Adequacy of Nutrient Intake Among Elderly Persons Receiving Home Care

ABSTRACT

This study examines the adequacy of the dietary intake based on age, sex, and level of nutritional risk among 98 frail elderly persons receiving home care through Community Care Access Centres. The dietary intakes were measured using 24-hour recalls and were compared with the dietary reference intake. The participants' intakes of both macronutrients and micronutrients were found to be inadequate. On average, elderly persons were consuming more than the recommended amount of protein, but the average intakes of many vitamins and minerals were less than optimal based on the average intakes. Paradoxically, more than half of elderly participants were overweight or obese. The results highlight the need for appropriate nutrition, education, and support for elderly persons receiving home care.     

Physical Activity and Fruit and Vegetable Intake Among American Indians

The American Indian population has among the highest rates of obesity in the United States. Thus, it is critical to understand factors related to this epidemic (e.g., physical activity, nutrition) among this ethnic minority population. The current study examined factors related to engaging in at least 4 days of physical activity (PA) per week and factors related to consuming at least 5 fruits and vegetables (FV) per day among a sample of American Indians in the Midwest. We used multiple methods to recruit participants for this study, including recruitment at pow wows, focus groups, health fairs, new student orientation for American Indian students, and other venues. A total of 998 American Indians (76% participation rate) completed a survey assessing sociodemographics, physical activity level, fruit and vegetable intake, and perceptions regarding the recommendations for physical activity and fruit and vegetable intake. Factors associated with exercising ≥4 days in the past week (44.77% of the sample) include being younger (P = .002), being male (P < .001), having at least some college education (P = .048), eating ≥5 FV per day, and higher perceived number of days of PA recommended (P < .001). Factors associated with eating ≥5 servings of FV per day (37.01% of the sample) included exercising ≥4 days in the past week (P < .001) and higher perceived number of servings of FV recommended (P < .001). These findings highlight the importance of education in enhancing engagement in positive weight control behaviors and the importance of addressing both physical activity and nutrition among the American Indian population.     

Peer Reviewed: A Diabetes Self-Management Program Designed for Urban American Indians

Background

Although the American Indian population has a disproportionately high rate of type 2 diabetes, little has been written about culturally sensitive self-management programs in this population.

Context

Community and clinic partners worked together to identify barriers to diabetes self-management and to provide activities and services as part of a holistic approach to diabetes self-management, called the Full Circle Diabetes Program.

Methods

The program activities and services addressed 4 components of holistic health: body, spirit, mind, and emotion. Seven types of activities or services were available to help participants improve diabetes self-management; these included exercise classes, educational classes, and talking circles.

Consequences

Ninety-eight percent of program enrollees participated in at least 1 activity, and two-thirds participated in 2 or more activities. Program participation resulted in a significant improvement in knowledge of resources for managing diabetes.

Interpretation

The Full Circle Diabetes Program developed and implemented culturally relevant resources and supports for diabetes self-management in an American Indian population. Lessons learned included that a holistic approach to diabetes self-management, community participation, and stakeholder partnerships are needed for a successful program.     

杨浦区中老年妇女预防骨质疏松及营养摄入状况调查

迄今为止 ,骨质疏松仍缺乏理想的治疗方法 ,积极的预防则显得尤为重要。合理饮食、补充足够的钙质作为预防骨质疏松的一项重要措施 ,已越来越受到人们的重视。为了解中老年妇女对骨质疏松所持的态度 ,有针对性地开展健康教育 ,2 0 0 2年 1 1月 ,第二军医大学护理系对上海市杨浦区中老年妇女进行了调查研究。对象与方法1 对象　上海市杨浦区五角场社区 40岁以上的中老年妇女 1 0 0人。发放调查问卷 1 0 0份 ,回收 89份 ,有效回收问卷 89份 ,有效率为 89 0 %。调查对象年龄从 40～ 84岁 ,平均年龄为 58 4± 1 0 5岁。在 89名被调查者中 ,大…     

Nutrient Intake,Body Composition,Blood Cholesterol and Glucose Levels among Adult Asian Indians in the United States

Asian Indian (AI) immigrants have been suggested to be at increased risk for chronic disease. This study examined the metabolic risk factors for CVD among AI immigrants participating in a health fair in Southern Michigan, in the U.S. Participants included AI men (n = 44) and women (n = 57) who completed a demographic questionnaire, blood lipid (TC and HDL-C) and blood glucose (BG) test, resting BP check (SBP and DBP), body composition analysis and 24-h diet recall. For the entire group, the mean values were: BMI = 25.5, % body fat (BF) = 29.3; SBP = 129 mmHg; DBP = 76 mmHg; TC = 198 mg/dL; HDL-C = 48 mg/dL; BG = 111 mg/dL. Significant gender differences were observed: % BF (20% vs. 36%, P < 0.0001), lean body mass (122 vs. 48 lbs, P < 0.0001), HDL-C (42 vs. 52 mg/dL, P < 0.0025), TC/HDL-C (4.86 vs. 4.11, P < 0.03) and BG (122 vs. 105 mg/dL, P < 0.0001), for males and females, respectively. Dietary carbohydrate, protein and fat contributed 64, 14 and 25% of total energy intake. Among males, BMI was positively correlated with % BF (0.729, P < 0.01) and negatively correlated with HDL-C (−0.457, P < 0.05). Among females, BMI was positively correlated with % BF (0.801, P < 0.01), SBP (0.425, P < 0.05) and DBP (0.538, P < 0.01), and negatively correlated with % energy from saturated fat (−0.523, P < 0.01) and calcium intake (−0.445, P < 0.05). Despite having a dietary intake that meets the National Cholesterol Education Program, Adult Treatment Panel III recommendations, this group was at a higher risk for chronic disease, by virtue of increased BMI and % BF along with an altered metabolic profile (high BP and TC and low HDL-C).     

