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Nutritional, immunological and health status of the elderly population living in poor neighbourhoods of Quito, Ecuador

Published online by Cambridge University Press:  08 March 2007

Fernando Sempértegui ,
Bertha Estrella ,
Negar Elmieh ,
Michael Jordan ,
Tanvir Ahmed ,
Alicia Rodríguez ,
Katherine L. Tucker ,
Davidson H. Hamer ,
Philip G. Reeves  and
Simin Nikbin Meydani
Fernando Sempértegui*
Affiliation:
Corporación Ecuatoriana de Biotecnología, Ave. Colón 1468 y Nueve de Octubre. Of. 508, Quito, Ecuador
Bertha Estrella
Affiliation:
Corporación Ecuatoriana de Biotecnología, Ave. Colón 1468 y Nueve de Octubre. Of. 508, Quito, Ecuador
Negar Elmieh
Affiliation:
Nutritional Immunology Laboratory, Jean Mayer/USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA, USA
Michael Jordan
Affiliation:
The Division of Geographic Medicine and Infectious Disease, Tufts – New England Medical Center, Boston, MA, USA
Tanvir Ahmed
Affiliation:
Nutritional Immunology Laboratory, Jean Mayer/USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA, USA
Alicia Rodríguez
Affiliation:
Corporación Ecuatoriana de Biotecnología, Ave. Colón 1468 y Nueve de Octubre. Of. 508, Quito, Ecuador
Katherine L. Tucker
Affiliation:
Nutritional Immunology Laboratory, Jean Mayer/USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA, USA
Davidson H. Hamer
Affiliation:
Center for International Health and Development, Boston University School of Public Health, Boston, MA, USA
Philip G. Reeves
Affiliation:
USDA, ARS, Grand Forks Human Nutrition Research Center, Grand Forks, ND 58203, USA
Simin Nikbin Meydani*
Affiliation:
Nutritional Immunology Laboratory, Jean Mayer/USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA, USA
*
*Corresponding author: Dr Simin Nikbin Meydani, fax +1 617 556 3224, email [email protected], and Dr Fernando Sempe´rtegui, fax 593-2-2520638, email [email protected]
*Corresponding author: Dr Simin Nikbin Meydani, fax +1 617 556 3224, email [email protected], and Dr Fernando Sempe´rtegui, fax 593-2-2520638, email [email protected]
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Abstract

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The number of elderly people is increasing in less-developed countries. Although nutritional deficiencies and infectious diseases are generally more prevalent in resource-poor countries, the health and nutritional status of the elderly in South America in general, and in Ecuador, in particular, remains largely unstudied. The objective of the present study was to assess the nutritional, immunological and health status of elderly Ecuadorians. A cross-sectional study was conducted to evaluate a sample of elderly Ecuadorians with 24 h dietary recalls, biochemical and anthropometric measurements, delayed type hypersensitivity skin response and a health questionnaire. The 145 elders who enrolled had a mean age of 74·3 (sd 6·9) years. Of the subjects, 52 % exhibited BMI ≥25 kg/m2, whereas 9·1 % had BMI ≤20 kg/m2. Means of dietary intakes were below recommendations for most nutrients; exceptions were carbohydrate, fat, Fe and Se. Serum nutrient levels indicated that 50, 44, 43, 19 and 18 % of participants had deficiencies of Zn, Fe, vitamins B12 and D, and folate, respectively. The mean number of positive responses to seven recall antigens was 2·1 (sd 1·7) with an induration diameter of 9·9 (sd 7) mm, which are substantially lower than those reported for elders in developed countries. During the previous 6 months, 54 and 21 % of subjects reported at least one episode of respiratory infection or diarrhoea, respectively. Of these, 47 % sought care at a hospital or from a physician and 96 % from a relative or friend. In conclusion, while few elderly Ecuadorians were underweight, obesity was common. Micronutrient deficiencies were prevalent and may contribute to reduced immunological responses in this population.

