of crude fiber, vitamin B-6, magnesium and niacin. Thus, household size did appear to influence dietary compon- ent intakes. For a majority of the dietary components, the two person household sample obtained significantly greater quantities than did the one and three or more person house- hold samples. However, these three samples appeared to adequate mean intakes of the dietary components with many of them being over 100 percent NRC-RDA. The adequacy of mean intakes 169 of vitamin B-6, calcium, magnesium and zinc were, on the other hand, suspect for all three household size groups. These results agreed with those reported from the Nationwide Food Consumption Survey. 1977-78 (USDA, 1980) which indicated that adequate levels of all nutrients were consumed by the elderly with the exception of low intakes of vitamin B-6, calcium and magnesium. Other nationwide surveys (DHEW, 1972; DHEW, 1977) had reported inadequate intakes for iron, vitamin A, ascorbic acid and calcium; with the exception of calcium, these results were not observed in the diets of this elderly sample. Increasing age had a definite impact on nutrient intakes. For the majority of dietary components, there was a trend of decreased consumption levels as the age of the subjects increased. Previous research had also indicated a decrease in nutrient intakes as the subject aged (Fry et al, 1963; Swabson, 1964; Anon, 1966; McGandy et al, 1966; Macleod et al, 1966; Judge, 1976). There was an increased consumption of thiamin as the age of this sample increased, however. This was not observed in any of the priorinvestigations. Increased intakes of calcium had been observed in two previous research studies (Fry et al, 1963; Anon, 1966). This was not reported in the other investigations n0r in this study. There was no clear correlation of calcium intakes with increasing age for this sample, which was also reported by McGandy and co-workers (1966). The proportion of calories obtained from carbohydrate increased as the age of this sample increased; this was also reported by McGandy 170 and associates (1966) while Macleod and co-workers (1974) had indicated the opposite. The protein contribution to caloric intake remained constant while the percentage of fat contribution to caloric intake decreased, as was reported by McGandy and associates (1966). Household size had only a limited impact on dietary component intakes as the age of the sample increased. There was a clear correlation of greater intake levels with increased household size observed for only the subjects aged 65 to 69 years. The two person household sample for the subjects 70 to 74 years of age had more adequate intakes for many of the dietary components than did the one person household subjects. The sex of the subject also directly affected the intakes of various dietary components. In general, males had greater mean intakes for a majority of the dietary components, which was partially negated when examined on a recommended intake level basis for each sex. The males, however, had greater intakes of ascorbic acid, vitamin B—12, iron, calcium, phosphorus and zinc than did the females while the females had greater intakes of thiamin and vitamin A. These results were the opposite of those reported by Kaplan and co-workers (1955) and Macleod and associates (1974a, 1974b, 1975), while these results substantiated those reported by Lyons and Trulson (1956) and Kohrs and associates (1978). Stienkamp and co-workers (1956) reported that more men than women had inadequate intakes of thiamin and more women than men had low intakes of vitamin A. These results 171 were in accordance with those reported here from this inves- tigation for th nutrients which men reported greater intakes than did women. The Ten State Survey, 1968-70 (DHEW, 1972) revealed that elderly women had more adequate intakes of vitamin C than did elderly men which was not indicated in this investigation. The data reported from the HANES survey (DHEW, 1977) was similar for that reported here with the exception of inadequate ascorbic acid intakes by men. The Nationwide Food Consumption Survey, 1977-78 (USDA, 1980), however, reported that adequate levels of all nutrients were consumed by both sixes with the exception of low intakes of calcium, magnesium and vitamin B-6 by women. The low intakes of zinc indicated in this investigation were not substantiated by earleir research studies since the dietary intakes of this mineral have not been previously reported. Household size did not appear to have any impact on the consumption of the dietary components of the sample when partitioned by sex, especially for the males. When significant differences of intake levels had occurred in the female sample, the smallest household size group had greater intakes than had the largest household size group. SUMMARY A nationwide survey of elderly individuals, aged 62 years and older, revealed that household size had a definte impact on food consumption patterns and dietary component intakes. The sample population used was balanced by geo- graphic area, employment status, marital status and p0pula- tion density to be indicative of the national population. Meal locations and food items consumed during the third week of September 1977 were reported in seven day dietary records. These food diaries contained spaces for recording all foods and beverages consumed at three main meal periods and three snacking periods during the day. Information was obtained pertaining to the amount eaten plus the type, brand or flavor of the food item. Spaces also were included to indicate where the meal was eaten; at home, away from home or was not eaten. These raw data were gathered by Market Facts of Chicago, Illinois. The food diaries were then sent to Michigan State University where they were coded for computer analyses. The MSU Nutrient Data Bank was used for determining the dietary component intakes reported by this sample p0pulation. To examine the impact of household size on food con- sumption patterns and dietary component intakes the sample 