Magnesium status and association with diabetes in the Taiwanese elderly

The average dietary intake of magnesium is below recommended dietary allowances in many affluent Western countries. Prolonged low magnesium intake tends to result in hypomagnesaemia which might increase the risk of chronic diseases in elderly people. A national population-based cross-sectional nutrition survey, the Elderly Nutrition and Health Survey in Taiwan (1999-2000), was used to investigate the magnesium status and association with diabetes in the Taiwanese elderly. Dietary magnesium intake was based on 24-hour dietary recalls. Blood biochemical parameters including plasma magnesium and blood glucose were also measured. Average magnesium intake was 250 mg in men and 216 mg in women, which is equivalent to 68-70% of relevant Taiwanese Dietary Reference Intakes. The mean plasma magnesium concentration was 0.903 mmol/L in men and 0.906 mmol/L in women. The prevalence of a plasma magnesium level of <0.7 mmol/L was 0.7-0.9% in the elderly, and that of <0.8 mmol/L was 8.0-9.1%. Elderly vegans had a significantly lower magnesium intake than ovo-lacto vegetarians and non-vegetarians. Diabetic men and women had significantly higher blood glucose levels than non-diabetics. The risk of diabetes was elevated 3.25 times at plasma magnesium levels<0.863 mmol/L. There was an inverse association between plasma magnesium concentration and the prevalence of diabetes. However, no association was found between diabetes and low dietary magnesium. Taiwanese elderly persons had suboptimal levels of dietary magnesium intake, which although may be sufficient to avoid overt magnesium deficiency, may not be sufficient to reduce the risk of diabetes in the elderly. Further prospective study is required to help explain the differential results between dietary and plasma magnesium levels.     

Association of B vitamins status and homocysteine levels in elderly Taiwanese

To investigate the relationship between homocysteine (Hcy) and B vitamins status in the Taiwanese elderly population, an analysis was made of the plasma Hcy levels in elderly persons. The study sample was taken from the Elderly Nutrition and Health Survey in Taiwan (1999-2000) (Elderly NAHSIT) and included 1094 males and 1135 females aged 65-90 years. The results showed that average plasma Hcy was 13.3+/-0.6 micromol/ L for males and 10.6+/-0.7 micromol/L for females. The average plasma Hcy levels of males from all age groups were significantly higher than those of females, and significantly increased with age (P<0.0001). The overall prevalence of hyperhomocysteinemia (Hcy>15 micromol/L) was 23.4% for elderly males and 11.2% for elderly females, and this also increased with age (P<0.0001). In subjects with normal renal function, folate, vitamin B2, B6, and B12 status were significantly lower in males with hyperhomocysteinemia, while only folate and vitamin B12 were significantly lower in females with hyperhomocysteinemia. Further analysis suggested that folate, vitamin B6 or B12 insufficiency were associated with hyperhomocysteinemia in both sexes, while vitamin B2 insufficiency was significantly associated only in males. In elderly persons with adequate folate, vitamin B6, and B12 status, there was no significant association between vitamin B2 and hyperhomocysteinemia. This association occurred only in those who had concurrent poor folate, vitamin B6, or B12 status. The strength of the association between vitamin B12 insufficiency and hyperhomocysteinemia was not affected by simultaneous vitamin B2 or B6 insufficiency, but increased about 3-fold when combined with folate. This suggests that poor folate and vitamin B12 status has a synergistic effect on the risk of hyperhomocysteinema in the elderly, as did a poor folate and vitamin B6 status. Therefore, maintaining adequate vitamin B12 status and avoiding multiple B vitamin insufficiency, especially that of folate and vitamin B12 or B6, should be emphasized as an important measure for reducing plasma Hcy levels among elderly Taiwanese.     

Plasma retinol and tocopherol levels in Greek elderly population from an urban and a rural area: Associations with the dietary habits

Data on plasma concentrations of retinol and -tocopherol in elderly (over 65 years) living in the Mediterranean countries are sparse. In the current study, plasma retinol and -tocopherol concentrations were determined in 200 healthy subjects (82 men and 112 women) residing in an urban and in a rural area in South Western Greece. High prevalence of low plasma retinol concentration was observed for both sexes in each area. The 16.7% of males in urban and 25.4% in rural area had plasma retinol levels below 0.3 mg/l. The corresponding values for female subjects were 26% and 20.3%. Plasma -tocopherol was found to be within normal range in the rural area (only one male had plasma -tocopherol below 5 mg/l) while in the urban area 68.3% of men and 62% of women had plasma -tocopherol values below 5 mg/l. Differences in dietary habits between subjects living in the rural and in the urban area were revealed through a weekly food frequency questionnaire. This could partly explain the difference in -tocopherol concentrations between the two areas. The results of this study revealed high risk of vitamin A and E deficiency and suggests that the health care system in Greece should pay more attention on the social and health status of its elderly population.     

