The Effects of Nutrition-related Factors on Four-year Mortality Among a Biracial Sample of Community-dwelling Elders in the North Carolina Piedmont

The purpose of this epidemiological study was to estimate mortality risk associated with poor diet quality (consumption of five food groups), extremes of body mass index (BMI), waist circumference, and impaired food-related activities of daily living among community-dwelling older Black and White men and women. The design of the current study was a retrospective-prospective cohort study. The sample included residents (n = 1920) of five North Carolina Piedmont counties. The dependent variable was four-year all-cause mortality. Analyses were stratified by gender and race, and controlled covariates included: age, living with others, income, smoking and alcohol use, cognitive status, and overall self-rated health. Data were self-reported to interviewers, except BMI and waist, which were measured by trained interviewers. Difficulty in fixing meals elevated the risk of mortality between 2.7 and 6.5 times across the four gender-race groups. Among older adults, inability to fix a meal conferred more risk of mortality than did lack of financial means. Adequate servings of vegetables were uniformly protective, although significant only among Black males. Neither BMI nor waist circumference conferred significant mortality risk. These population-based findings suggest relationships between nutrition risk factors and mortality that are unique and require further focused studies.