Associations between fruit and vegetable intake, leisure-time physical activity, sitting time and self-rated health among older adults: cross-sectional data from the WELL study

Lifestyle behaviours, such as diet, physical activity and sedentary behaviour, are key factors to prevent chronic disease and to maintain health throughout the life-course. Although these lifestyle behaviours frequently coexist and are amenable to interventions, the relationships between them and how they interact with each other have received little attention. In addition, relatively little research has explored these behaviours and their shared association with health indicators in the 55-65 years age group, an increasing group of older adults in transition to retirement. Later adulthood is an important period because the impact of behavioural risk factors increases with age and many chronic diseases will present during this life-stage. People reaching retirement will also have access to more leisure-time which may impact their opportunities to engage in healthy or unhealthy behaviours.

Wellbeing, eating and exercise for a long life

The Wellbeing, Eating and Exercise for a Long Life (“WELL”) study is a population-based cohort study that aims to identify how intrapersonal, social and environmental factors influences nutrition and physical activity behaviours of older adults across urban and rural Victoria, Australia. A random sample of adults aged 55-65 years, completed a postal survey at baseline (2010). In analyses of cross-sectional data (n=3,644) we explored the relationships between fruit and vegetable intake, leisure-time physical activity, and sitting time, and their individual and shared association with good self-rated health, controlling for known confounders.

F&V intake and leisure-time physical activity were positively associated with self-rated health

The findings show that each additional serving of fruit and vegetable or 15 minute brisk walk per day, was associated with an approximately 10% increase in the odds of reporting health as good or better among women and men. The relationship remained statistically significant when all three lifestyle behaviours were included in the model, and after adjusting for BMI, smoking, long-term illness and socio-demographic characteristics (education, marital status and housing tenure). No significant association was found between sitting time, and selfrated health, but we discovered an interaction between sitting time and fruit and vegetable intake. This means, that the simultaneous influence of sitting time, and fruit and vegetable intake on self-rated health is not additive. Instead, the association between fruit and vegetable intake and self-rated health is dependent on sitting time and additional time spent sitting affected this association differently in women and men. Among men the association between fruit and vegetable intake and selfrated health strengthens with less time spent sitting (<10hr/day). Whereas, the reverse effect for added time spent sitting (>5hr/day) was found for women. It is possible that the different associations for men and women are a result of different patterns of sitting time, for example, prolonged periods versus intermittent sitting bouts.

Even small differences in lifestyle behaviours may influence the health status of the population

This study contributes to the scarce literature related to lifestyle behaviours and their association with health indicators among older adults. Results from the study provide further support that even small differences in lifestyle behaviours may influence the health status of the population. Furthermore, the results give justification for looking at health behaviours in combination, and the importance to examine both additive and synergistic effects on health outcomes. The WELL study will provide opportunities to examine lifestyle behaviours and their determinants longitudinally.

Understanding determinants of nutrition, physical activity and quality of life
among older adults: the Wellbeing, Eating and Exercise for a Long Life (WELL)
McNaughton SA, Crawford D, Ball K, Salmon J.
Health Qual Life Outcomes. 2012 Sep 12;10:109. doi: 10.1186/1477-7525-10-109.

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