Subjective Well-Being Is Associated with Food Behavior and Demographic Factors in Chronically Ill Older Japanese People Living Alone

• Published in: The Journal of nutrition, health & aging Vol. 22; no. 3; pp. 341 - 353
• Main Authors: Ishikawa, Midori, Yokoyama, T., Hayashi, F., Takemi, Y., Nakaya, T., Fukuda, Y., Kusama, K., Nozue, M., Yoshiike, N., Murayama, N.
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01-03-2018; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Aging; Behavior; Chronic Disease - psychology; Chronic illnesses; Cross-Sectional Studies; Demography - statistics & numerical data; Diet; Eating; Egg Hypersensitivity; Feeding Behavior - psychology; Female; Food; Food Supply; Frailty; Geriatrics/Gerontology; Health Behavior; Humans; Income; Japan - epidemiology; Male; Meals; Medicine; Medicine & Public Health; Mens health; Neurosciences; Nutrition; Odds Ratio; Older people; Personal Satisfaction; Primary Care Medicine; Prospective Studies; Psychological aspects; Quality of Life - psychology; Quality of Life Research; Residence Characteristics - statistics & numerical data; Shopping; Social Class; Socioeconomic Factors; Surveys and Questionnaires; Vegetables; Womens health; Japan; Older adults living alone; food accessibility; Japan; subjective well-being; social communication
• ISSN: 1279-7707; 1760-4788
• DOI: 10.1007/s12603-017-0930-3

Objectives
This study aimed to examine the relationships among subjective well-being, food and health behaviors, socioeconomic factors, and geography in chronically ill older Japanese adults living alone.
Design
The design was a cross-sectional, multilevel survey. A questionnaire was distributed by post and self-completed by participants.
Setting
The sample was drawn from seven towns and cities across Japan.
Participants
A geographic information system was used to select a representative sample of older people living alone based on their proximity to a supermarket. Study recruitment was conducted with municipal assistance.
Measurements
To assess subjective well-being and food and health behaviors of respondents with disease, a logistic regression analysis was performed using stepwise variable analyses, adjusted for respondent age, socioeconomic status, and proximity to a supermarket. The dependent variable was good or poor subjective well-being.
Results
In total, 2,165 older people (744 men, 1,421 women) completed the questionnaire (63.5% response rate). Data from 737 men and 1,414 women were used in this study. Among people with a chronic disease, individuals with good subjective well-being had significantly higher rates than those with poor subjective well-being for satisfaction with meal quality and chewing ability, food diversity, food intake frequency, perception of shopping ease, having someone to help with food shopping, eating home-produced vegetables, preparing breakfast themselves, eating with other people, and high alcohol consumption. A stepwise logistic analysis showed that the factors strongly related to poor subjective well-being were shopping difficulty (men: odds ratio [OR] = 3.19, 95% confidence interval [CI], 1.94–5.23; P < 0.0001; women: OR = 2.20, 95% CI, 1.54–3.14; P < 0.0001), not having someone to help with food shopping (women: OR = 1.41, 95% CI, 1.01–1.97; P = 0.043), not preparing breakfast (women: OR = 2.36, 95% CI, 1.40–3.98; P = 0.001), and eating together less often (women: OR = 1.99, 95% CI, 1.32–3.00; P = 0.002).
Conclusion
Subjective well-being of people with chronic diseases is associated with food intake and food behavior. The factors that affect poor subjective well-being in chronically ill older Japanese people living alone include food accessibility and social communication.