Keywords

ElderlyImmune senescenceLess-developed countriesMicronutrientsBody mass index
Type
Research Article
Information
British Journal of Nutrition , Volume 96 , Issue 5 , November 2006 , pp. 845 - 853
Copyright
Copyright © The Nutrition Society 2006

References

Allain, CC, Poon, LS, Chan, CSG, Richmond, W & Fu, PC (1974) Enzymatic determination of total serum cholesterol. Clin Chem 20, 470–475.CrossRefGoogle ScholarPubMed
Anonymous (1988) Cobas Mira Chemistry System, Operator's Manual. Software Version 8735. Nutley, NJ: Roche Diagnostic Systems.Google Scholar
Anonymous (2001) Document 2001. Catalog: 68100E. Stilwater, MN DiaSorin Inc.Google Scholar
Araki, A & Yoshiyasu, S (1987) Determination of free and total homocysteine in human plasma by high-performance liquid chromatography with fluorescence detection. J Chrom 422, 43–52.CrossRefGoogle ScholarPubMed
Bailey, AL, Maisey, S, Southon, S, Wright, AJ, Finglas, PM & Fulcher, RA (1997) Relationships between micronutrient intake and biochemical indicators of nutrient adequacy in a (free-living) elderly UK population. Br J Nutr 77, 225–242.CrossRefGoogle Scholar
Barthelmai, W & Czok, R (1962) Enzymatic determination of glucose in the blood, central spinal fluid, and urine (article in German). Klin Wochenscht 40, 585–589.CrossRefGoogle Scholar
Bieri, JG, Tolliver, TJ & Catignani, GL (1979) Simultaneous determination of α-tocopherol and retinol in plasma or red cells by high pressure liquid chromatography. Am J Clin Nutr 32, 2143–2149.CrossRefGoogle ScholarPubMed
Blaum, CS, Fries, BE & Fiatarone, MA (1995) Factors associated with low body mass and weight loss in nursing home residents. J Gerontol 50A, M152–M168.CrossRefGoogle Scholar
Brumbaugh, W & Walther, MJ (1991) Improved selenium recovery from tissue with modified sample decomposition. J Assoc Off Anal Chem 74, 570–571.Google ScholarPubMed
Cross, CE, Halliwell, B, Borish, ET, Pryor, WA, Ames, BN, Saul, RL, McCord, JM & Harman, D (1987) Oxygen radicals and human disease. Ann Intern Med 107, 526–545.CrossRefGoogle ScholarPubMed
Crossley, KB & Peterson, PK (1996) Infections in the elderly. Clin Infect Dis 22, 209–215.CrossRefGoogle ScholarPubMed
Daly, JS & Ertingshausen, G (1972) Direct method for determining inorganic phosphate in serum with the "Centrifichem". Clin Chem 18, 263–265.CrossRefGoogle ScholarPubMed
Dawson, JB, Ellis, DJ & Newton-Hohn, M (1968) Direct estimation of copper in serum and urine by atomic absorption. Clin Chem Acta 21, 33.CrossRefGoogle ScholarPubMed
Driskell, JA (1994) Vitamin B 6 requirements of humans. Nutr Res 14, 293–324.CrossRefGoogle Scholar
Esders, TW & Michrina, CA (1979) Purification and properties of L-alpha-glycerophosphate oxidase from Streptococcus faecium ATCC 12755. J Biol Chem 254, 2710–2715.CrossRefGoogle ScholarPubMed
Flegal, KM, Carroll, MD, Kuczmarski, RJ & Johnson, CL (1998) Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J Obes Relat Metab Disord 22, 39–47.CrossRefGoogle ScholarPubMed
Fleming, DJ, Jacques, PF, Dallal, GE, Tucker, KL, Wilson, PW & Wood, RJ (1998) Dietary determinants of iron stores in a free-living elderly population: The Framingham Heart Study. Am J Clin Nutr 67, 722–733.CrossRefGoogle Scholar
Food and Nutrition Board (2004) Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. Washington, DC: National Academies Press http://www.nap.edu/catalog/10925.html.Google Scholar
Food and Nutrition Board+Institute of Medicine (2000) Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc Washington, DC National Academies Press http://www.nap.edu/catalog/10026.html.Google Scholar
Food and Nutrition Board. Institute of Medicine of the National Academies (2000) Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids Washington, DC National Academies Press http://www.nap.edu/catalog/10490.html.Google Scholar
