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LETTER TO THE EDITOR |
Department of Social and Behavioral Health, Program on Aging and Health Promotion School of Rural Public Health Texas A&M Health Science Center College Station, TX E-mail: jrsharkey{at}srph.tamhsc.edu
Dear Dr. Noelker:
Dr. Ettinger raises important questions about the influence of oral health and swallowing on food intake. In my article on food insufficiency, I focused on the potential influence of an individual's economic context on healthful eating. Although I intentionally did not include other factors that may also influence food choice (e.g., oral health, difficulty opening packages or containers, transportation, proximity of food stores and food service places, or other physical or cognitive limitations), I have recognized the importance of oral health in prior published work on dietary intake in this population (Sharkey et al., 2002). In that article, my colleagues and I found that self-reported diminished sense of taste was associated with lower dietary intake in energy, protein, phosphorus, thiamin, and riboflavin. However, in bivariate and multiple regression models, difficulty chewing, swallowing, or use or fit of dentures was not associated with dietary intake outcomes. These prior findings may well suggest that older individuals develop dietary strategies to cope with dental problems.
The point of the article in question, which was based on a proposed economic context model, was not about dietary intake, but about whether homebound older adults with diabetes were at greater risk for heightened food insufficiency over 1 year, despite regular receipt of home-delivered meals. Future work will include other factors that influence food choice and dietary intake, such as those raised by Dr. Ettinger. At that time, the overall conceptual model will be broadened to include oral health as well as environmental factors.
Sincerely,
References
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