Objective: To obtain insight into dietary habits of elderly people and how these habits have evolved from middle to old age.
Design: Cross-sectional study of dietary patterns around 1990; retrospective cohort study of changes in dietary intake since middle age.
Setting: Five cohorts: East and West Finland, Zutphen (Netherlands), Crevalcore (Italy), and Montegiorgo (Italy).
Subjects: Men aged 70-90 years around 1990.
Methods: Food intake was estimated using a cross-check dietary history adjusted to the local situation.
Results: (i) Cross-sectional: Significant differences were observed between the countries for all food groups, energy and nutrients (P < 0.05). The Finnish diet was characterised by a high consumption of animal products and potatoes, the Italian diet by a high consumption of cereals, vegetables, fruits and alcohol. The Dutch diet was generally intermediate. (ii) Longitudinal: The decrease in energy intake since middle age varied from 4.2 MJ/day in the Finnish cohorts to 2.1 MJ/day in Italy. Also the consumption of most food groups decreased but the consumption of vegetables and fruits increased. Saturated fatty acid intake decreased by 3 E% in the Finnish cohorts and decreased by < 1 E% in Italy. Alcohol intake decreased by approximately 7 E% in Italy while it increased by 2.5 E% in the Netherlands.
Conclusions: Although the general patterns of dietary intake of the different cultures still can be recognised at old age, the variation between them has become smaller. Compared to their dietary intake at middle age, however, the dietary pattern of the Finnish and Dutch cohorts has changed slightly in the direction of a healthy diet, while the diet of the Italian men remained Mediterranean, and thus more healthy, at old age.