172 173 population was divided into three groups. The one person household sample contained 125 subjects (22% of the sample), the two person household sample had 360 members (64% of the sample) while the three or more person household sample contained 76 individuals (14% of the sample).. Six facets of the impact of household size on food consumption patterns were investigated: the frequency of meal consumption, the frequency and types of foods consumed during the survey week, the dietary component intakes by the sample p0pula- tions, the impact of dietary supplements on nutrient intakes, differences observed due to increasing age and consumption variations between the sexes. In general, the smaller household size sample ate more frequently than did the larger size household sample. The one and two person household samples consumed more meals per week than did the three or more person household sample. The one person household sample consumed a greater percent- age of snacks than did the three or more person household sample. The smaller size household groups ate breakfasts and dinners more frequently away from home than did the larger household size group. Beverages, eggs and main meal items were consumed at home more often by the three or more person household sample while dairy products were consumed more frequently by the two person household group than by the one person household sample. There was a slight increase in the percentage contribution of breads and a significant increase 174 in the contributions of meats and vegetables to the diets as household size got progressively larger; while the opposite occurred for the consumption of crackers, fruits and dietary supplements. The at home consumption of flood requiring little preparation was influenced by household size while the consumption of foods requiring preparation was not; the larger household sample consumed breads-RLP, meats-RLP and main meal items-RLP more frequently than did the smaller household sample. Away from home food consumption frequencies were not as dependent on household size as were the at home frequencies. The two and three or more person household sample included dairy products more frequently in their diets than did the one person household sample while the two person household sample consumed breads more often than did the one person household sample. The three or more person household sample consumed crackers more frequently than did the one and two person household samples while just the reverse occurred for dietary supplements when used away from home. As household size increased, the inclusion of pasta, rice and potatoes in the diets decreased. The nutrient analyses‘for these food consumption patterns revealed that household size had a definite impact on dietary component intakes. The two person household sample obtained significantly greater quantities of a major- ity of the dietary components from their diets than did the one and three or more person household samples. This indicated that the two person household sample consumed 175 greater amounts of the food items than did the other two household size samples. The two person household sample obtained greater amounts of calories, cholesterol, fat, protein, total carbohydrate, total sugar, thiamin, ribo- flavin, vitamin B-12, iron, calcium, zinc, phosphorus, sodium, potassium and copper from their food intakes than did the one and three or more person households samples. Both the one and two person household samples obtained greater percentages NRC-RDA of ascorbic acid, vitamin A and vitamin E from their diets than did the three or more person household sample. No differences due to household size were observed for the intakes of crude fiber, vitamin B-6, magnesium and niacin. For a majority of subjects, regardless of household size, the intakes of vitamin B-6 calcium, magnesium and zinc was less than two-thirds of the NRC—RDA. Increasing age also was observed to have a definite impact on nutrient intakes. For a majority of the dietary components, there was a trend of decreased consumption levels as the age of the subjects increased. However, thiamin intake levels increased as the age of this sample increased. Household size only had a limited impact on dietary component intakes for the various age groups of the sample. A direct correlation of greater intake levels with increased household size was observed for the subjects aged 65 to 69 years. The two person household sample for the subjects 70 to 74 years of age obtained higher intake levels for many of the dietary components than did the one 176 person household subjects. The sex of the subject also directly affected the intakes of various dietary components. In general, males had greater mean intake levels for a majority of the dietary components. These differences were partially negated when the results were examined on a recommended intake level (NRC-RDA) basis for each sex. The males, however, obtained greater percentages NRC-RDA from their diets of ascorbic acid, vitamin B—12, iron, calcium, phosphorus and zinc than did the females while the females obtained greater percentages of NRc-RDA for thiamin and vitamin A. Household size did not appear to have any impact on the consumption of dietary components, especially for the males. When significant differences in intake levels occurred in the female sample, the smallest household size group had greater mean intakes than did the largest household size group. Household size did have an impact on the usage of dietary supplements by this elderly population. The one person household sample used dietary supplements more often and used a greater number of tablets than did the three or more person household sample. Differences also were noted in the types of dietary supplements used by the three household size samples. However, dietary supplements tended to increase the average daily nutrient intakes of those dietary components already at an appropriate level while contributing little to the nutrients consumed in low amounts, particularly