The aim of the present work was to evaluate the associations of bio-clinical, dietary, and other lifestyle characteristics with the prevalence of hypertriglyceridemia among older individuals living in the Mediterranean islands. Information was collected for an extensive array of demographic, bio-clinical, and dietary characteristics, including serum lipids, body weight and height, and food group and nutrient information derived from a food frequency questionnaire. Serum lipid analyses showed that 37% and 35% of males and females, respectively, had elevated triglyceride (TG) levels. After adjustment for a variety of potential confounders, including age, gender, hypertension, physical activity, smoking, and energy consumption, individuals with type 2 diabetes (T2D) had a 112% higher likelihood of hypertriglyceridemia (95% CI 1.28-3.51). When reported energy intake was quantified in tertiles of consumption, those in the highest tertile (i.e., intakes > 1300 kcal) had a 156% higher (p < 0.01) likelihood of having hypertriglyceridemia compared to the lowest tertile (i.e., <1000 kcal). Analysis by gender showed that energy intake did not predict hypertriglyceridemia in females (p = 0.31) or in those who were normal weight (p = 0.16) or overweight (p = 0.96). However, in males (odds ratio per 1 kcal = 1.001, 95% CI 1.000-1.002) and obese participants (odds ratio per 1 kcal = 1.001, 95% CI 1.000-1.002), excess energy consumption was associated with elevated TG. In conclusion, we found that a considerable proportion of the older adults living in the Mediterranean islands and participating in this study had elevated TG levels. Furthermore, the energy intake and a finding of T2D were positively associated with occurrence of hypertriglyceridemia.
The aim of the present work was to evaluate the repeatability and the validity of a short food frequency questionnaire (FFQ) that could be used for older people living in Mediterranean areas. The semi-quantitative FFQ included questions regarding the frequency of consumption of the main food groups and beverages typically consumed in the Mediterranean areas as well as some questions regarding eating habits of older persons. During 2006-2007, for the repeatability assessment (within 10-30 days), 150 individuals (51 +/- 17 yrs, 40% males) were studied, while another 190 individuals (74 +/- 9 yrs, 52% males) were enrolled for the validation purposes. Agreement of the FFQ with the 3-day food records was evaluated using the Bland-Altman method and the Kendall's tau-b coefficient. Repeatability was tested using the Cohen's kappa coefficient. Between 3-day food records and the FFQ, good agreement for alcohol (tau-b = 0.64, p < 0.001) was found, while moderate agreement for food and beverage groups of greens (tau-b = 0.32, p < 0.001), fruits (tau-b = 0.35, p < 0.001), cereals (tau-b = 0.61, p < 0.001), sweets (tau-b = 0.51, p < 0.001), and coffee (tau-b = 0.58, p < 0.001) was observed. Low, but still significant, agreement for fish (tau-b = 0.21, p = 0.001), legumes (tau-b = 0.23, p < 0.001), vegetables (tau-b = 0.23, p < 0.001), pasta (tau-b = 0.25, p < 0.001), potatoes (tau-b = 0.17, p = 0.006) and meat consumption (tau-b = 0.14, p < 0.001) were also found. The FFQ was also valid regarding the estimation of macronutrients and energy intake. Sensitivity analyses by sex, age category ( 75 yrs), and education status showed similar validity of the FFQ in each subgroup, except for elders older than 75 years. The repeatability of the FFQ was fair in all foods tested (Cohen's kappa coefficients varied between 0.15-0.39, p-values < 0.05). The suggested FFQ seems to be a reasonably valid and repeatable measure of dietary intake and can be used in older persons living in the Mediterranean areas.
The persistence of hunger and its growing impact on suffering in the world isdisheartening. As seen in Figure1, for the first time in human history, the number of people living with chronic hunger ...
Low-income older adults are at increased risk of cutting back on basic needs, including food and medication. This study examined the relationship between food insecurity and cost-related medication non-adherence (CRN) in low-income Georgian older adults. The study sample includes new Older Americans Act Nutrition Program participants and waitlisted people assessed by a self-administered mail survey (N = 1000, mean age 75.0 + so - 9.1 years, 68.4% women, 25.8% African American). About 49.7% of participants were food insecure, while 44.4% reported practicing CRN. Those who were food insecure and/or who practiced CRN were more likely to be African American, low-income, younger, less educated, and to report poorer self-reported health status. Food insecure participants were 2.9 (95% CI 2.2, 4.0) times more likely to practice CRN behaviors than their counterparts after controlling for potential confounders. Improving food security is important inorder to promote adherence to recommended prescription regimens.
