Frequency of Fruit and Vegetable Intake, Modification and Avoidance Behaviours Linked to Chewing Difficulty Among Community-Dwelling Elderly in a Peri-Urban Area in Nigeria

Abstract

Introduction: Older adults are at risk of inadequate dietary intake due
to factors like chewing difficulty.
Objective: This study was conducted to assess the prevalence of
chewing difficulty among the community-living elderly in Nigeria in
relation to their fruit and vegetable intake, modification and
avoidance behaviours.
Methods: This descriptive cross-sectional study comprised of a
random sample of 264 community-dwelling elderly aged ≥ 60 years living in Lagelu local government
area, Ibadan. A semi-structured interviewer administered questionnaire was used to elicit
information from the respondents about their socio-demographic characteristics, oral health
characteristics, chewing ability, fruit and vegetable consumption, food modification and avoidance.
General Linear Model (GLM) Univariate was used to assess mean difference in fruit and vegetable
intake after modification, adjusting for age and also monthly earnings in respondents with chewing
difficulty at 5% level of significance. Linear regression model was used to predict factors influencing
fruit and vegetable intake.
Results: The mean age of the respondents was 70.5 ±9.0 years, predominantly female (64.4%). Fruit
and vegetable intake among all respondents was about 61.05±18.05 times per week. Prevalence of
chewing difficulty was 42.8% and about 33.0% reported one or more missing teeth. Among
respondents with chewing difficulty, 64.6% avoided one or more fruits/vegetables while only 25.7%
modified one or more fruits/vegetables. Those avoiding many foods (≥ 3) and those not modifying
any fruit/vegetable were more likely to have lower intake of fruits and vegetables than those that
avoided lesser (0-2) or modified fruits/vegetables respectively (p<0.001). After adjusting for age,
green-leafy vegetables had no association with modification (p=0.978). Linear regression model
showed that fruit/vegetable modification had more impact on fruit and vegetable intake than food
avoidance.
Conclusion: Fruit and vegetable intake was significantly higher among respondents without chewing
difficulty compared to those with chewing difficulty. A high prevalence of food avoidance and low
prevalence of food modification among the respondents having chewing difficulty was also observed.
These behaviors have contrasting relationships with fruit and vegetable consumption with
modification having the comparably better influence. Hence, with improvement in food modification
behaviors, there is potential to improve consumption of fruits and vegetables among the elderly.