Association Between Dietary Variety and Masticatory Behaviors Measured Using Wearable Device Among Community-Dwelling Older Adults in Japan: A Multilevel Meal-by-Meal Analysis

Abstract

Background: Consuming a variety of foods is believed to promote thorough chewing; however, it remains unclear whether individuals who consume various foods actually chew them thoroughly. Therefore, this study aimed to examine the association between dietary variety and masticatory behaviors, measured using wearable devices, among community-dwelling older adults. Methods: Participants were from the Itabashi Longitudinal Study of Aging, meeting the eligibility criteria, including the ability to exchange messages via smartphone or computer. Masticatory behaviors (number of chews, chewing duration, and speed) and meal photo data were objectively measured using an ear-worn bite sensor and its application for two or three meals per day for at least three days at home. The “modified Dietary Variety Score (m-DVS)” (range 0–10, with higher values indicating greater dietary variety) was calculated by registered dietitians. Generalized linear mixed models assessed the association between m-DVS as the exposure variable and masticatory behaviors as the outcome variable. Covariates included sociodemographic status, health behavior, health status, oral health, and oral function. Results: Five hundred and eighty-seven mealtime data entries from 63 participants were included in the analysis. The m-DVS was significantly positively associated with the number of chews (cycles, unstandardized regression coefficient = 116.5, 95% confidence interval [CI] = 85.2 to 147.8) and chewing duration (min, unstandardized regression coefficient = 1.7, 95% CI = 1.3 to 2.2). Conclusions: Consuming more varied food groups was associated with more chews and longer chewing duration among community-dwelling older adults, potentially promoting thorough chewing.