Older adults who use vitamin/mineral supplements differ from nonusers in nutrient intake adequacy and dietary attitudes
Older adults who use vitamin/mineral supplements differ from nonusers in nutrient intake adequacy and dietary attitudes
复制标题
DOI：
10.1016/j.jada.2007.05.010
复制
发表时间：
2007-08-01
影响因子：
--
通讯作者：
Moshfegh, Alanna J.
中科院分区：
文献类型：
--
作者：
Sebastian, Rhonda S.;Cleveland, Linda E.;Moshfegh, Alanna J.
目的测量51岁及以上维生素/矿物质补充剂使用者和非补充剂使用者的营养摄入充分性，确定补充剂补充剂的有效性，并确定补充剂使用的预测因素。研究对象为居住在美国家庭中的4384名51岁及以上的成年人(1777名日常补充剂使用者，428名不经常服用补充剂的人，2179名不经常服用补充剂的人)。统计分析使用爱荷华州立大学的方法估计了常见的营养摄入量分布。应用估计平均需要量(耳朵)切点法来确定老年人在从补充剂中摄取营养之前和之后不符合要求的比例。学生t检验被用来评估使用者和非使用者之间的差异。结果在研究的一个或多个性别年龄组中，补充剂使用者的比例明显低于非补充剂使用者，他们从耳朵以下的食物中单独摄入维生素A、B-6和C、叶酸、锌和镁的比例要小得多。即便如此，仅从食物来源摄入叶酸、维生素E和镁的吸毒者和非吸毒者中，只有不到50%的人会接触到耳朵。总体而言，补充剂改善了老年人的营养摄入量。在考虑了补充剂的作用后，80%或更多的使用者听到了维生素A、B-6、B-12、C和E、叶酸、铁和锌，但没有镁。然而，一些补充剂使用者，特别是男性，超过了铁和锌的允许上限摄入量，一小部分女性超过了维生素A的允许上限摄入量。与老年男性使用补充剂相关的重要社会人口学因素是年龄组、大都市地区和教育程度。种族、地区、吸烟状况和素食状况是女性的重要影响因素。对遵循健康饮食重要性的态度是男性和女性补充剂使用的一致预测因素。结论很大比例的老年人仅从食物中摄取的许多营养素并不充足。补充剂在一定程度上起到了补偿作用，但估计只有一半的人每天使用补充剂。在为这一年龄段的患者制定补充剂使用建议时，应考虑这些普遍存在的不足之处。在这一高危人群中，改变饮食态度可能会导致更高的补充剂使用率。
Objective To measure nutrient intake adequacy of vitamin/mineral supplement users and nonusers aged 51 years and older, determine the efficacy of supplement practices in compensating for dietary deficits, and identify predictors of supplement use.Design Analyses of two 24-hour recalls, demographic variables, and attitude questions collected during the Continuing Survey of Food Intakes by Individuals and Diet and Health Knowledge Survey in 1994 to 1996. Data were weighted to be representative of older Americans.Subjects Four thousand three hundred eighty-four adults aged 51 years and older (1,777 daily supplement users, 428 infrequent users, and 2,179 nonusers) residing in households in the United States.Statistical analyses Usual nutrient intake distributions were estimated using the Iowa State University method. The Estimated Average Requirement (EAR) cutpoint method was applied to determine the proportion of older adults not meeting requirements before and after accounting for nutrient intake from supplements. Student t tests were used to assess differences between users and nonusers. Logistic regression was used to determine sociodemographic and attitudinal predictors of supplement use.Results For one or more of the sex-age groups studied a significantly smaller proportion of supplement users than nonusers had intakes from food alone below the EAR for vitamins A, B-6, and C; folate; zinc; and magnesium. Even so, less than 50% of both users and nonusers met the EAR for folate, vitamin E, and magnesium from food sources alone. Overall, supplements improved the nutrient intake of older adults. After accounting for the contribution of supplements, 80% or more of users met the EAR for vitamins A, B-6, B-12, C, and E; folate; iron; and zinc, but not magnesium. However, some supplement users, particularly men, exceeded Tolerable Upper Intake Levels for iron and zinc and a small percentage of women exceeded the Tolerable Upper Intake Level for vitamin A. Significant sociodemographic factors related to supplement use for older men were age group, metropolitan area, and educational status. Race, region, smoking status, and vegetarian status were significant factors for women. Attitude about the importance of following a healthful diet was a consistent predictor of supplement use for both men and women.Conclusions A large proportion of older adults do not consume sufficient amounts of many nutrients from foods alone. Supplements compensate to some extent, but only an estimated half of this population uses them daily. These widespread inadequacies should be considered when developing recommendations for supplement use for clients in this age group. Modifying dietary attitudes may result in a higher rate of supplement use in this at-risk population.