DOI QR코드

DOI QR Code

Comparison of nutrient intakes by nutritional anemia and the association between nutritional anemia and chronic diseases in Korean elderly: Based on the 2013-2015 Korea National Health and Nutrition Examination Survey Data

  • Received : 2019.05.09
  • Accepted : 2019.08.29
  • Published : 2019.12.01

Abstract

BACKGROUND/OBJECTIVES: The elderly are reported to have a high prevalence of nutritional anemia when they have lower intakes of nutrients or chronic diseases. This study was conducted to compare nutritional status according to nutritional anemia and to determine associations between nutritional anemia and chronic diseases in Korean elderly. SUBJECTS/METHODS: This study utilized data on 3,258 elderly aged ${\geq}65$ years gathered during the $6^{th}$ Korea National Health and Nutrition Examination Survey 2013-2015. Subjects were divided into nutritional anemia (NA) group (n = 415) and non-NA group (n = 2,843) by hemoglobin concentration. Nutrient intakes were assessed using dietary intake data obtained using the 24-hour recall method. The odds ratios (ORs) for nutritional anemia by chronic diseases were determined. Statistical analysis was performed using SPSS Ver. 23.0. RESULTS: Of 3,258 subjects, 12.7% had nutritional anemia. Intakes of potatoes, pulses, and mushrooms by males and potatoes, fruits, meats, eggs, and seafood by females were significantly lower in NA group than in non-NA group. The proportion of the subjects whose intakes of protein, vitamin A, vitamin $B_1$, vitamin $B_2$, niacin, and iron less than estimated average requirement (EAR) were significantly higher in NA group compared to non-NA group. After adjusting for age, the number of family members, energy intake, and alcohol drinking, ORs for nutritional anemia in the subjects with diabetes and myocardial infarction or angina pectoris were significantly higher by 1.74 times and 1.59 times as compared to the subjects without those diseases, respectively. However, ORs for nutritional anemia in the subjects with obesity, abdominal obesity, and hypertriglyceridemia were significantly lower by 0.64 times, 0.60 times, and 0.59 times as compared to the subjects without those diseases, respectively. CONCLUSIONS: The results of this study suggested that nutritional management should be done to enable the Korean elderly to consume foods with high hematopoietic nutrients density to prevent nutritional anemia. Korean elderly need to make regular efforts to check for nutritional anemia.

