Original articleLifestyle and dietary correlates of dispositional optimism in men: The Zutphen Elderly Study
Introduction
An individual's level of dispositional optimism—defined in terms of generalized positive outcome expectancies, life engagement, and a future orientation—is related to physical well-being and to lower cardiovascular disease (CVD) morbidity [1], [2] and mortality [3], [4]. The mechanism through which dispositional optimism appears to prevent CVD is still unclear, but may be partially mediated through prudent lifestyle and dietary behavior. It is well established that a low body mass index (BMI), moderate alcohol use, physical activity, and nonsmoking are associated with a lower risk of CVD mortality [5], [6], [7], [8]. In addition, dietary patterns rich in fruits and vegetables [9], [10], fiber and wholegrain cereals [10], [11], and fatty fish and fish fatty acids [12], [13], and low in saturated and trans fatty acids [14], [15] have convincingly been associated with reduced risks of CVD morbidity and mortality. Cocoa intake may also protect against CVD [16]. Especially for older subjects, it is important to adopt healthy lifestyle and dietary behaviors that reduce these risks in order to increase life expectancy [7], [8]. Studies have indicated that the combined effects of lifestyle and dietary factors yield the largest protective effects; for example, a low risk pattern of lifestyle and dietary factors was associated with a 60% lower relative risk of all-cause mortality [6].
Few studies (particularly in older subjects) have related positive psychological factors to dietary and lifestyle factors. A cross-sectional study among 8690 Finnish adults aged 31 years old found that optimism was positively associated with eating more fresh vegetables, salads, berries, fruit, foods rich in fiber, and low-fat cheese and milk [17]. Optimism was inversely associated with current smoking. In women, optimism was positively associated with fish intake, while men with a heavy alcohol intake were less optimistic than other men. Because dietary intake was assessed through postal questionnaires concerning the previous 6 months, this may have reduced accuracy and may also have introduced bias. In another cross-sectional study among 128 elderly subjects (aged 65–80 years old), dispositional optimism was related to nonsmoking, moderate alcohol consumption, brisk walking, and vigorous physical activities (in older women only) [18]. Dietary factors, however, were not assessed.
The Zutphen Elderly Study, in which data were collected at four time points with 5-year intervals, provided the opportunity to assess longitudinally the potential lifestyle and dietary correlates of dispositional optimism in community-dwelling, elderly men. We hypothesized that one's level of optimism was related to healthy lifestyle (i.e., physical activity, smoking, and alcohol consumption) and dietary behaviors. We focused on the consumption of fruit, vegetables, fiber, saturated fat, trans fatty acid, and fish fatty acids, which are part of dietary guidelines [7], [8]. We adjusted for sociodemographic factors, such as age, education, living arrangement, self-rated health, and morbidity, that are known correlates of dispositional optimism [3], [19], [20] and because lifestyle and dietary factors may be confounded by health status (especially at old age).
Section snippets
Study population
The Zutphen Elderly Study is an extension of the Zutphen Study that was initiated in 1960, in which 555 men were still alive in 1985. The Zutphen Study started as the Dutch contribution to the Seven Countries Study on lifestyle, biological risk factors, and CVD in middle-aged men in Finland, Italy, Greece, the former Yugoslavia, Japan, the United States, and the Netherlands. In 1985, an additional random sample of 711 men of the same age also living in Zutphen but not belonging to the original
Results
Table 1 shows sociodemographic, lifestyle, and dietary factors at baseline and after 5, 10, and 15 years of follow-up. At baseline, the 773 men were on average 72.1 (S.D. 5.2) years old (range 64 to 84). The mean dispositional optimism score statistically significantly decreased over 15 years of time. The proportion of men living alone and having CVD (of borderline statistical significance), diabetes mellitus, and cancer increased, while the proportion of men feeling healthy and the number of
Discussion
This population-based, prospective study shows that optimism is positively associated with health-promoting behavior in elderly men. Men with a relatively high level of dispositional optimism were physically more active, avoiding smoking more often, using alcohol more often, and having more healthful diets (dietary patterns richer in fruit, vegetables, fiber, and fatty fish) than men with lower levels of optimism. Low optimism may be an underlying predisposing factor to explain why unhealthy
Acknowledgments
We thank Dr. H.C. Boshuizen, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands, for her assistance in the statistical analyses. The Zutphen Elderly Study was funded by the Netherlands Prevention Foundation and the National Institute of Aging, Bethesda, MD, USA.
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