View
1
Download
0
Category
Preview:
Citation preview
!1AARP Research © MARCH 2019 ALL RIGHTS RESERVED
RESEARCH BRIEF
Brain Health and Nutrition Behavior in African American/Black Adults Age 40-Plus
Brain Health, Nutrition, and Mental Well-being
Support for nutrition’s impact on brain health continues to increase.1
Previous research has shown positive connections between consumption
of specific foods, such as fruits, vegetables, and fish, and better brain
health.1 Although healthier food choices are better for brain health, studies
have also found race-based differences in diet quality,2 perceptions of
healthy diet,3 and eating patterns.4 Therefore, it is important to investigate
the relationships between brain health and nutrition behaviors in African
American/Black adults compared to other racial groups.
An AARP survey about nutrition behaviors and brain health included an
oversample of African American/Black adults age 40 and older (N=350).
Six in 10 (60%) African American/Black respondents reported their brain
health status as very good or excellent. This is similar to rates among Whites (64%) and Hispanics (56%).
h"ps://doi.org/10.26419/res.00187.003
African American adults with better overall health tended to have better self-reported brain health than their peers with lower overall health.
1 Moore et al., “Current Evidence Linking Nutrition with Brain Health in Ageing.” 2 McCabe-Sellers et al., “Assessment of the Diet Quality of US Adults in the Lower Mississippi Delta.” 3 Lucan et al., “Concepts of Healthy Diet Among Urban, Low-Income, African Americans.” 4 Li et al., “Racial Differences in Eating Patterns and Food Purchasing Behaviors among Urban Older Women.”
Mental well-being was assessed through a series of related questions that
were summed into a composite score, with possible scores ranging from
14 to 70.5 These questions asked respondents to report their frequency of
different feelings such as feeling optimistic, relaxed, and confident, among
others. In general, there is a positive association between better brain
health and higher mental well-being scores. Overall scores for African
American/Black respondents (52.2) were also similar to White (52.3) and
Hispanic (53.3) adults.
!2AARP Research © MARCH 2019 ALL RIGHTS RESERVED www.aarp.org/research
Health and Nutrition Behaviors
Just 41 percent of African American respondents self-reported their overall health to be very good or excellent. This is
noteworthy due to the connection between overall health and brain health: African American adults with better overall
health tended to have better self-reported brain health than their peers with lower overall health. This difference was
substantial, with 93 percent of those reporting excellent/very good overall health also reporting excellent/very good
brain health, compared to only 37 percent of those with lower overall health reporting excellent/very good brain health.
Survey respondents were asked about the frequency of engaging in different activities that contribute to a healthy
lifestyle, including eating nutritious and well-balanced meals; managing stress effectively in their lives; exercising;
socializing with family, friends or others; and feeling well rested. For this analysis, the criteria of a “healthy behavior”
required a frequency of “most or all the time (5-7 days per week).”
Ate nutritious andwell-balanced
meals
Managed stress effectively
Exercised Socialized with family,friends or others
Felt well-rested
56%55%58%54%55%
80%74%80%72%
80%
≥5 Days per Week ≤4 Days per Week
Healthy Behaviors and Better Brain Health Status (% Reporting Excellent/Very Good Brain Health)
5 NHS Health Scotland, University of Warwick, and University of Edinburgh, “Warwick-Edinburgh Mental Well-Being Scale (WEMWBS).”
African American/Black adults who reported eating nutritious and well-balanced meals most or all days of the week were more likely to report better brain health than their peers who did not.
!3AARP Research © MARCH 2019 ALL RIGHTS RESERVED www.aarp.org/research
African American/Black adults who reported eating nutritious and well-
balanced meals most or all days of the week were more likely to report
better brain health than their peers who did not (80% versus 55%). This
was true for the other healthy behaviors as well (see chart above).
Approximately one-third (35%) of African American/Black adults age 40
and older did not engage in any of the noted healthy behaviors five days
a week or more often. African American adults who reported meeting
three or more healthy behaviors were more likely to report excellent/very
good brain health (85%) than their peers reporting one to two healthy
behaviors (55%) or no healthy behaviors (47%) (see chart at right). This
suggests a correlation between engagement in healthy behaviors and
better self-reported brain health.
When compared to other races/ethnicities, African Americans were less
likely to eat nutritious and well-balanced meals most or all days of the
week than White respondents (26% versus 37%). A similar relationship
was found for socializing with family and friends between African
Americans and Whites (36% versus 44%). However, African Americans
were more likely to effectively manage their stress most or all days of the
week than Hispanic respondents (43% versus 32%). Additionally, a
significantly larger proportion of African American adults age 40 and
older did not meet any healthy behaviors (35%) compared to Whites
(26%) but similar to Hispanics (39%).