Congregate meal sites were funded to assist socioeconomically disadvantaged, rural older individuals in improving their health-related practices. Although the participants in the program are largely female, the meals are designed to meet one third of the daily caloric intake of a 70-year-old male, and to satisfy his recommended dietary allowances for total fat, fiber, calcium, and sodium. The actual percentage of the required nutrient intake contributed by meals served at congregate sites is indefinite. Moreover, the ability of congregate meal participants to manage their diets and their receptiveness to helpful nutrition information in that regard is unknown. Our objective was to promote nutritional knowledge in economically disadvantaged, rural older participants by studying its impact on their ability to benefit from congregate meal programs. We used a test, intervention, retest methodology to examine the effect of short-term nutrition interventions on congregate meal site participants' nutrition knowledge. The objective was to determine the participants' potential for managing their own diets (e.g., their ability to determine what diet behaviors are appropriate for specific chronic conditions). We found that while congregate meal site participants have knowledge of nutrition recommendations, their ability to apply this information in helping themselves to prevent or control their chronic conditions remains in question.
It's a popular question. On the morning shows, on the Web, and in newspapers and magazines, the “latest findings” on health promoting diets or ingredients are reported and explained (and sometimes ...
Older adults frequently report use of vitamin and mineral (VM) supplements, although the impact of supplements on dietary adequacy remains largely unknown. The purpose of the current study was to evaluate micronutrient intakes of older adults with emphasis on identifying nutrients most improved by VM supplements, nutrients most likely to remain inadequate, and nutrients most likely consumed in excess. Community-based volunteers were recruited from senior centers and completed a questionnaire querying demographic data, current health status, and VM supplement use. Participants (n = 263) were then contacted by telephone to complete two 24-hour diet recalls and confirm VM supplement use. Dietary adequacy was determined by comparing the ratio of mean dietary intake to the Dietary Reference Intakes (DRI). Dietary consumption was lowest for vitamins D and E, calcium, and magnesium. VM supplementation most improved intakes of vitamins E, D, B(6), folic acid, and calcium. Participants were most likely to exceed the Tolerable Upper Limit with supplementation of niacin, folic acid, and vitamin A.
In 2009, scientists Elizabeth Blackburn, Carol Greider, and Jack Szostak won the Nobel Prize in Physiology and Medicine for their work on telomeres. These scientists discovered how the chromosomes are copied during cell division and also how they are protected against degradation. In fact, new research supports the role of nutrition in the protection of telomeres. Per Jennings et al. (1), certain nutrients may modulate oxidative damage, telomere shortening, and cell senescence, playing an important role affecting aging and longevity. Recently, Xu et al. (2) showed that in women taking a multivitamin or supplements of vitamins C and E the length of telomeres was affected.
The purpose of this study was to determine whether institutionalized older individuals taking proton pump inhibitors (PPI) for more than 12 months were more likely to have vitamin B12 deficiency than individuals not taking PPI, and whether cyanocobalamin nasal spray would improve their vitamin B12 status. Participants were long-term care residents aged 60–89 years. PPI users (n = 17) were treated with cyanocobalamin nasal spray for 8 weeks; non-PPI users (n = 19) were not treated but were followed for the same time duration. Serum samples from all subjects were analyzed for vitamin B12 and serum methylmalonic acid (sMMA) at baseline and the end of the 8-week treatment. There was a significant difference in mean vitamin B12, sMMA, and frequency of deficiency between control and intervention groups at baseline. After treatment, there was an increase (p = 0.012) in serum vitamin B12 concentration, and a decrease (p = 0.004) in frequency of deficiency in PPI users. Thus, we found that institutionalized older individuals on PPI for more than 12 months may be more likely to be vitamin B12 deficient than non-PPI users. Additionally, treatment of PPI users with cyanocobalamin nasal spray for 8 weeks could improve vitamin B12 status.
The aim of this study was to define the factors associated with the presence or risk of malnutrition in older adults (>65 years of age) attending health care centers in Lleida, Catalonia, using a cross-sectional study approach. Nutritional parameters assessed included the Mini Nutritional Assessment Scale, sociodemographic and psychosocial factors, functional and cognitive status, swallowing and oral problems, texture and route of administration of the diet, changes in dietary intake, and presence of digestive disorders. A total of 398 individuals (184 men) with an average age of 77 years were included in the assessment. Poor nutritional status was recorded in 58% of the individuals. Factors independently associated with unsatisfactory nutritional status included weight loss, functional dependence, cognitive impairment, loneliness, living without a partner, history of heart disease, lung disease, and the presence of acute vomiting.
The Nutrition Screening Initiative DETERMINE Checklist (NSI) is used throughout the United States to assess nutrition risk of those requesting the services of the Older Americans Act Nutrition Program (OAANP). This study examined the ability of the NSI to evaluate nutrition risk by comparing the responses between NSI and matched comparable survey questions using the self-administered mail survey data that were collected among 924 new OAANP applicants in Georgia (mean age 75.0 ± 9.2 years, 68.8% women, 26.1% Black). Ninety-four percent of our sample provided at least one discordant response (i.e., disagreement between responses to the NSI and matched questions). Questions regarding food intake most frequently yielded discordant responses. Black participants were more likely to provide discordant responses for the meal frequency question. Food insecure individuals were less likely to provide discordant responses for food intake questions. Those who lived alone were less likely to provide discordant responses for the dairy intake question. Some NSI items may have limited ability to reliably assess nutritional risk of older adults. Further efforts are warranted to improve nutritional assessment tools for use in vulnerable older adults.
