Intakes of Lean Proteins and Processed Meats and Differences in Mental Health between Rural and Metro Adults 50 Years and Older
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Protocol
2.2. Statistical Analyses
3. Results
3.1. Descriptive Statistics
3.2. Comparisons between Those Residing in Rural versus Metro Counties
3.3. The Interaction between Days with Depression and Days with Anxiety on Mental Health Status
3.4. Associations between Dietary Intake with Depression or Anxiety
4. Discussion
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Age | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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50–55 Years | 56–61 Years | 62–64 Years | 65–70 Years | ≥71 Years | Missing or Prefer Not to Answer | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Rural | 165 (32.7%) | 151 (30.0%) | 103 (20.4%) | 53 (10.5%) | 31 (6.2%) | 1 (0.2%) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Metro | 32 (24.1%) | 34 (25.6%) | 18 (13.5%) | 21 (15.8%) | 28 (21.1%) | 0 (0.0%) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Sex | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Female | Male | Other | Missing or Prefer Not to Answer | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Rural | 265 (52.6%) | 232 (46.0%) | 6 (1.2%) | 1 (0.2%) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Metro | 82 (61.7%) | 50 (37.6%) | 0 (0.0%) | 1 (0.8%) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Race and Ethnicity | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
African American | American Indian/Alaska Native | Asian American/Pacific Islander | Hispanic | Non-Hispanic White | Other | Missing or Prefer Not to Answer | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Rural | 48 (9.5%) | 15 (3.0%) | 21 (4.2%) | 25 (5.0%) | 385 (76.4%) | 10 (2.0%) | 0 (0.0%) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Metro | 1 (0.8%) | 2 (1.5%) | 2 (1.5%) | 5 (3.8%) | 133 (88.0%) | 6 (4.5%) | 0 (0.0%) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Education | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Did Not Finish High School | High School Graduate | Some College | Associate’s Degree | Bachelor’s Degree | Some Graduate School | Post-Graduate Degree | Missing or Prefer Not to Answer | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Rural | 13 (2.6%) | 76 (15.1%) | 123 (24.4%) | 101 (20.0%) | 140 (27.8%) | 26 (5.2%) | 25 (5.0%) | 0 (0.0%) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Metro | 1 (0.8%) | 0 (7.5%) | 24 (18.0%) | 21 (15.8%) | 46 (34.6%) | 7 (5.3%) | 24 (18.0%) | 0 (0.0%) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Household Income | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
USD 0–24,999 | USD 25,000–49,999 | USD 50,000–74,999 | USD 75,000–99,999 | USD 100,000–149,999 | ≥USD 150,000 | Missing or Prefer Not to Answer | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Rural | 18 (3.6%) | 70 (13.9%) | 113 (22.4%) | 154 (30.6%) | 78 (15.5%) | 43 (8.5%) | 28 (5.6%) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Metro | 6 (4.5%) | 19 (14.3%) | 27 (20.3%) | 34 (25.6%) | 25 (18.8%) | 10 (7.5%) | 12 (9.0%) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Cohabitation | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Lives Alone | Lives with a Spouse or Partner | Lives with Other Persons | Missing or Prefer Not to Answer | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Rural | 105 (20.8%) | 384 (76.2%) | 15 (3.0%) | 0 (0.0%) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Metro | 35 (26.3%) | 95 (71.4%) | 3 (2.3%) | 0 (0.0%) |
