• Aasha I Hoogland, Charles E Hoogland, Shoshana H Bardach, Yelena N Tarasenko, and Nancy E Schoenberg.
• From the Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, the Department of Psychology, University of South Florida, Tampa, the Sanders Brown Center on Aging, Graduate Center for Gerontology, University of Kentucky, Lexington, the Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, and the Department of Behavioral Science, University of Kentucky, Lexington.
• South. Med. J. 2019 Aug 1; 112 (8): 444-449.

ObjectivesTo better understand the disproportionate burdens from cancer, cardiovascular disease, diabetes mellitus, stroke, and other chronic conditions related to energy balance, we studied diet and physical activity patterns in younger and older adults in rural Appalachia by using a nonclinical, cross-sectional, community-based sampling approach.MethodsA total of 651 younger (ages 18-59) and 254 older (ages ≥60) Appalachians were recruited from 43 churches or community organizations. Participants answered questions about fruit and vegetable intake and physical activity. Analyses were adjusted for clustering within churches.ResultsCompared with older Appalachians, younger Appalachians consumed significantly fewer fruits and vegetables (P = 0.01) and reported significantly more moderate-to-vigorous physical activity (P = 0.01). Regardless of age, engagement in healthy behaviors was suboptimal and well below national averages.ConclusionsThis community-based sample demonstrated elevated behavioral risk factors that likely contribute to some of the nation's highest rates of premature mortality. Despite suboptimal dietary intake and physical activity, results indicate some potential leverage points between the generations that may be used to improve health. For example, the older generation could benefit from engaging with their younger relatives in physical activities while advocating for a better-rounded diet. Given traditions of intergenerational connectedness, mutual aid, and self-reliance, transmission of healthier behaviors across the generations may be beneficial in the rural Appalachian context.

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