1) quantify the association between food avoidance and modification due to oral health problems; 2) quantify the relationship between these nutritional self-management strategies and dietary quality; and 3) determine foods associated with these self-management strategies.
Rural North Carolina
Six hundred thirty-five community-dwelling adults aged 60 years and older.
Demographic and food frequency data and oral health assessments were obtained during home visits. Avoidance (none, 1–2 foods, 3–14 foods) and modification (0–3 foods, 4–5 foods) was assessed for foods representing oral health challenges. Food frequency data were converted into Healthy Eating Index-2005 (HEI-2005) scores. Linear regression models tested the significance of associations between HEI-2005 measures and food avoidance and modification.
Thirty-five percent of the sample avoided 3–14 foods and 28% modified 4–5 foods. After adjusting for age, sex, ethnicity, poverty, education, and tooth loss, the total HEI-2005 score was lower (P<0.001) for persons avoiding more foods and higher for persons modifying more foods (P<0.001). Those avoiding 3–14 foods consumed more saturated fat and energy from solid fat and added sugar and lower intake of non-hydrogenated fats than those avoiding <3 foods. Those who modified 4–5 foods consumed less saturated fat and solid fat and added sugar but more total grains than those modifying <4 foods.
Food avoidance and modification due to oral health problems are associated with significant differences in dietary quality. Approaches to minimize food avoidance and promote food modification by persons having eating difficulties due to oral health conditions are needed.