Two feminized male American Indians

Two American Indian males are described who wish to change sex. Both appear to be anatornically normal; one is a monozygotic twin. In both cases, feminine identification began very early in life. In both cases, there were early acceptance and positive reinforcement of the feminine behavior. These two males and the environment in which they live are contrasted with the anthropological literature published decades ago describing the unique Indian tribal role played by feminized males.     

Predictors of wellness and American Indians

Wellness is an important American Indian (AI) concept, understood as being in balance with one's body, mind, and environment. Wellness predictors are reported in this paper within the context of health. A cross-sectional randomized household survey of 457 AI adults at 13 rural health care sites in California was conducted. Measures included wellness perceptions, barriers, health status/health conditions, spirituality, cultural connectivity, high-risk behaviors and abuse history. Statistical analysis obtained the best predictive model for wellness. Predictors of wellness were general health status perception, participation in AI cultural practices and suicide ideation. Significant differences in wellness status were observed depending on experience of adverse events in childhood and adulthood (neglect, physical abuse, and sexual abuse). Cultural connectivity (speaking tribal language, participating in AI practices, and feeling connected to community) was also associated with perceptions of wellness. Recommendations are for culturally-appropriate education and interventions emphasizing community and cultural connectivity for improving wellness status.     

Measures of Food Intake Among Rural Elderly

In order to evsluate the nutrition status of the elderly-whether for research, clinical evaluation, or the development of community health programs-the assessment of food intake of both elderly individuals and populations is essential. The rural elderly are at risk of developing nutritional problems because of their limited economic resources, transportation, health services, and increased isolation. While the rural elderly represent the greatest segment of Americans over age 65, there is little information about their food intake and dietary problems. The purpose of this research was to conduct a pilot study which would identify the most reliable means of assessing food intake among a population of rural elderly citizens. The results of this investigation suggest that the three-day food record, and the diet history were more reliable than the 24-hour recall in measuring the food intake of 30 females and 17 males living in rural North Carolina.     

营养素摄入量与高脂血症的关系

目的探索各类营养素摄入量与高胆固醇血症、高甘油三酯血症之间的关系。方法用现况调查结合病例对照研究的方法，随机抽取271名调查对象，按血脂检测结果分为病例组和对照组。用食物模型和流行病学问卷调查表的方法，调查研究对象1年中各种食物摄人量，按食物成分表换算成17类营养素的摄入量，比较病例组和对照组间各类营养素摄入量的差异。结果单因素检验结果显示，病例组每天能量、蛋白质、碳水化合物及粗纤维的摄入量（分别为13193KJ，111．91g，606．31g，10．53g）大于对照组（分别为10904．77KJ，97．23g，427．80g，8．75g），单不饱和脂肪酸的摄入量低于对照组（分别为10．28g和13．97g）。因子分析结果显示，高胆固醇血症病例能量因子得分高于对照组；高甘油三酯血症病例能量因子得分高于对照组，脂肪因子得分低于对照组。结论能量摄入过多是高胆固醇血症和高甘油三酯血症发病的危险因素，不饱和脂肪酸摄入不足是高甘油三酯血症发病的危险因素。     

Underreporting of Energy Intake, Socioeconomic Status, and Expression of Nutrient Intake

The relationship between socioeconomic status and nutrient intake was examined in a recent study. The investigators used three different expressions of nutrient intake in an attempt to overcome the confounding effect of underreporting on interpretation of dietary intake data. Biologic validation attempts were inconclusive as to which expression yielded the most accurate results.     

成都社区居民膳食营养素摄入分析

目的 了解成都市区社区居民膳食摄入情况,为制定干预策略和防治措施提供科学依据.方法 调查员经过统一培训,对成都市金牛区随机抽取的6个社区共180户居民进行入户问卷调查.结果 本次调查人群能量、蛋白质摄入为推荐摄入量(recommended nutrient intakes,RNI)的80％左右,碳水化合物为RNI的56％,脂肪超过RNI约40％.VitB6、叶酸低于RNI的20％,VitC、VitA、核黄素、硫胺素低于RNI的60％,烟酸符合RNI标准,VitE超过RNI约40％.钙摄入不足RNI的52％,锌、钾、硒、镁、铁、铜摄入在RNI的75％以上,钠分别超过RNI 156％.结论 本次调查人群膳食能量、碳水化合物、蛋白质摄入不足,脂肪摄入过量；绝大部分维生素、矿物质尤其是维生素B族和钙摄入不足.