Regarding Your MENTAL Health (Stress, Depression, Emotions, etc.) in the Past 30 Days, How Many Days Would You Consider Your Mental Health “Not Good?” | |||||||
---|---|---|---|---|---|---|---|
0–5 Days | 6–10 Days | 11–15 Days | 16–20 Days | 21–25 Days | 26–30 Days | Missing or Prefer Not to Answer | |
Rural | 292 (57.9%) | 111 (22.0%) | 71 (14.1%) | 19 (3.8%) | 11 (2.2%) | 0 (0.0%) | 0 (0.0%) |
Metro | 78 (58.6%) | 24 (18.0%) | 24 (18.0%) | 4 (3.8%) | 1 (0.8%) | 1 (0.8%) | 0 (0.0%) |
Regarding Your MENTAL Health, in the Past 30 Days, How Many Days Were You Unable to Perform Your Usual, Daily Activities (Self-Care, Work, Recreation, etc.)? | |||||||
0–5 Days | 6–10 Days | 11–15 Days | 16–20 Days | 21–25 Days | 26–30 Days | Missing or Prefer Not to Answer | |
Rural | 345 (68.5%) | 85 (16.9%) | 41 (8.1%) | 22 (4.4%) | 8 (1.6%) | 3 (0.6%) | 0 (0.0%) |
Metro | 107 (80.5%) | 17 (12.8%) | 4 (3.0%) | 3 (2.3%) | 0 (0.0%) | 2 (1.5%) | 0 (0.0%) |
In the Past 30 Days, for How Many Days Have you Felt SAD, BLUE, or DEPRESSED? | |||||||
0–5 Days | 6–10 Days | 11–15 Days | 16–20 Days | 21–25 Days | 26–30 Days | Missing or Prefer Not to Answer | |
Rural | 286 (56.7%) | 119 (23.6%) | 61 (12.1%) | 30 (6.0%) | 7 (1.4%) | 1 (0.2%) | 0 (0.0%) |
Metro | 83 (62.4%) | 27 (20.3%) | 16 (12.0%) | 4 (3.0%) | 2 (1.5%) | 1 (0.8%) | 0 (0.0%) |
In the Past 30 Days, for How Many Days Have You Felt WORRIED, TENSE, or ANXIOUS? | |||||||
0–5 Days | 6–10 Days | 11–15 Days | 16–20 Days | 21–25 Days | 26–30 Days | Missing or Prefer Not to Answer | |
Rural | 246 (48.8%) | 146 (29.0%) | 76 (15.1%) | 28 (5.6%) | 7 (1.4%) | 1 (0.2%) | 0 (0.0%) |
Metro | 77 (57.9%) | 30 (22.6%) | 16 (12.0%) | 4 (3.0%) | 3 (2.3%) | 3 (2.3%) | 0 (0.0%) |
How Often Do You Eat a Meal or Snack That Includes a Source of Lean Protein (Lean Meat, Poultry, Fish and Other Seafood, Eggs, Dairy, Soy and Other Beans, and Other Substitutes)? | ||||||||
---|---|---|---|---|---|---|---|---|
Never | Rarely | Less Than Once per Week | About Once per Week | Every Two or Three Days | Once per day | More Than Once per Day | Missing or Prefer Not to Answer | |
Rural | 1 (0.2%) | 7 (1.4%) | 5 (1.0%) | 44 (8.7%) | 158 (31.3%) | 166 (32.9%) | 123 (24.4%) | 0 (0.0%) |
Metro | 1 (0.8%) | 1 (0.8%) | 4 (3.0%) | 6 (4.5%) | 41 (30.8%) | 36 (27.1%) | 44 (33.1%) | 0 (0.0%) |
How Often Do You Eat a Meal or Snack That Includes a Processed Meat (Bacon, Sausage, Cold Cuts, Deli Meats, etc.)? | ||||||||
Never | Rarely | Less Than Once per Week | About Once per Week | Every Two or Three Days | Once per Day | More Than Once per Day | Missing or Prefer Not to Answer | |
Rural | 4 (0.8%) | 35 (6.9%) | 55 (10.9%) | 112 (22.2%) | 139 (27.6%) | 115 (22.8%) | 44 (8.7%) | 0 (0.0%) |
Metro | 4 (3.0%) | 12 (9.0%) | 25 (18.8%) | 23 (17.3%) | 44 (33.1%) | 20 (15.0%) | 5 (3.8%) | 0 (0.0%) |
How Often Do You Eat a Meal or Snack That Includes a Fruit? | ||||||||
Never | Rarely | Less Than Once per Week | About Once per Week | Every Two or Three Days | Once per Day | More Than Once per Day | Missing or Prefer Not to Answer | |
Rural | 2 (0.4%) | 15 (3.0%) | 34 (6.7%) | 36 (7.1%) | 115 (22.8%) | 190 (37.7%) | 112 (22.2%) | 0 (0.0%) |
Metro | 2 (1.5%) | 5 (3.8%) | 3 (2.3%) | 8 (6.0%) | 29 (21.8%) | 46 (34.6%) | 40 (30.1%) | 0 (0.0%) |