85%
55%
47%0
1 to 2
3+
Fruit Vegetables Dairy Protein Grains
Number of Healthy Behaviorsand Brain Health
(% Reporting Excellent/Very Good Brain Health)
1%6%
13%39%
45%
# of healthy behaviors
Food Group Recommendations
(% Meeting Recommendation)
MyPlate Recommendations
Fruit: 1.5 - 2 cups per day Vegetables: 2 - 3 cups per day
Dairy: 3 cups per day Protein: 5-6 cups per day Grains: 5-7 cups per day
*From: https://www.choosemyplate.gov (amount varies by age and gender)
Meeting Nutritional Guidelines
Meeting nutritional guidelines was low across all food groups for African
American adults age 40 and older. The US Department of Agriculture first
developed a nutritional tool called MyPlate in 2010 to assist individuals
with understanding dietary guidelines. MyPlate has since been updated
to reflect the 2015-2020 Dietary Guidelines for Americans.6 Fewer than
half of African American adults met MyPlate’s fruit (45%) and vegetable
(39%) guidelines, and even fewer met guidelines for dairy (13%), protein
(6%), and grains (1%). Within the African American sample, those who
met fruit guidelines were more likely to report very good or excellent
brain health than their peers who did not (66% versus 55%). This
suggests that meeting MyPlate nutritional recommendations may
contribute to better brain health among African American respondents.
6 UnitedStatesDepartmentofAgriculture,“ChooseMyPlate.Gov.”
!4AARP Research © MARCH 2019 ALL RIGHTS RESERVED
The overall patterns of meeting nutritional guidelines was similar for all race and ethnic groups with one exception.
Fewer African American/Black respondents met dairy guidelines than White respondents (13% versus 23%) and
Hispanic respondents (18%). Similar to their White and Hispanic counterparts, about 40 percent of African American
adults did not meet the nutritional guidelines in any food group, and only 11 percent met the guidelines in three or
more food groups.
Consumption of Specific Foods
www.aarp.org/research
7 GlobalCouncilonBrainHealth,“Brain-FoodGCBHRecommendaTonsonNourishingYourBrainHealth.”
Specific foods have been identified as healthy (i.e., fish/seafood, beans and legumes, olive oil, raw nuts, berries, etc.)
and less healthy (i.e., red meat, desserts, beverages with sugar, prepared foods, whole-fat dairy, etc.)7 More African
American adults age 40 and older reported eating fish or seafood at least once a week (57%) than reported eating red
meat (53%). Additionally, many consumed beans/legumes and olive oil at least once per week, but few consumed
these foods three or more times per week (see table below).
In a typical week, African Americans tended to consume fewer healthy foods such as beans, legumes, and olive oil
than other racial/ethnic groups, but they also reported lower consumption of red meat, dessert and prepared foods
relative to Whites.
Healthy Foods
% Who Consume at Least Once in a Typical Week
% Who Consume 3+ Days per Week
Less Healthy Foods
Any type of fish/seafood
57% 25%Beans and Legumes
43% 17%Olive Oil
40% 22%Raw Nuts
33% 19%Berries
27%15%
Red Meats
53% 23%Desserts
47% 24%Beverages with Sugar
48% 28%Prepared Foods
23% 8%
13%
15%
16%
19%
20%
22%
29%
30%
37%
38%Eating healthy would be too expensive
It is hard to eat a healthy diet
My family may not like the taste of healthy foods
I am not a “healthy foods types” of person
I do not know what foods are best to eat
I generally don’t have much of an appetite
I do not like the test of healthy foods
Changing my diet will not make that much of a difference
No stores nearby that sell healthy food
Issues, illness, or condition that make it difficult to eat
Barriers to Healthy Nutrition (% Agree)
!5AARP Research © MARCH 2019 ALL RIGHTS RESERVED www.aarp.org/research
Barriers to Healthy Nutrition and Behavior Change
Since healthy nutrition is positively related to brain health, it is important to consider why some people do not meet
nutritional guidelines. The top barriers to healthy nutrition cited by African American adults age 40 and older included
cost, the difficulty associated with healthy eating, the taste of healthy foods, and not being a “healthy foods type”
person (see chart above). The average number of reported barriers was similar between African Americans and other
races/ethnicities; however, frequencies of specific barriers differed. African Americans were more likely to report not
knowing what foods are best to eat and that there are no stores nearby that sell healthy foods as barriers than White
respondents were. There were no differences in specific barriers or total number of barriers reported based on income.
This could indicate that healthy eating is perceived as expensive and inaccessible to all, regardless of income, and
might be a promising point for education interventions.
Sugar-Sweetened Beverages
Almost 50 percent of African American adults age 40+ reported consumption of sugar-sweetened beverages in a typical week, and 28 percent consumed these
beverages three or more days per week. Consumption of beverages with
sugar was much higher in African Americans than Whites and Hispanics.
African American adults who did not consume sugar-sweetened beverages
were more likely to report excellent/very good brain health than those
that did (69% versus 55%).