Food insecurity and hunger are real and growing problems in the United States. Among older adults, the prevalence of food insecurity is at a 14-year high and occurred in more than 8% of households with older adults in 2008 according to USDA. However, the rate is at least 10% higher when less severe degrees of food insecurity are considered. Emerging research suggests that several segments of the older adult population are particularly vulnerable to food insecurity, including those receiving or requesting congregate meals, home-delivered meals, and other community-based services. Thus, national and state estimates of food insecurity may obscure problems in specific subgroups of older adults. Older adults are at high risk of chronic health problems that can be exacerbated by food insecurity, poor nutritional status, and low physical activity. To help improve targeting of food and nutrition programs to those most in need because of food insecurity and/or nutrition-related chronic health problems, the purposes of this review are (1) to define the prevalence and consequences of food insecurity; (2) to discuss the outcomes of some food, nutrition, disease prevention, and health promotion programs targeted to older adults in Georgia, the state with the 3rd highest prevalence of food insecurity; and (3) to make recommendations for research, service, and advocacy related to monitoring and alleviating food insecurity and related health problems in older adults.
The purpose of this study was to explore the relationship of obesity and physical limitations with food insecurity among Georgians participating in the Older Americans Act (OAA) congregate meal-site program (N = 621, median age = 76 years, 83% female, 36% Black, and 64% White, convenience sample). Food insecurity was assessed using the modified 6-item US Household Food Security Survey Module; obesity was defined as Body Mass Index (BMI) or waist circumference (WC) class I or II obesity; and physical limitations (arthritis, joint pain, poor physical function, weight-related disability) were based on the Disablement Process. A series of multivariate logistic regression models found weight-related disability and obesity (WC class II) may be potential risk factors for food insecurity. Thus, obesity and weight-related disability may be risk factors to consider when assessing the risk of food insecurity and the need for food assistance in this vulnerable subgroup of older adults.
The majority of older adults take nutritional supplements (NS) to prevent deficiencies and/or because they are interested in the potential health promoting effects of these nutrients. This review explores the evidence of benefit for supplements of multivitamin/minerals (MVM), antioxidant nutrients, and vitamin D/calcium. Major conclusions include the following: While recommendations that older adults take a daily MVM are common, there is limited scientific support for the health-related efficacy of these supplements. In contrast, a number of antioxidant nutrients have been extensively studied. The evidence does not support a recommendation for vitamins A, C, E, or antioxidant combinations in the prevention of CVD or cancer. Based on encouraging preliminary findings, more study is recommended on the benefit of antioxidant supplements for age-related macular degeneration and of selenium for cancer prevention. In contrast to the state of the art for antioxidant supplements, there is strong and compelling support for the health benefits of supplements of Vitamin D and calcium when intake/status of these nutrients is not optimal. Thus, specific recommendations for these supplements in older adults are warranted.
The aim of this study was to determine if (1) participation in Home-Delivered Meals (HDM) results in improved dietary patterns and nutrient intake, lower food insecurity, and reduced loss of weight; (2) subgroups of older persons are more likely to benefit; and (3) nutritional indicators of impact other than nutrient intake may be useful. The design used was quasi-experimental, with longitudinal assessment of individuals on HDM at baseline (before receipt of services), 6, and 12 months, and comparison to non-randomized group receiving other services. Outcomes included measured weight and height, 24-hour dietary recall, and food insecurity. Paired t test, multiple linear regression, and selection models using multiple logistic regression were performed. All older persons in three New York State counties referred for aging services over a 5-month period were asked to participate (n = 456), and 212 agreed (171 on HDM). At 6 months, the sample size was 101 (34 discharged, 42 hospital/died/moved, 26 chose not to continue), and at 12 months it was 68 (similar reasons). After receiving meals for 6 and 12 months, participants showed greater improvement in most dietary intake variables than either a non-HDM comparison group or HDM participants who ate no HDM meal on the day of assessment. Compared to initial values, participants improved significantly in some variables for dietary patterns, nutrient intake, and nutrient density, and were less likely to be food insecure. Furthermore, HDM was more likely to impact those living alone and those with poorer initial status. This study provides strong evidence that HDM has a positive impact on the nutritional well-being of older persons. Food insecurity and dietary patterns are useful nutritional indicators of impact.
" Journal of Nutrition for the Elderly Becomes the Journal of Nutrition in Gerontology and Geriatrics ." Journal of Nutrition For the Elderly, 29(4), pp. 345–346
While there is growing recognition of the complexity of required medical and personal decision making at the end of life, the interpretation of how nutrition support and hydration should be managed...