Keywords

References

  1. Seshadri S. Nutritional anemia during pregnancy, early childhood and adolescence: the critical development periods. In: Vir SC, editor. Public Health Nutrition in Developing Countries. New Delhi: WPI Publishing; 2011. p.674-712.
  2. United Nations. World Population Ageing. New York (NY): United Nations; 2009.
  3. World Health Organization Scientific Group on Nutritional Anaemias; World Health Organization. Nutritional Anaemias: Report of a WHO Scientific Group. Geneva: World Health Organization; 1968.
  4. Ershler WB, Sheng S, McKelvey J, Artz AS, Denduluri N, Tecson J, Taub DD, Brant LJ, Ferrucci L, Longo DL. Serum erythropoietin and aging: a longitudinal analysis. J Am Geriatr Soc 2005;53:1360-5. https://doi.org/10.1111/j.1532-5415.2005.53416.x
  5. Stauder R, Thein SL. Anemia in the elderly: clinical implications and new therapeutic concepts. Haematologica 2014;99:1127-30. https://doi.org/10.3324/haematol.2014.109967
  6. Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood 2004;104:2263-8.
  7. Patel KV. Epidemiology of anemia in older adults. Semin Hematol 2008;45:210-7. https://doi.org/10.1053/j.seminhematol.2008.06.006
  8. Andres E, Vogel T, Zulfiqar A. Anemia in elderly patients: state of art, with a focus on nutritional anemia. In: Means RT Jr, editor. Anemia in the Young and Old. Basel: Springer; 2019. p.179-93.
  9. Andres E, Federici L, Serraj K, Kaltenbach G. Update of nutrientdeficiency anemia in elderly patients. Eur J Intern Med 2008;19:488-93. https://doi.org/10.1016/j.ejim.2008.01.016
  10. Park JH, Kwon HK, Kim BI, Choi CH, Choi YH. A survey on the oral health condition of institutionalized elderly people resident in free asylum. J Korean Acad Dent Health 2002;26:555-66.
  11. Shin SK, Kim HJ, Choi BY, Lee SS. A comparison of food frequency for the elderly regarding different family types: based on Community Health Survey for 2008. Korean J Nutr 2012;45:264-73. https://doi.org/10.4163/kjn.2012.45.3.264
  12. Cho SA. The world is getting old ... Is there a country for the elderly? [Internet]. Seoul: Chosun Ilbo Corporation; 2017 [cited 2019 February 15]. Available from: http://news.chosun.com/site/data/html_dir/2017/04/21/2017042101779.html.
  13. Korean Statistical Information Service. Prevalence of anemia [Internet]. Daejeon: Statistics Korea; 2018 [cited 2019 February 15]. Available from: http://kosis.kr/statHtml/statHtml.do?orgId=117&tblId=DT_11702_N110.
  14. e-Country index (KR). Life table, national approval statistics. No. 101035 [Internet]. Daejeon: Statistics Korea; 2018 [cited 2019 February 15]. Available from: http://www.index.go.kr/potal/main/EachDtlPageDetail.do?idx_cd=2758.
  15. Korean Statistical Information Service. Major population indicators [Internet]. Daejeon: Statistics Korea; 2017 [cited 2019 February 15]. Available from: http://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_1BPA002&vw_cd=MT_ZTITLE&list_id=A41_10&seqNo=&lang_mode=ko&language=kor&obj_var_id=&itm_id=&conn_path=MT_ZTITLE.
  16. Joung KH, Oh YH, Lee YK, Oh MA, Kang YN, Kim KR, Hwang NH, Kim SJ, Lee SH, Lee SG, Hong SY. Survey of the Elderly in 2017. Sejong: Korea Institute for Health and Social Affairs; 2017.
  17. e-Medical Information (KR). Women in their forties, should be anemic caution [Internet]. Seoul: e-Medical Information; 2017 [cited 2019 March 6]. Available from: http://www.kmedinfo.co.kr/news/ articleView.html?idxno=43747.
  18. Jung CW. Anemia in the elderly. Proceedings of the 62th Fall Conference of The Korean Association of Internal Medicine. Seoul: The Korean Association of Internal Medicine; 2011. p.153-6.
  19. Kim MJ, Yun JM. The presence or absence of osteoarthritis and related risk factors in Korean elderly using the 6th Korea National Health and Nutrition Examination Survey (2013-2014 KNHANES VI). Korean J Food Nutr 2017;30:995-1006. https://doi.org/10.9799/ksfan.2017.30.5.995
  20. Ministry of Health and Welfare; The Korean Nutrition Society. Dietary Reference Intakes for Korean. Seoul: The Korean Nutrition Society; 2015.
  21. Rural Development Administration, National Rural Resources Development Institute (KR). Food Composition Table. 9th ed. Jeonju: Rural Development Administration, National Rural Resources Development Institute; 2016.
  22. Ministry of Health and Welfare (KR); Korea Centers for Disease Control & Prevention. Health Behavior and Chronic Disease Statistics 2012. Cheongju: Korea Centers for Disease Control & Prevention; 2014.
  23. Ministry of Health and Welfare (KR); Korea Centers for Disease Control & Prevention. Korea National Health and Nutrition Examination Survey Raw Data Use Guidelines. Cheongju: Korea Centers for Disease Control & Prevention; 2017.
  24. Tettamanti M, Lucca U, Gandini F, Recchia A, Mosconi P, Apolone G, Nobili A, Tallone MV, Detoma P, Giacomin A, Clerico M, Tempia P, Savoia L, Fasolo G, Ponchio L, Della Porta MG, Riva E. Prevalence, incidence and types of mild anemia in the elderly: the “Health and Anemia” population-based study. Haematologica 2010;95:1849-56. https://doi.org/10.3324/haematol.2010.023101
  25. Walsh JR. Hematologic disorders in the elderly. West J Med 1981;135:446-54.
  26. Lim YJ, Choi YS. Seasonal nutrient intakes of elderly women living alone as compared to those living with family in the Gyeongbuk rural area. Korean J Community Nutr 2007;12:58-67.