How Often Do You Eat a Meal or Snack That Includes a Vegetable? | ||||||||
Never | Rarely | Less Than Once per Week | About Once per Week | Every Two or Three Days | Once per Day | More Than Once per Day | Missing or Prefer Not to Answer | |
Rural | 2 (0.4%) | 7 (1.4%) | 13 (2.6%) | 45 (8.9%) | 101 (20.0%) | 175 (34.7%) | 161 (31.9%) | 0 (0.0%) |
Metro | 1 (0.8%) | 2 (1.5%) | 5 (3.8%) | 3 (2.3%) | 29 (21.8%) | 44 (33.1%) | 49 (36.8%) | 0 (0.0%) |
How Often Do You Eat a Meal or Snack That Includes a Leafy, Green Vegetable (Spinach, Kale, Lettuce, etc.)? | ||||||||
Never | Rarely | Less Than Once per Week | About Once per Week | Every Two or Three Days | Once per Day | More Than Once per Day | Missing or Prefer Not to Answer | |
Rural | 3 (0.6%) | 12 (2.4%) | 29 (5.8%) | 50 (9.9%) | 149 (29.6%) | 166 (32.9%) | 95 (18.8%) | 0 (0.0%) |
Metro | 3 (2.3%) | 4 (3.0%) | 6 (4.5%) | 9 (6.8%) | 52 (39.1%) | 37 (27.8%) | 2 (16.5%) | 0 (0.0%) |
How Often Do You Eat a Meal or Snack That Includes Nuts and Seeds? | ||||||||
Never | Rarely | Less Than Once per Week | About Once per Week | Every Two Or Three Days | Once per Day | More Than Once per Day | Missing or Prefer Not to Answer | |
Rural | 3 (0.6%) | 32 (6.3%) | 51 (10.1%) | 119 (23.6%) | 147 (29.2%) | 118 (23.4%) | 34 (6.7%) | 0 (0.0%) |
Metro | 3 (2.3%) | 14 (10.5%) | 9 (6.8%) | 23 (17.3%) | 34 (25.6%) | 35 (26.3%) | 15 (11.3%) | 0 (0.0%) |
How Often Do You Eat a Meal or Snack That Includes Beans (Kidney Beans, Chickpeas, Lentils, etc.)? | ||||||||
Never | Rarely | Less Than Once per Week | About Once per Week | Every Two or Three Days | Once per Day | More Than Once per Day | Missing or Prefer Not to Answer | |
Rural | 11 (2.2%) | 35 (6.9%) | 79 (15.7%) | 117 (23.2%) | 167 (33.1%) | 74 (14.7%) | 21 (4.2%) | 0 (0.0%) |
Metro | 4 (3.0%) | 22 (16.5%) | 21 (15.8%) | 33 (24.8%) | 35 (26.3%) | 17 (12.8%) | 1 (0.8%) | 0 (0.0%) |
Variable | Location | Median or Percentage | Interquartile Range (Min, Max) | Χ2 or U a (p) |
---|---|---|---|---|
Age (Ordinal) | Rural | 2.00 | 1.00–3.00 (1, 5) | 7.099 (p = 0.008) |
Metro | 3.00 | 2.00–3.00 (1, 5) | ||
Sex (Categorical) | Rural | 46.0% Male | - | −1.806 (p = 0.071) |
Metro | 37.6% Male | - | ||
Race and Ethnicity (Categorical) | Rural | 76.4% non-Hispanic white | - | 3.458 (p < 0.001) |
Metro | 88.0% non-Hispanic white | - | ||
Education (Ordinal) | Rural | 4.00 | 3.00–5.00 (1, 7) | 16.457 (p < 0.001) |
Metro | 5.00 | 3.00–5.00 (1, 7) | ||
Household Income (Ordinal) | Rural | 4.00 | 3.00–5.00 (1, 6) | 0.446 (p = 0.504) |
Metro | 4.00 | 3.00–5.00 (1, 6) | ||
Cohabitation (Categorical) | Rural | 20.8% Live alone | - | 1.357 (p = 0.175) |
Metro | 26.3% Live alone | - | ||
Number of “Not Good” Mental Health Days in the Last 30 Days (Ordinal) | Rural | 1.00 | 1.00–2.00 (1, 6) | 0.002 (p = 0.961) |
Metro | 1.00 | 1.00–2.00 (1, 6) | ||
Number of Days Unable to Perform Activities due to Poor Mental Health (Ordinal) | Rural | 1.00 | 1.00–2.00 (1, 6) | 6.781 (p = 0.009) |
Metro | 1.00 | 1.00–1.00 (1, 6) | ||
Number of Days with Depressive Symptoms in the Last 30 Days (Ordinal) | Rural | 1.00 | 1.00–2.00 (1, 6) | 1.161 (p = 0.281) |
Metro | 1.00 | 1.00–2.00 (1, 6) | ||
Number of Days with Anxiety Symptoms in the Last 30 Days (Ordinal) | Rural | 2.00 | 1.00–2.00 (1, 6) | 3.121 (p = 0.077) |
Metro | 1.00 | 1.00–2.00 (1, 6) | ||
Lean Protein Intake (Ordinal) | Rural | 6.00 | 5.00–6.00 (1, 7) | 3.660 (p = 0.056) |
