8 This suggests that a high intake of fruits and vegetables may be beneﬁcial for maintaining optimal weight, and perhaps decreasing risk of chronic disease, even at very advanced age. However, additional, ideally longitudinal, research collecting more detailed food intake data is needed to support this contention. In addition, as social isolation, missing teeth, digestion diﬃculties, poor self-reported health, cost and preparation issues have been identiﬁed as barriers to fruit and vegetable intake in older adults [41–43], research is needed to determine if and to what degree these or other potential barriers may be inﬂuencing the intake of fruit, vegetables, and other low energy, high nutrient dense foods in the very old. Clinically deﬁned anemia was present in greater than 60% of the centenarians in the lowest BMI grouping. After controlling for demographic covariates, a strong association remained between low BMI and anemia but not with other health conditions and indicators. Accordingly, low BMI had been identiﬁed as an independent correlate or risk factor for anemia in some previous studies in older adults and clinical populations [44–46], but not in others [47]. Although older adults with a low BMI are considered to be at nutritional risk [47, 48], it cannot be assumed that the anemia observed in underweight older adults is primarily of dietary or nutritional etiology. Indeed, our previous studies indicate a similar prevalence of anemia in vitamin B12- deﬁcient and vitamin B12-adequate in Georgia centenarians [7] and a high prevalence of inﬂammatory anemia, either alone or in combination with nutritional deﬁciencies, in this population [49]. Nonetheless, as anemia is associated with increased mortality in acute and chronic disease states, particularly in those underweight [50, 51], it is important to monitor and treat this condition, as appropriate, in the very old. In summary, this secondary analysis provides evidence of an inverse association between fruit and vegetable intake and body weight status in a population-based study of centenarians. In addition, both underweight and overweight emerged as potential risk factors for various chronic diseases, emphasizing the importance of monitoring weight and of maintaining a healthy weight, even at very advanced ages. A major strength of the study is the inclusion of a population- based sampling of centenarians with greater diversity in race, place of residence, and functional status than would be typically obtained with a convenience sample. Limitations of the study include the relatively small sample size, lack of information regarding physical activity, and reliance on data of frequency of intake for only a few food groupings rather than the use of a more extensive food frequency questionnaire including individual foods and serving sizes as per our earlier convenience study of centenarians [23, 24]. Absence of intake data on key dietary components including grains/cereals and sweets/desserts necessitated the use a series of nonindependent binary logistic regression models instead of a more complex, single multinomial logistic regression to explore potential associations between BMI and dietary intake patterns. Thus, speciﬁcally designed studies including more detailed information of dietary intake, physical activity data, and additional chronic disease indicators are needed to Journal of Aging Research verify associations, or lack thereof, between dietary intake patterns, weight status, and chronic health conditions in the very old. Furthermore, as dietary habits and other characteristics of this sample from Georgia likely diﬀer from those of centenarians from other countries and cultures, our ﬁndings need replication in other population groups. Acknowledgments Authors acknowledge the valuable recruitment and data acquisition eﬀort from M. Burgess, K. Grier, E. McCarthy, L. Strong, and S. Reynolds, data acquisition team manager; S. Anderson, M. Janke, and T. Savla, data management; M. Poon for project ﬁscal management. A preliminary report of these data was presented at the Experimental Biology 2011 meeting, Washington, DC. The Georgia Centenarian Study (Leonard W. Poon, PI) is funded by 1P01-AG17553 from the National Institute on Aging. Additional investigators in the Georgia Centenarian Study include Jonathan Arnold (University of Georgia), Marla Gearing (Emory University School of Medicine), Robert C. Green (Boston University School of Medicine), S. Michal Jazwinski (Tulane University Health Sciences Center), Peter Martin (Iowa State Univer- sity), Maurice MacDonald (Iowa State University), William R. Markesbery (deceased), Willard L. Rodgers (University of Michigan), John L. Woodard (Wayne State University), Christopher Rott (University of Heidelberg), Ilene C. Siegler (Duke University), and J. Lisa Tenover (Palo Alto VA Health Care System). References [1] K. C. Neidert and B. Borner, Nutrition Care of the Older Adult: A Handbook for Dietetics Professionals Working throughout the Continum of Care, American Dietetic Association, 2nd edition. [2] K. Kitamura, K. Nakamura, T. Nishiwaki, K. Ueno, and M. Hasegawa, “Low body mass index and low serum albumin are predictive factors for short-term mortality in elderly Japanese requiring home care,” Tohoku Journal of Experimental Medicine, vol. 221, no. 1, pp. 29–34, 2010. [3] D. T. Villareal, C. M. Apovian, R. F. Kushner, and S. Klein, “Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society,” American Journal of Clinical Nutrition, vol. 82, no. 5, pp. 923–934, 2005. [4] D. K. Houston, B. J. Nicklas, and C. A. Zizza, “Weighty concerns: the growing prevalence of obesity among older adults,” Journal of the American Dietetic Association, vol. 109, no. 11, pp. 1886–1895, 2009. [5] M. Tjepkema, “Adult obesity,” Health Reports/Statistics Canada, vol. 17, no. 3, pp. 9–25, 2006. [6] M. A. Johnson, A. Davey, S. Park, D. B. Hausman, and L. W. Poon, “Age, race and season predict vitamin D status in African American and White centenarians and octogenarians,” Journal of Nutrition, Health and Aging, vol. 12, pp. 690–695, 2008. [7] M. A. Johnson, D. B. Hausman, A. Davey, L. W. Poon, R. H. Allen, and S. P. Stabler, “Vitamin B12 deﬁciency in African American and white octogenarians and centenarians in Georgia,” Journal of Nutrition, Health and Aging, vol. 14, no. 5, pp. 339–345, 2010.