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Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA 94143-0560
2To whom correspondence should be addressed.
The number and proportion of older U.S. adults who live alone have
increased dramatically in the past three decades, and there is concern
that these individuals may have particularly poor dietary quality. We
examined the association of four living arrangements (living with a
spouse only, with a spouse plus someone else, with someone other than a
spouse or living alone) with dietary quality (the number of low
nutrients out of a possible 15, with low defined as <67% of the
recommended dietary allowance) among 6525 U.S. adults aged 50–64 y and
those 
65 y in the third National Health and Nutrition Examination
Survey (NHANES III 1988–1994). Among non-Hispanic Caucasian
adults, those who lived with a spouse only had better dietary quality,
with significant differences ranging from 0.8 to 1.5 fewer low
nutrients compared with those with other living arrangements. Effects
of living arrangements on dietary quality were also seen among
non-Hispanic African-Americans, Mexican-Americans, and those of
"other" races, but differences were significant only for
African-American men aged >65 y living with a spouse plus others
(1.6 additional low nutrients compared with those living with a spouse
only). Energy intake was strongly associated with dietary quality, but
did not account for the associations between living arrangements and
dietary quality. Although middle-aged and older adults with living
arrangements other than living with a spouse only (including those
living alone) tended to have poorer dietary quality, the effects varied
substantially across age, gender and ethnic categories.
KEY WORDS: • older adults • living arrangements • dietary quality • nutrient intake • NHANES III
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