The Role of Older Adults in 2- and 3-Generation Households: Implications for Diet Quality and Household Food Security

ABSTRACT

Food insecurity rates have declined overall (pre-COVID), but have increased significantly among older adults in the past decade. The majority of older adults in the U.S. also have suboptimal diet quality. An older adult's household role may influence their diet quality and the household's food security status, especially in mixed-generation households, but this hypothesis has yet to be tested.To explore the relationships between an older adult's household role, the household's food security status, and the older adult's diet quality in mixed-generation households.A cross-sectional analysis of a nationally-representative sample of U.S. households with at least 1 older adult (age 60+ years) from the 2011-2016 NHANES was conducted (n = 8,136). Households were categorized as older adult as head of household and child caregiver (ie, child(ren) present, but no adults 18-59 years, HHC), head of household, but not a caregiver (HHNC), and neither head of household nor caregiver (ie, reference person < 60 years, NHNC). The U.S. Household Food Security Survey and Healthy Eating Index-2015 (HEI-2015) from a single dietary recall were used to assess food security status and diet quality, respectively.Weighted chi-square and ANOVA tests were used to compare food security status and HEI-2015 scores across household categories, respectively.HHNC households were significantly more likely to be fully food secure (84% FFS, P < 0.001) than HHC households (67% FFS) and NHNC households (68% FFS). Older adults as HHNC had significantly higher HEI-2015 scores (mean 53.7, P < 0.001) than HHC older adults (50.2) and NHNC older adults (51.5).Findings suggest that caregiving demands may have a negative influence on food security and diet quality of older adults in mixed generation households. While such relationships have potential bearing on nutrition programming and policy, further research is needed to understand the underlying household dynamics, including more advanced analyses to account for potential covariates (eg, the number and age of children and roles of other household members).