  27. Bae JS, Kim MH, Kim SB. Effects of nutrition education and personalized lunch service program for elderly at senior welfare center in Jeonju. Korean J Community Nutr 2013;18:65-76. https://doi.org/10.5720/kjcn.2013.18.1.65
  28. Carmel R. Nutritional anemias and the elderly. Semin Hematol 2008;45:225-34. https://doi.org/10.1053/j.seminhematol.2008.07.009
  29. Lopez-Contreras MJ, Zamora-Portero S, Lopez MA, Marin JF, Zamora S, Perez-Llamas F. Dietary intake and iron status of institutionalized elderly people: relationship with different factors. J Nutr Health Aging 2010;14:816-21. https://doi.org/10.1007/s12603-010-0118-6
  30. Haider LM, Schwingshackl L, Hoffmann G, Ekmekcioglu C. The effect of vegetarian diets on iron status in adults: a systematic review and meta-analysis. Crit Rev Food Sci Nutr 2018;58:1359-74. https://doi.org/10.1080/10408398.2016.1259210
  31. Doyle W, Crawley H, Robert H, Bates CJ. Iron deficiency in older people: interactions between food and nutrient intakes with biochemical measures of iron; further analysis of the National Diet and Nutrition Survey of people aged 65 years and over. Eur J Clin Nutr 1999;53:552-9. https://doi.org/10.1038/sj.ejcn.1600787
  32. Huang Y, Wong Y, Wueng S, Cheng C, Su K. Nutrient intakes and iron status of elderly men and women. Nutr Res 2001;21:967-81. https://doi.org/10.1016/S0271-5317(01)00308-6
  33. Rutishauser IH, Bates CJ, Paul AA, Black AE, Mandal AR, Patnaik BK. Long-term vitamin status and dietary intake of healthy elderly subjects. 1. Riboflavin. Br J Nutr 1979;42:33-42. https://doi.org/10.1079/BJN19790087
  34. Joo EJ, Kim IS, Seo EA. Nutritional status of iron of elderly in Jeon-Ju area. Korean J Community Nutr 2000;5:493-501.
  35. Juarez-Cedillo T, Basurto-Acevedo L, Vega-Garcia S, Manuel-Apolinar L, Cruz-Tesoro E, Rodriguez-Perez JM, Garcia-Hernandez N, Perez-Hernandez N, Fragoso JM. Prevalence of anemia and its impact on the state of frailty in elderly people living in the community: SADEM study. Ann Hematol 2014;93:2057-62. https://doi.org/10.1007/s00277-014-2155-4
  36. Yun MJ, Yun ME, Kim MR. Blood nutrition indices and disease diagnosis by anemia in Korean adults. J Korean Soc Food Sci Nutr 2017;46:1443-52. https://doi.org/10.3746/jkfn.2017.46.12.1443
  37. Eichner ER, Hillman RS. Effect of alcohol on serum folate level. J Clin Invest 1973;52:584-91. https://doi.org/10.1172/JCI107219
  38. Lindenbaum J, Lieber CS. Hematologic effects of alcohol in man in the absence of nutritional deficiency. N Engl J Med 1969;281:333-8. https://doi.org/10.1056/NEJM196908142810701
  39. Shi Z, Zhen S, Wittert GA, Yuan B, Zuo H, Taylor AW. Inadequate riboflavin intake and anemia risk in a Chinese population: five-year follow up of the Jiangsu Nutrition Study. PLoS One 2014;9:e88862. https://doi.org/10.1371/journal.pone.0088862
  40. Thomson CA, Stanaway JD, Neuhouser ML, Snetselaar LG, Stefanick ML, Arendell L, Chen Z. Nutrient intake and anemia risk in the women's health initiative observational study. J Am Diet Assoc 2011;111:532-41. https://doi.org/10.1016/j.jada.2011.01.017
  41. Kim YK, Lee HO, Chang R, Choue R. A study on the food habits, nutrient intake and the disease distribution in the elderly (aged over 65 years)(I). Korean J Community Nutr 2002;7:516-26.
  42. Zhang J, Wang CR, Jin SH, Song PK, Meng LP, Man QQ, Jia SC. Risk factors on anemia among rural elderly women aged 50-75 y in Xinning county, Anhui province, China. Zhonghua Liu Xing Bing Xue Za Zhi 2009;30:227-30.
  43. Li HC, Ryu HK. Study on relevance of nutritional status, nutrient intake, and chronic disease risk based on Mini Nutritional Assessment (MNA) of elderly people in Shandong province of China. Korean J Community Living Sci 2017;28:5-16. https://doi.org/10.7856/kjcls.2017.28.1.5
  44. Kim H, Yoon JL, Lee A, Jung Y, Kim MY, Cho JJ, Ju YS. Prognostic effect of body mass index to mortality in Korean older persons. Geriatr Gerontol Int 2018;18:538-46. https://doi.org/10.1111/ggi.13213
  45. Semba RD, Ricks MO, Ferrucci L, Xue QL, Guralnik JM, Fried LP. Low serum selenium is associated with anemia among older adults in the United States. Eur J Clin Nutr 2009;63:93-9. https://doi.org/10.1038/sj.ejcn.1602889
  46. Thomas MC, Tsalamandris C, MacIsaac RJ, Jerums G. The epidemiology of hemoglobin levels in patients with type 2 diabetes. Am J Kidney Dis 2006;48:537-45. https://doi.org/10.1053/j.ajkd.2006.06.011
  47. Lee TH. Depleting nutrients with diabetic drugs taking [Internet]. Seoul: Brunch; 2018 [cited 2019 April 20]. Available from: https://brunch.co.kr/@4173924/3.
  48. Kim HY. Recent trends in rheumatoid arthritis treatment. Korean J Intern Med 1996;51:271-9.
  49. Hong TJ. Diagnosis of coronary artery disease. J Korean Med Assoc 2004;47:714-25. https://doi.org/10.5124/jkma.2004.47.8.714

Cited by

  1. Iron in the General Population and Specificities in Older Adults: Metabolism, Causes and Consequences of Decrease or Overload, and Biological Assessment vol.15, 2019, https://doi.org/10.2147/cia.s269379
  2. 한국 노인의 비만도에 따른 만성질환 및 영양섭취 실태조사 - 국민건강영양조사 2016~2018 자료를 이용하여 - vol.33, pp.4, 2020, https://doi.org/10.9799/ksfan.2020.33.4.428
  3. Relationship between psychological distress and the adherence to the Korean healthy eating index (KHEI): the Korea National Health and Nutrition Examination Survey (KNHANES) 2013 and 2015 vol.15, pp.4, 2021, https://doi.org/10.4162/nrp.2021.15.4.516
  4. Compromised intestinal integrity in older adults during daily activities: a pilot study vol.21, pp.1, 2021, https://doi.org/10.1186/s12877-021-02573-4