Association between dietary folate-rich food intake and folate status of elderly Taiwanese

To investigate the relationship between folate status and dietary folate intake in the Taiwanese elderly, we analyzed plasma folate levels and dietary folate intake in 725 males and 705 females aged 65-90 years, sampled from the Elderly Nutrition and Health Survey in Taiwan (1999-2000) (Elderly NAHSIT). Results showed that the mean plasma folate levels were 22.9+/-1.4 nmol/L (10.1+/-0.6 ng/ml) for males and 29.5+/-1.6 nmol/L (13.0+/-0.7 ng/ml) for females. The average plasma folate concentrations of males from all age groups were significantly lower than those of females (P<0.0001). None of the study subjects had a plasma folate below 7 nmol/L (3 ng/ml). However, 18.6% of males and 12.1% of females had marginal folate deficiency, with plasma folate between 7-14 nmol/L (3-6 ng/ml). This suggests that elderly males have a poorer folate status than elderly females in the Taiwanese population. The percentage of marginal folate deficiency tended to increase with age among females (P trend=0.0137). The average estimated folate intakes were 379+/-18 microg/d in males and 351+/-27 microg/d in females. However, 45.5% of males and 48.8% of females had a dietary folate intake below 2/3 of the RDA of 400 microg/d. Our results indicated that dietary folate intake is positively correlated with plasma folate levels (r=0.10, P<0.05). In addition, dietary folate intake increased with increased intakes of vegetables, mushrooms and fruit. A lower intake of fruit appeared to be responsible for the higher prevalence of marginal folate deficiency among females over the age of 80 years.     

Iron status of the Taiwanese elderly: the prevalence of iron deficiency and elevated iron stores

Iron status, prevalence of iron deficiency and elevated iron stores, and the effect of gastrointestinal ulceration on iron status in free-living Taiwanese elderly persons were all assessed in a nationally representative, cross-sectional nutrition survey--the Elderly NAHSIT. The survey included blood measurements of iron indices. Data were collected from 1202 elderly men and 1152 elderly women aged 65 years and older. Multiple iron measures, including serum ferritin (SF), transferrin saturation (Tsat), and hemoglobin were used to evaluate the prevalence of iron deficient erythropoiesis (ID) and iron deficiency anemia (IDA). Despite no routine practice of iron fortification in Taiwan, elderly subjects had a low prevalence of ID and IDA. The prevalence of ID was 2.3% in men and 1.4% in women. The prevalence of IDA was 2.5% in men and 2.0% in women. In contrast, 15.7% of men and 9.8% of women had elevated iron stores as diagnosed by SF>300 microg/L. Subjects with a history of gastrointestinal ulceration had significantly lower serum ferritin than those without ulcers, but the prevalence of anemia, ID and IDA was unaffected. In conclusion, elderly people in Taiwan are an iron-replete population with a high prevalence of elevated iron stores and a low prevalence of iron deficiency.     

Nutritional status in elderly population in kibbutzim

This study was conducted in order to assess the nutritional status of thiamin, riboflavin, pyridoxine, carotene, retinol, ascorbic acid, plasma iron, hemoglobin and plasma albumin of the elderly living in two cooperative farms (Kibbutzim), in Israel. Blood samples from elderly subjects aged 60 to 85 (33 women, 26 men), were collected for analysis. Thiamin, riboflavin and pyridoxine status were assessed by using enzymatic activation coefficient. Transketolase was used for determining thiamin status, glutathione reductase for determining riboflavin status and glutamate oxaloacetate transaminase for pyridoxine status. Transketolase activation coefficient ranged from 1.05-1.59 with a mean 1.18 and SEM 0.02, glutathione reductase coefficient ranged from 1.08-1.50 with a mean 1.25 and SEM 0.07 and glutamate oxaloacetate transaminase activation coefficient ranged from 1.71-2.15 with a mean 1.83 and SEM 0.06. Deficient levels were found in the following: Leucocyte ascorbic acid 5% of the population, hemoglobin 18%, plasma iron 20%, carotene 32% and plasma retinol 20%, thiamin 14% and riboflavin 32%. No deficient state was found in pyridoxine.     