!6AARP Research © MARCH 2019 ALL RIGHTS RESERVED www.aarp.org/research
Food Insecurity
There are also significant associations between all food insecurity
situations and brain health. Almost 60 percent of African American
respondents reported that they have been unable to afford the healthier
foods they would rather buy, and over 50 percent report they have run out
of money for food before the end of the month. Additionally, almost one in
four were often hungry because they cannot afford to buy food. Those
who have experienced food insecurity were less likely to report very good
or excellent brain health than their more food-secure peers. For example,
only 53 percent of respondents indicated that they have run out of money
for food before the end of the month reported a brain health status of very
good or excellent, compared to 74 percent of their peers who had not.
African American adults reported a higher likelihood for all food insecurity
situations than White adults, similar to Hispanic adults.
24%
30%
34%
42%
56%
58%
I have been unable to afford the healthier foods I would rather buy
Food Insecurity (% Ever Experienced)
African American respondents indicated being very likely to make healthier nutrition choices with awareness of positive health benefits for brain health and other health conditions.
I have run out of money for foodbefore the end of the month
I have had to choose betweenbuying food and paying bills
I have had to skip meals in orderto stretch my food budget
I have had to choose between buying food and buying medication
I am often hungry because Icannot afford to buy food
Nutrition Behavior Change
Since brain health is impacted by nutrition, interventions aimed at
changing eating behaviors may help improve nutrition and therefore brain
health. Fifty-eight percent (58%) of African American adults age 40 and
older reported that they would be more likely to change their diet if their
doctor told them to. Sixty-eight percent (68%) had confidence in their
abilities to eat a healthier, well-balanced diet knowing that it could help
them improve or maintain their brain health; however, only 62 percent
intended to make eating a healthy diet part of their regular routine.
Individuals who were confident in their abilities to eat a healthier, well-
balanced diet (70% versus 53%) and individuals who intended to make a
healthy, well-balanced diet part of their regular routine (69% versus 52%)
were more likely to report better brain health than their peers who were
not confident and did not intend to do this.
African American respondents indicated being very likely to make
healthier nutrition choices with awareness of positive health benefits for
brain health and other health conditions. Approximately 80 to 85 percent
of African American adults age 40 or older were willing to eat more fish/
seafood, limit red meat, and limit whole-fat dairy consumption to improve
or maintain their brain health.
!7AARP Research © MARCH 2019 ALL RIGHTS RESERVED www.aarp.org/research
Additionally, almost all were willing to eat a healthier diet to reduce the risk
of cognitive decline, heart disease, and diabetes (see chart at right).
African Americans were significantly more likely to indicate they would
make these healthier nutrition choices (i.e., eat more fish/seafood, less red
meat, less whole-fat dairy, a healthy diet) than White respondents.
Summary
Overall, the majority of African American adults age 40 and older
indicated very good or excellent brain health status, which was positively
associated with better overall health and mental well-being. Better brain
health was also associated with frequent participation in healthy
behaviors, meeting fruit guidelines, and not consuming sugar-sweetened
beverages. Across all income levels, the most commonly named barrier to
healthy nutrition for African American adults was economic, suggesting
there may be a perception of low value for the money in addition to cost-
prohibitive access. Regarding food security, African American older adults
were much less food secure than White older adults, but similar to
Hispanic older adults. Food insecurity was also associated with brain
health status; those experiencing situations of food insecurity were more
likely to report lower brain health than those who did not. Regardless of
barriers and food security, high levels of willingness for behavior change
were reported among African American adults. With awareness of
benefits for brain health and other health conditions, 80 to 90 percent of
respondents were willing to make positive nutrition behavior changes,
which was significantly higher than willingness in White respondents. This
suggests that educational interventions as well as interventions improving
health food access may improve nutrition and therefore brain health.
Behavior Change by Race/Ethnicity
(% Meeting Recommendation)
Eat more fish/seafood
Limit red meat
Limit whole- fat dairy
Cognitive decline
Heart Disease
Diabetes
African American/Black
Hispanic
White
“. . . to maintain or im
prove brain health”“E
at a healthy diet to reduce risk of . . .”
59%
85%
85%
55%
88%
80%
64%
84%
83%
85%
95%
97%
86%
95%
95%
86%
85%
93%
95%
85%
!8AARP Research © MARCH 2019 ALL RIGHTS RESERVED www.aarp.org/research
Methodology
Survey data presented in this brief were collected through an online, national survey of adults age 40 and older fielded
from October–November 2017. This study was completed as part of a series of surveys on brain health in adults
concerning multiple areas including exercise, mental well-being, sleep, social engagement, and cognitive activities in
addition to nutrition. For more information please see https://www.aarp.org/health/brain-health/global-council-on-brain-
health/resource-library/
This research brief was written by Kerri Vasold and Madeline Eller. The
original report was written by Laura Mehegan (lmehegan@aarp.org),
Chuck Ra inv i l l e (g ra inv i l l e@aarp .o rg) , and Laura Skufca
(lskufca@aarp.org).
Visual Production Credits
Page 1: iStock.com/IPGGutenbergUKLtd
Page 1: iStock.com/Tijana87
Page 5: iStock.com/fermate
Page 7: iStock.com/gorodenkoff
Recommended