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Topical Area: Methods

Methods (Poster Session)

(P26-007-23) Development and Validation of an Older Adult Nutrition Equity Index (NEI) and Association With the Healthy Eating Index (HEI) in Older Black and White U.S. Adults

Monday, July 24, 2023
11:45 AM – 12:45 PM ET
Location: Poster Board 363
Disclosure(s):
Aarohee Fulay, PhD, MPH: No relevant financial relationship(s) with ineligible companies to disclose.
Samaneh Farsijani, PhD, RD: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: We aimed to develop a novel, broader measure of nutrition equity in older U.S. adults that includes functional ability. We examined the convergent validity of the nutrition equity index (NEI) compared to food insufficiency (FI) via the Healthy Eating Index (HEI).

Methods: The Health, Aging, and Body Composition Study (Health ABC) is a prospective, longitudinal cohort of Medicare-eligible, community-dwelling Black and White men and women. Included participants (N = 2569, 74.7 ± 2.9 years) had baseline (1997-98) and 1 year follow-up nutrition equity-related data, and 1 year follow-up FI, key covariates, and the 1995 HEI from a 108-item interviewer administered food frequency questionnaire. FI was a modified validated question on ample food amount/variety from the U.S. Department of Agriculture. NEI consisted of 8 questions (including FI): anxiety about money for food, limited money for food, hunger, home food acquisition, and difficulty: shopping, preparing meals, and carrying groceries. Participants received a point on the NEI each time a response indicated nutrition equity. Low nutrition equity was classified as 0 – 7 out of 8. Convergent validity was assessed via multivariable linear regressions between FI and NEI, respectively, with HEI, adjusted for sociodemographic, lifestyle and comorbidity factors.

Results: Of participants, 13.4% had FI and 44.9% had low NEI. Black older adults were more likely to have FI (20.3%) and low NEI (59.7%) with Black women disproportionately affected (p < 0.001 for all). FI (vs. non-FI) and low NEI (vs. high NEI) were more likely to have
Conclusions: Low NEI included >30% more participants vs. FI alone and showed convergent validity. NEI was similar to FI for HEI associations, though importantly identified more older adults with nutrition inequity.

Funding Sources: National Institute of Health (NIH)/National Institute on Aging T32 Epidemiology of Aging Training Grant. Health ABC: NIH & Agency for Healthcare Research and Quality.