Dietary variety predicts low body mass index and inadequate macronutrient and micronutrient intakes in community-dwelling older adults
Dietary variety predicts low body mass index and inadequate macronutrient and micronutrient intakes in community-dwelling older adults
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DOI：
10.1093/gerona/60.5.613
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发表时间：
2005-05-01
影响因子：
5.1
通讯作者：
McCrory, MA
中科院分区：
文献类型：
--
作者：
Roberts, SB;Hajduk, CL;McCrory, MA
背景体重指数低和微量营养素缺乏与老年发病率和死亡率增加有关。研究了饮食多样性的不良模式是否能预测老年人的低BMI和低微量营养素摄入。在1994-1996年个人食物摄入量持续调查中，对1174名健康成年男性和女性（年龄21 - 90岁）进行了全国调查数据的横断面分析，这些人提供了生理学上合理的饮食数据。测量包括报告的能量摄入量，蛋白质摄入量（符合推荐膳食允许量的百分比），微量营养素摄入量（符合14种微量营养素估计平均需求量的百分比）和BMI。与21至60岁的成年人相比，61岁或61岁以上的成年人消费的食物种类更多，从更广泛的食物组中选择食物，有更多种类的微量营养素密集食物和能量弱的食物，并且有更少种类的微量营养素弱的食物（p < .05至.001）。然而，与BMI较高的老年人相比，BMI较低（< 22 kg/m2）的老年人消耗的能量密度较低（p < .05）。在控制混杂变量的多元回归模型中，能量密集型食物的种类预测了所有年龄段的能量摄入量和BMI（能量的R-2 = 0.124，BMI的R-2 = 0.574，p <0.001）。与年轻人相比，老年人中微量营养素摄入不足的比例较高（p < .05），特别是维生素E、钙和镁，但食用特别多种富含微量营养素的食物有助于抵消这些趋势（p < .05）。低BMI和食用低种类的微量营养素密集食物的老年人尤其面临营养风险，只有65.4%的人食用蛋白质的推荐膳食摄入量，没有人达到所有14种微量营养素的估计平均需求量。与以前认为老年人饮食单调的说法相反，这项研究表明，与60岁或60岁以下的成年人相比，61岁或61岁以上的成年人消费的食物种类更多，而且微营养素密集和能量不足的食物种类更多。虽然在任何年龄阶段，食用种类较少的能量密集型食物都可能导致能量摄入量和体重的减少，但在老年阶段，需要增加食用的微量营养素密集型食物的种类，以防止微量营养素缺乏。这些研究结果表明，所有成年人都需要关于随着年龄的增长而不断变化的饮食多样性需求的建议，以保持健康，并且低BMI的老年人特别容易受到饮食不足的影响。
Background. Low body mass index (BMI) and micronutrient deficiencies are associated with increased morbidity and mortality rates in old age. Whether adverse patterns of dietary variety predict both low BMI and low micronutrient intakes in older adults was investigated.Methods. A cross-sectional analysis of national survey data was conducted in 1174 healthy adult men and women (ages 21 to 90 years) who provided physiologically plausible dietary data in the 1994-1996 Continuing Survey of Food Intakes by Individuals. Measurements included reported energy intake, protein intake (percentage meeting Recommended Dietary Allowance), micronutrient intakes (percentage meeting Estimated Average Requirements for 14 micronutrients), and BMI.Results. Adults who were 61 years or older consumed a greater total variety of foods, chose foods from a wider range of food groups, had a greater variety of micronutrient-dense foods and energy-weak foods, and had a lower variety of micronutrient-weak foods compared with adults ages 21 to 60 years (p < .05 to .001). However, older adults with low BMIs (< 22 kg/m(2)) consumed a lower variety of energy-dense foods compared with older adults with higher BMIs (p < .05). The variety of energy-dense foods predicted both energy intake and BMI at all ages in multiple regression models controlling for confounding variables (R-2 = .124 for energy, R-2 = .574 for BMI, p < .001). A higher percentage of older persons had inadequate micronutrient intakes compared with younger persons (p < .05), especially vitamin E, calcium, and magnesium, but consumption of a particularly wide variety of micronutrient-rich foods helped counterbalance these trends (p < .05). Older adults who had a low BMI and consumed a low variety of micronutrient-dense foods were particularly at nutritional risk, with only 65.4% consuming the Recommended Dietary Allowance for protein and none meeting the Estimated Average Requirements for all 14 micronutrients.Conclusions. In contrast to previous suggestions that older persons consume a monotonous diet, this study showed that adults who were 61 years or older consumed a greater total food variety, and a greater variety of micronutrient-dense and energy-weak foods, compared with adults who were 60 years or younger. Although consumption of a low variety of energy-dense foods may contribute to reduced energy intake and body weight at any age, the variety of micronutrient-dense foods consumed needs to increase in old age to prevent micronutrient deficiencies. These findings suggest that all adults need advice on the changing needs for dietary variety with aging to maintain health, and that older persons with low BMI are particularly vulnerable to dietary shortfalls.