Eating alone linked to angina, poorer nutrition in older women
Click Here to Manage Email Alerts
Older women who primarily ate alone were more likely to have angina and worse nutrition than those who ate with others, according to a South Korean study published in the journal Menopause.
“Traditionally, eating with others has been the norm in South Korea due to its strong collective culture,” Han-Gyo Choi, PhD, RN, of the Catholic University of Korea’s College of Nursing in Seoul, and colleagues wrote. “However, a growing number of people are eating alone due to increased numbers of nuclear families and single-person households.”
Social distancing during the COVID-19 pandemic and food delivery services have only added to this, the researchers said.
Previously, eating alone was found to negatively affect mental and physical health, so the researchers aimed to establish how eating alone is related to CVD and nutrition.
Choi and colleagues analyzed data from 590 menopausal women aged 65 years or older who self-reported sociodemographic characteristics, health behavior characteristics, nutritional status and incidence of CVD and risk factors in the 2016 Korean National Health and Nutrition Examination Survey VII-1.
Of women who ate more than two meals a day alone (EA), 79.7% were widowed, and 81.1% of women who ate more than two meals a day with others (EO) lived with their spouses. The EA group had a significantly lower monthly average household income than the EO group ($1,597.10 vs. $2,253.56; P = .011).
Women in the EO group were more aware of nutrition labels than those in the EA group (43.3% vs. 29.5%; P = .012). They also more often used nutrition labels (8.5% vs. 3.8%; P = .014) and said nutrition labels affected their food choices (7% vs. 1.7%; P = .016). Smoking, perceived stress, alcohol consumption and aerobic activity did not significantly differ between the two groups.
The EO group had a significantly higher energy intake than the EA group, consuming 1,472.52 kcal, whereas the EA group only consumed 1,357.67 kcal (P = .018). They also had higher intakes of carbohydrates (264.15 g vs. 243.48 g; P = .012), dietary fiber (21.23 g vs. 18.91 g; P = .027), sodium (2,647 mg vs. 2,329.73 mg; P = .025) and potassium (2,521.1 mg vs. 2,213.58 mg; P = .013).
The researchers also found that the incidence rate of angina was 2.58 times higher (95% CI, 1.2-5.55) in the EA group after adjusting for age, income, marital status, aerobic activity and awareness, and the use and impact of nutrition labels.
The study’s limitations included its cross-sectional design, the researchers’ reliance on self-reported data and potential confounding factors may not have been accounted for in the analysis, Choi and colleagues wrote. They recommended a prospective study to investigate the relationship between eating alone and CVD risk.
“Results of this study demonstrated the importance of an eating companion in older women, which might be useful for establishing health care and welfare policies to consider nutrition education and cardiovascular disease screening for older women who mainly eat alone,” the researchers wrote.
Perspective
Back to Top
Stephanie S. Faubion, MD, MBA, FACP, NCMP, IF
A recent cross-sectional study involving the Korean National Health and Nutrition Examination Survey VII-1 data from 2016 investigated the health behaviors, nutrition status and the likelihood of having cardiovascular diseases in 590 older (≥ 65 years) menopausal women according to whether they ate alone (defined as eating more than two meals per day alone) or ate with others. Results showed that women who ate alone were less aware of nutrition labels, less aware of the impact of nutrition labels and less likely to use nutrition labels than those who ate with others. Older women who ate alone also had lower intake of energy (kcal), carbohydrate and fiber, and were 2.58 times more likely to have angina than their peers who ate with others.
Although it is unclear what the mechanistic link between eating alone and symptomatic heart disease may be, prior studies have described ties between eating alone and depression. Depression, in turn, has been associated with physiologic changes, including nervous system activation, systemic inflammation and hypercoagulability. In addition to poorer nutritional intake, older women who ate alone were more likely to be widowed and to have lower incomes. These results are not surprising given that lower socioeconomic status and social isolation contribute to lower quality of life, greater rates of depression and poorer health. It is likely that eating alone is a proxy for social isolation which, as we have learned during the COVID-19 pandemic, places individuals at increased risk for both mental and physical health issues. Given that women live longer than men do, finding ways for older women who are socially isolated to engage and create meaningful social ties may not only improve their nutrition but also their overall health. Understanding the impact of social isolation from a broader perspective, including health and welfare considerations as well as the economic impact related to increased health care expenditures, is needed to address this important issue.
Collapse
Read more about
Click Here to Manage Email Alerts