Metro | 6.00 | 5.00–7.00 (1, 7) | ||
Processed Meat Intake (Ordinal) | Rural | 5.00 | 4.00–6.00 (1, 7) | 7.719 (p = 0.005) |
Metro | 5.00 | 3.00–5.00 (1, 7) | ||
Fruit Intake (Ordinal) | Rural | 6.00 | 5.00–6.00 (1, 7) | 3.153 (p = 0.076) |
Metro | 6.00 | 5.00–7.00 (1, 7) | ||
Vegetable Intake (Ordinal) | Rural | 6.00 | 5.00–7.00 (1, 7) | 0.931 (p = 0.335) |
Metro | 6.00 | 5.00–7.00 (1, 7) | ||
Leafy Green Intake (Ordinal) | Rural | 6.00 | 5.00–6.00 (1, 7) | 0.236 (p = 0.627) |
Metro | 5.00 | 5.00–6.00 (1, 7) | ||
Nuts and Seeds Intake (Ordinal) | Rural | 5.00 | 4.00–6.00 (1, 7) | 2.354 (p = 0.125) |
Metro | 5.00 | 4.00–6.00 (1, 7) | ||
Beans Intake (Ordinal) | Rural | 5.00 | 4.00–5.00 (1, 7) | 5.723 (p = 0.017) |
Metro | 4.00 | 3.00–5.00 (1, 7) |
Dietary Intake Variable | Univariate (n = 637) | Partially Adjusted Model Including Demographic Covariates (n = 589) a | Fully Adjusted Model Including Dietary Covariates (n = 589) b | |||
---|---|---|---|---|---|---|
β ± S.E. c | p | β ± S.E. | p | β ± S.E. | p | |
Lean protein intake | −0.189 ± 0.036 | <0.001 | −0.146 ± 0.037 | <0.001 | −0.117 ± 0.040 | 0.004 |
Processed meat intake | 0.043 ± 0.028 | 0.133 | −0.010 ± 0.030 | 0.741 | 0.016 ± 0.032 | 0.614 |
Fruit intake | −0.139 ± 0.030 | <0.001 | −0.093 ± 0.032 | 0.004 | −0.096 ± 0.038 | 0.011 |
Vegetable intake | −0.120 ± 0.036 | <0.001 | −0.055 ± 0.035 | 0.115 | −0.027 ± 0.044 | 0.536 |
Leafy green intake | 0.021 ± 0.031 | =0.512 | 0.039 ± 0.033 | 0.232 | 0.078 ± 0.041 | 0.059 |
Nut and seed intake | −0.021 ± 0.029 | =0.512 | −0.022 ± 0.030 | 0.461 | −0.003 ± 0.035 | 0.925 |
Bean intake | 0.058 ± 0.029 | <0.001 | 0.003 ± 0.031 | 0.920 | 0.014 ± 0.037 | 0.712 |
Dietary Intake Variable | Univariate (n = 637) | Partially Adjusted Model Including Demographic Covariates (n = 589) a | Fully Adjusted Model Including Dietary Covariates (n = 589) b | |||
---|---|---|---|---|---|---|
β ± S.E. c | p | β ± S.E. | p | β ± S.E. | p | |
Lean protein intake | −0.145 ± 0.037 | <0.001 | −0.108 ± 0.037 | 0.004 | −0.086 ± 0.040 | 0.031 |
Processed meat intake | 0.086 ± 0.029 | 0.003 | 0.044 ± 0.30 | 0.146 | 0.089 ± 0.040 | 0.005 |
Fruit intake | −0.157 ± 0.031 | <0.001 | −0.105 ± 0.032 | 0.001 | −0.095 ± 0.038 | 0.012 |
Vegetable intake | −0.138 ± 0.034 | <0.001 | −0.089 ± 0.035 | 0.011 | −0.051 ± 0.044 | 0.242 |
Leafy green intake | −0.012 ± 0.032 | 0.712 | −0.006 ± 0.033 | 0.853 | 0.068 ± 0.041 | 0.103 |
Nut and seed intake | −0.028 ± 0.30 | 0.356 | −0.022 ± 0.30 | 0.452 | 0.032 ± 0.035 | 0.929 |
Bean intake | −0.003 ± 0.030 | 0.916 | −0.070 ± 0.031 | 0.025 | −0.092 ± 0.037 | 0.013 |
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Johnson, N.R.; Stastny, S.N.; Garden-Robinson, J. Intakes of Lean Proteins and Processed Meats and Differences in Mental Health between Rural and Metro Adults 50 Years and Older. Nutrients 2024, 16, 3056. https://doi.org/10.3390/nu16183056
Johnson NR, Stastny SN, Garden-Robinson J. Intakes of Lean Proteins and Processed Meats and Differences in Mental Health between Rural and Metro Adults 50 Years and Older. Nutrients. 2024; 16(18):3056. https://doi.org/10.3390/nu16183056
Chicago/Turabian StyleJohnson, Nathaniel R., Sherri N. Stastny, and Julie Garden-Robinson. 2024. "Intakes of Lean Proteins and Processed Meats and Differences in Mental Health between Rural and Metro Adults 50 Years and Older" Nutrients 16, no. 18: 3056. https://doi.org/10.3390/nu16183056