In the United Kingdom (UK), the population of the very old (TVO) aged 85 and over has increased by 186% between 1981 and 2021(1). As life expectancy rises, ensuring optimal nutrition in TVO becomes essential to reduce the prevalence of chronic diseases(2).
The Newcastle 85+ study is a cohort of 793 participants which aimed to assess the spectrum of health in TVO(3). Dietary intake data were collected using two non-consecutive 24-hour dietary recalls. The study presented here aimed to characterise the dietary intake of TVO using the NOVA food classification system. Foods were classified into four NOVA categories: 1) unprocessed/minimally processed foods, 2) processed culinary ingredients, 3) processed foods, and 4) ultra-processed foods (UPF) and were categorised into tertiles based on percentage energy consumed as UPF. Macronutrient intakes between tertiles of UPF consumption were examined using Analysis of Variance.
The average daily total energy intake (TE) was 1681.8 kcal (SD = 512.8) and 26.3% of TE came from NOVA 1, 6.86% from NOVA 2, 15.2% from NOVA 3 and 51.7% from NOVA 4 (UPF). Among macronutrient contributions from UPF of TE, carbohydrates contributed 57.3% (SD = 10.2), protein contributed 12.5% (SD = 3.4), and fat contributed to 32.0% (SD = 8.9). The average fibre intake from UPF was 48.6% of the mean total fibre intake (SD = 3.5).
Significant differences in macronutrient intake were shown across tertiles of UPF intake of TE. Energy intake declined across tertiles but did not reach statistical significance (p = 0.081), with means of 1730.1 kcal, 1684.2 kcal, and 1630.9 kcal in the 1st, 2nd, and 3rd tertiles, respectively. Carbohydrate intake as percentage of TE was significantly higher in the highest UPF tertile (50.2%) compared to the lowest (45.6%, p < 0.001). Conversely, protein contribution to TE showed the greatest decline across tertiles (14.8%, p < 0.001). Similarly, fat intake decreased significantly across tertiles (36%, p < 0.05). Fibre intake was significantly lower in the highest tertile when expressed as grams per day (p < 0.05).
Foods from the UPF group which contributed the highest amount of percentage TE from carbohydrates, was white bread (17.4%), wholemeal bread (11.5%), and breakfast cereals (9.7%). Protein sources included white bread (13.3%), bacon and ham (11.3%), and wholemeal bread (10.7%), while fat intake was dominated by fat spreads (10.3%), sweet biscuits (7.6%), and pies and pastries (7.2%).
These findings show the potential reliance on UPF as sources of dietary energy and fibre to the diet of 85 year olds. These outcomes reflect a distinct dietary profile compared to cohorts of adults aged 18 and over.