Association between folate status,diabetes, antihypertensive medication and age-related cataracts in elderly Taiwanese

Objective  

To evaluate possible risk factors for cataract in elderly Taiwanese, and to investigate whether the relationship between age and cataract in older persons is modified by other cataract-associated risk factors.     

Nutritional status and oxidative stress in an elderly Sardinian population

Weight loss and overweight/obesity-frequent consequences of malnutrition-may impair functional status and worsen concomitant morbidities in the elderly, often through changes in oxidative balance. In order to verify the relationships between these factors, a group of elderly people living on the island of Sardinia (Italy) underwent health and nutritional status assessment and oxidative balance evaluation. The elderly subjects had significantly higher d-ROMs test and body mass index (BMI) values than controls (d-ROMs 325.4 ± 66.3 vs. 295.4 vs 58-9 CARR U, p = 0.006; BMI 28.0 ± 4.6 vs. 21.7 ± 1.4 kg/m², p < 0.0001). The risk of malnutrition in the elderly subjects was evaluated with the Mini Nutritional Assessment (MNA), which showed that 32 of the 111 elderly subjects (28.8%) were at risk of malnutrition, of whom 11 (34%) were overweight and 10 (31-2%) obese. Oxidative stress was negatively and significantly correlated with nutritional status. Oxidative stress may precede malnutrition, even in the absence of weight loss. Routine evaluation of nutritional status and oxidative balance in the elderly may help identify an early risk of malnutrition so that treatment can be personalized.     

农村老年人行为习惯及营养状况影响因素分析

目的 探讨农村老年人群营养卫生状况及影响因素。方法 采用整群抽样法在安徽省某县农村地区抽取2个行政村,实足年龄在60岁～常住老年人,采用自编调查表进行问卷调查。结果 营养初筛量表评分为(6.194±4.139)分。农村老年人营养卫生良好469人(21.2%)、中度危险597人(27.0%)、营养卫生不良1146人(51.8%)。自评营养卫生状况与营养初筛量表得分明显相关(Spearman相关系数r_s为0.359,P<0.0001)。多因素有序结果的累积比数Logistic回归分析显示,年龄较高(OR=0.71)、起居困难较重(OR=0.30)、参加娱乐活动(OR=0.81)、睡眠良好(OR=0.55)、经济来源本人或配偶(OR=0.79)、社会支持较好(OR=0.97)为保护因素;而文化程度较高(OR=1.48)、子女外出务工(OR=1.51)孤独感较重(OR=1.04)为危险因素。结论 农村老年人群营养卫生状况不容乐观,且受多种因素影响,应大力加强营养健康教育,从而顺利实现健康老龄化进程。     

Vitamin status, immunity and infections in an elderly population

The relations between vitamin status and immunological parameters or number of infections have been investigated in self-sufficient healthy individuals aged 60 and over. A total of 411 subjects agreed to participate, but 202 were discarded from the main statistical analysis since they could have had their immune or nutritional status modified by a recent infection, vaccination or drug consumption. Plasma concentrations of retinol, alpha-tocopherol, ascorbic acid and vitamin B6 were determined. Three indices of cellular immunity were measured: percentages of T-cell subsets, lymphoproliferative response to phytohaemaglutinin and delayed-type hypersensitivity to 7 ubiquitous antigens. A questionnaire about past infections was presented. Two results, supported by previous experimental observations, should be underlined. Vitamin B6 status was positively related to percentages of T-cell subsets: the lowest percentages of CD5 and CD4 cells were observed in the low B6 status group (50.6 and 32.6 per cent) and the highest percentages in the high B6 status group (62.0 and 41.0 per cent), with intermediate values in the medium group (57.6 and 39.5 per cent). Vitamin E status was negatively related to the number of past infections: subjects with a high alpha-tocopherol plasma concentration had fewer infections during the last 3 years (1.0) than those with a medium (2.2) or a low (2.3) concentration. In spite of these two observations, cellular immunity did not seem to be strongly related to vitamin status in the supposedly healthy population studied.     