the minerals. Thus, the composition of supplements should be reconsidered before their use is 177 advocated for the elderly. In conclusion, household size, in general, had an impact on the dietary component intakes and the food consumption patterns of this elderly sample. However, when this sample was partitioned into sub-groups by sex and increasing age, there was little observed due to household size. Further investigations of the influence of this sociological factor on the diet adequacy of the elderly need to conducted to determine more precise contributions of the food groups to specific dietary component intakes since a difference in the food consumption patterns among the household size groups had been observed. The use of the Basic Four Food groups in educational programs designed for the elderly should be encouraged to assure that appropriate amounts of different types of foods are being consumed - 4 servings of dairy products, 2 servings of meat, 2-4 servings of grain products and 4 servings of fruits and vegetables. This food group program was developed with respect to the recommended dietary daily allowances. However, before implementing specific food plans for older people it is necessary to investgate their food preferneces. These choices in food items will reflect not the only sociological charact- eristics of the elderly but alos their ethnic background. This factor is very important in developing feeding programs since people tend to have definite food preferences and probably would not eat food they dislike, no matter what the nutrientional considerations may be. Therefore, more detailed studies might include in-depth analyses of other 178 sociological and demographic characteristics of the elderly within each household sample: an analysis of the impact of income on the number of meals eaten away from home and of employment status on snacking habits, for example. Utilizing height/weight information provided by the subjects, another analysis might include a comparison of the food habits of obese and non-obese elderly. Another interesting study would be to investigate, in more detail, the contribu- tion of away from home food consumption patterns to the total food patterns by this age population within each household size group. If accurate information could be collected on drug usage, the implication of drugs/drug metabolism on nutritional status of the elderly based on dietary intakes might be investigated. APPENDICES 179 APPENDIX I Food Items in the 21 Food Groups Used in the Analyses Food Group Food Type Example Alcoholic Beverages Alcohol Manhatten Table Wine Beverages Carbonated Cola Type Diet Soft Drinks Non-Carbonated Lemonade Powdered Drink Mixes Other Coffee Tea Water Breads 1 Breads-RP Pancakes All home pre- , pared Waffles All home pre- pared Muffins & Biscuits Bran Muffin Baking Powder Biscuit P0pover Sweet Breads & Banana Bread Pastries Cinnamon Bun Breads-RLP2 Bread Combinations Tortilla & Products Pancakes, Waffles & French Toast Buns & Romls Breads & Toasts Commercial Bread Pancake Mixes Frozen Waffles Brown & Serve Dinner Rolls Hamburger Buns Pita Bread Cracked Wheat Bran Raisin Toast APPENDIX I (cont'd.). 180 Food Group Food Type Example Breakfast Bars Commercial Products Breakfast Pastry Doughnuts Sweet Roll Candy Hard Lollipop Chewy Caramel Chocolate Fudge Marshmallow Circus Peanuts Cereals Ready-to-Eat All varieties Chips & Nuts Crackers Dairy Products Desserts Needs to be Cooked Chips Nuts Saltine Snack Crackers Croutons Milk Cheese Ice Creams Cakes Cookies All varieties Corn Chips Pretzels All varieties All varieties All varieties All varieties Whole 2% Lowfat Cheddar Limburger Ricotta All types Ices & Sherberts Ice Cream Bar Chocolate Angelfood "Lunch-Box" Filled Brownies Commercial APPENDIX I (cont'd.). Food Group Eggs Fruit Main Meal Items Main Meal Items-RP Main Meal Items-RLP Meats Meats-RP 181 Food Type Pies Other Desserts Eggs Fruit Fruit Juices Combination Dishes Combination Dishes Beef Lamb Pork Poultry Seafood Example Fruit Cream POppy Seed Fruit Dumpling Custard Gelatin Strudel Haw Fried Scrambled All varieties Raw Processed All varieties Fresh Processed Cheese Souffle Ham Casserole Pork Chow Mein Salmon Cakes Tuna Salad Canned Entrees Packaged Dinners Frozen Dinners Frozen Pizza All cuts All cuts All cuts Chicken Turkey All types Haddock Oysters Scallops APPENDIX I (cont'd.). 1232 Food Group Food Type Jxample Meats-RLP Frozen Entrees Cod Pot Roast Meat Loaf Luncheon Meats Frankfurters Pasta, Rice & Potatoes Soups Soups-RP Soups-RLP Vegetables Vitamin/Mineral Supplements Pasta Rice Potatoes Soup Stews & Chowders Soups Vegetables VegetableoJuice Vitamins Minerals Pork type loaf Canned Tuna Macaroni Egg Noodles Brown Long Grain Converted White All types Mashed Scalloped Dehydrated Chicken Beef Vegetable Corn Chowder Beef Stew All processed commercial types All types Fresh Processed Mixed Cocktail Juices Single Multiple Multiple Plus Bone Meal Dolomite Selenium Multiple Calicum Fluoride 183 APPENDIX I (cont'd.). Food Group Food Type Other Example Whey Natural Rutin Dandelion Juice Protein-Amino Acid 1Requires Preparation. 2Requires Little Preparation. 184 APPENDIX II Vitamin/Mineral Supplements in the General Types of Dietapy Sppplements Used in the Analyses Supplement Type Vitamin/Mineral Supplement Single Vitamin Vitamin A Vitamin B—12 Vitamin C Vitamin D Vitamin E Niacinamide Riboflavin Thiamin Multiple Vitamin Alfalfa Brewer's Yeast B Complex B Complex with C Dandelion Juice Multiple Wheat Germ Single Mineral Kelp n.i Selenium Iron Calcium Zinc Fluoride Multiple Mineral Bone Meal Multiple Dolomite Vitamin & Mineral Multiple Vitamin plus Iron Calcium plus Vitamin D Macro/Micro Nutrient Whey Protein-Amino Acid Lecithin Geritol Not Specified Natural Rutin LIST OF REFERENCES Adams, C.F. 1975. Agriculture Handbook No. 456: Nutritive Value of American Foods, In Common Units. Agriculture Research Service, United States Department of Agricul- ture, Washington, D.C. Anon. 1966. 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