Anthropometric measures and nutritional status in a healthy elderly population

Background  

Anthropometric evaluation is an essential feature of geriatric nutritional evaluation for determining malnutrition, being overweight, obesity, muscular mass loss, fat mass gain and adipose tissue redistribution. Anthropometric indicators are used to evaluate the prognosis of chronic and acute diseases, and to guide medical intervention in the elderly. We evaluated anthropometric measurements and nutritional status as they relate to age and gender in healthy elderly people.     

Effects of vitamin D in the elderly population: current status and perspectives

Besides its well-known effect on bone metabolism, recent researches suggest that vitamin D may also play a role in the muscular, immune, endocrine, and central nervous systems. Double-blind RCTs support vitamin D supplementation at a dose of 800 IU per day for the prevention of falls and fractures in the senior population. Ecological, case–control and cohort studies have suggested that high vitamin D levels were associated with a reduced risk of autoimmune diseases, type 2 diabetes, cardio-vascular diseases and cancer but large clinical trials are lacking today to provide solid evidence of a vitamin D benefit beyond bone health. At last, the optimal dose, route of administration, dosing interval and duration of vitamin D supplementation at a specific target dose beyond the prevention of vitamin D deficiency need to be further investigated.     

Homebound status in a community-dwelling elderly population in Japan

The present study investigated the association between sociodemoraphic profiles, health condition and functional disabilities of subjects with a homebound status in a rural community setting. The subjects were residents aged 65 years or over in a mountain village of Japan. A comprehensive questionnaire was used to obtain their data. Among the 1,002 residents, the information of 866 residents (85%), who voluntarily completed the entire survey, was obtained for this study. All the subjects were native Japanese. Of the 866 subjects investigated, 301 (34.8%) were homebound as defined by the parameters of this study. Univariate analysis revealed age, female gender, functional impairment (vision, hearing and memory), all the ADL impairments, and the use of a portable toilet were associated with homebound status. Multivariate analysis revealed that older age, female gender, visual and two ADL impairments (moving inside the home and bathing) and use of a portable toilet remained significantly related to homebound status. Homebound elderly people have more functional limitation and disability related factor than their nonhomebound counterparts. Functional impairment, particularly in the mobility domain and sensory disturbances, was associated with homebound status. These data indicate the importance of assessment in the provision of home care for elderly people.     

Plasma retinol and total carotenes and fracture risk after long-term supplementation with high doses of retinol

ObjectiveObservational studies suggest that moderate intakes of retinol and increased circulating retinol levels may increase fracture risk. Easy access to supplements, combined with an aging population, makes this a potentially important association. The aim of this study was to investigate plasma retinol and total carotene concentrations in relation to fracture risk after long-term supplementation with retinol and/or beta-carotene in 998 adults between 1990 and 2007.MethodsParticipants were 663 men and 335 women in a cancer prevention program who were initially randomized to a retinol (7.5 mg RE/d) or beta-carotene (30 mg/d) supplement between 1990 and 1996. After 1996, all participants received the retinol supplement only. Plasma retinol and total carotene, medication use and various lifestyle factors were measured at annual clinic visits. Fractures were identified by self-report in 2007. The risk for any fracture or osteoporotic fracture was modeled using Cox proportional hazard models.ResultsOver a median follow-up of 7.8 y, 123 participants with plasma samples reported an incident fracture. Although plasma retinol concentrations were markedly higher than those reported in observational studies, no association was observed between plasma retinol and risk for any fracture (hazard ratio [HR], 0.86 μmol/L; 95% confidence interval [CI], 0.65–1.14) or osteoporotic fracture (HR, 0.97 μmol/L; 95% CI, 0.66–1.43). A lower risk for any fracture was suggested with increasing plasma total carotenes (HR, 0.85 μmol/L; 95% CI, 0.71–1.01).ConclusionsThis study does not support earlier reports of an increased fracture risk associated with increased plasma retinol concentration. The potential for carotenes to prevent fractures deserves further investigation.     

Social relationships and allostatic load in Taiwanese elderly and near elderly

Despite the increasing evidence linking aspects of the social environment to a range of health outcomes, important questions remain concerning the precise mechanisms or pathways through which social circumstances exert their influence. Biological pathways are one important area of current research interest. Using data from the Social Environment and Biomarkers of Aging Study (SEBAS) in Taiwan, we examined relationships between social environment characteristics and an index of cumulative biological dysregulation ("allostatic load," AL) in near elderly (NE) (aged 54-70) and elderly Taiwanese (aged 71+). Longitudinal data on levels of social integration and extent of social support were used to predict cumulative AL at the final survey year. Linear regression analyses revealed that among the NE, presence of a spouse between 1996 and 2000 was associated with lower AL in 2000 among men, but not women. Among the elderly, ties with close friends and/or neighbors were found to be significantly related to lower AL for both men and women. Perceived qualities of these social relationships did not show consistent associations with AL. This relatively modest set of significant relationships stands in contrast to somewhat stronger patterns of findings from studies in Western societies. Cross-cultural differences between Western societies and an East Asian society such as Taiwan raise the intriguing possibility that contextual, normative influences on social experience affect the patterns of association between features of these social worlds and the physiological substrates of health.     

Plasma lutein and zeaxanthin and the risk of age-related nuclear cataract among the elderly Finnish population

Oxidative stress plays an important role in cataractogenesis. Previous studies have shown that long-term dietary intake of antioxidants (lutein and zeaxanthin) may decrease the risk of age-related cataracts. The aim of the present study was to examine whether plasma concentrations of lutein and zeaxanthin are related to age-related nuclear cataract in the elderly population. Subjects were participants in the Kuopio Ischaemic Heart Disease Risk Factor Study and they were classified into tertiles according to plasma concentrations of lutein and zeaxanthin. The association of plasma lutein and zeaxanthin concentrations with age-related nuclear cataract in 1689 elderly subjects (aged 61-80 years) was investigated in the present cross-sectional study by using the Cox proportional hazards model. A total of 113 cases of incident age-related cataracts were confirmed, of which 108 cases were nuclear cataracts. After adjustment for age, examination year, sex, BMI, smoking, alcohol consumption, serum LDL-cholesterol, serum HDL-cholesterol, years of education, use of oral corticosteroids, history of diabetes and history of hypertension with current use of antihypertensive medication, subjects in the highest tertiles of plasma concentrations of lutein and zeaxanthin had 42 and 41 % lower risks of nuclear cataract, respectively, compared with those in the lowest tertiles (relative risk (RR) = 0·58, 95 % CI 0·35, 0·98; P = 0·041 for lutein and RR = 0·59, 95 % CI 0·35, 0·99; P = 0·046 for zeaxanthin). In conclusion, we suggest that high plasma concentrations of lutein and zeaxanthin were associated with a decreased risk of age-related nuclear cataract in the elderly population.     

The impact of socioeconomic status on the incidence of metabolic syndrome in a Taiwanese health screening population

Objectives

The purpose of this study was to estimate the incidence of metabolic syndrome (MS) in a 5-year follow-up adult population in Taiwan who were examined at the Major Health Screening Center, and to assess possible socioeconomic determinants of the syndrome in this sample.

Methods

The longitudinal study included 9,389 adults, aged 35?C74?years, who visited the Major Health Screening Center from 1998?C2002, and were followed up for 5?years.

Results

The 5-year cumulative incidence of MS in this sample was 11.37%, and the weighted incidence was 12.46%; 14.95% for men and 9.89% for women, respectively. After adjustment for behavioral and habits, family history, gender and age, education level was associated with the incidence of MS. With middle school and lower as a baseline, the incidence of MS for high school, junior college, and college and above was OR 0.80, 95% CI 0.64?C1.00; OR 0.80, 95% CI 0.62?C1.03 and OR 0.65, 95% CI 0.50?C0.83, respectively.

Conclusions

The standardized cumulative incidence of MS was 12.46%. Lower education level was an important socioeconomic determinant of MS in women.     

Vitamin C status and nutrient interactions in a healthy elderly population

Vitamin C status and interactions with other nutrients were studied in 677 healthy, noninstitutionalized elderly people aged 60-98 y. Although 6% of the males and 3% of the females showed marginal vitamin C status (plasma ascorbic acid 11 to less than 23 mumol/L), only one person had a plasma ascorbic acid (AA) level less than 11 mumol/L. At all levels of total vitamin C intake, mean plasma AA levels were higher in females than males. Vitamin C supplement use was associated with generally higher blood levels of vitamins B-6, B-12, and E and folate in both sexes and with higher levels of retinol in females. However, after both age and the total dietary intake of the specific nutrient being examined were controlled for, plasma AA levels were significantly correlated only with plasma levels of vitamin E and folate in females.