Friedewald, WT, Levy, RI & Frederickson, DS (1972) Estimation of the concentration of low density lipoprotein cholesterol in plasma without use of the preparative ultracentrifuge. Clin Chem 18, 499–502.CrossRefGoogle ScholarPubMed
Garrow, JS & Webster, J (1985) Quetelet's index (W/H 2) as a measure of fatness. Int J Obes 9, 147–153.Google Scholar
Gindler, EM & Helth, DA (1971) Colorimetric determination with bound (calmagite) of magnesium in human blood serum. Clin Chem 17, 662.Google Scholar
Gross, R (1997) CRONOS (cross-cultural research on the nutrition of older subjects). Food Nutr Bull 18, 267–303.CrossRefGoogle Scholar
Hall, WD, Clark, LT & Wenger, NK (2003) The metabolic syndrome in African Americans: a review. Ethn Dis 13, 414–428.Google ScholarPubMed
Hamfelt, A (1962) A method of determining pyridoxal phosphate in blood by decarboxylation of L-tyrosine- 14 C (U). Clin Chim Acta 7, 746–748.CrossRefGoogle Scholar
High, KP (2001) Nutritional strategies to boost immunity and prevent infection in elderly individuals. Clin Infect Dis 33, 1892–1900.CrossRefGoogle ScholarPubMed
Holt, C & Brown, KH (2004) Assessment of the risk of zinc deficiency in populations and options for its control. Food Nutr Bull 25, 99S.Google Scholar
Ingman, F & Ringbom, A (1966) Spectrophotometric determination of small amounts of magnesium and calcium employing calmagite. Microchem J 10, 545.CrossRefGoogle Scholar
Instituto Nacional de Nutrición (1965) Tabla de Composición de los Alimentos Ecuatorianos Quito. Quito, Ecuador: Ministerio de Previsión Social y Sanidad.Google Scholar
Institute of Medicine (1997) Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride Washington, DC National Academies Press. http://www.nap.edu/books/0309063507/html.Google Scholar
Institute of Medicine (1998) Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline Washington, DC National Academies Press. http://www.nap.edu/catalog/6015.html.Google Scholar
Institute of Medicine (2000 a) Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids Washington, DC: National Academies Press. http://www.nap.edu/catalog/9810.html.Google Scholar
Institute of Medicine (2000 b) Dietary Reference Intakes: Applications in Dietary Assessment Washington, DC: National Academies Press. http://books.nap.edu/catalog/9956.html.Google Scholar
Instituto Nacional de Estadistica y Censos (2001) Censo de Población y Vivienda de 2001. Quito, Ecuador: INEC.Google Scholar
Lesourd, BM (1995) Protein undernutrition as the major cause of decreased immune function in the elderly: clinical and functional implications. Nutr Rev 53, Suppl.S86–S94.CrossRefGoogle ScholarPubMed
Lethbridge-Cejku, M, Schiller, JS & Bernadel, L (2004) Summary health statistics for U.S. adults: National Health Interview Survey, 2002. Vital Health Stat 10, 1–151.Google Scholar
Lindenbaum, J, Rosenberg, IH, Wilson, PW, Stabler, SP & Allen, RH (1994) Prevalence of cobalamin deficiency in the Framingham elderly population. Am J Clin Nutr 60, 2–11.CrossRefGoogle ScholarPubMed
Maruyama, H & Coursin, DB (1968) Enzymic assay of pyridoxal phosphate using tyrosine apodecarboxylase and tyrosine-1- 14 C. Anal Biochem 26, 420–429.CrossRefGoogle Scholar
Meydani, SN, Meydani, M, Blumberg, JB, Leka, LS, Siber, G, Loszewski, R, Thompson, C, Pedrosa, MC, Diamond, RD & Stollar, BD (1997) Vitamin E supplementation and in vivo immune response in healthy elderly subjects. A randomized controlled trial. JAMA 277, 1380–1386.CrossRefGoogle ScholarPubMed
Meydani, SN, Meydani, M, Rall, LC, Morrow, F & Blumberg, JB (1994) Assessment of the safety of high-dose, short-term supplementation with vitamin E in healthy older adults. Am J Clin Nutr 60, 704–709.CrossRefGoogle ScholarPubMed
Meydani, SN & Santos, MS (2000) Aging: nutrition and immunity Nutrition and Immunology: In Principles and Practice, pp. 403–421 [Gershwin, ME, German, JB and Keen, CL, editors]. Totowa, NJ: Humana Press Inc.Google Scholar
Michaylova, V & Ilkova, P (1971) Photometric determination of micro amounts of calcium with arsenazo III. Anal Chem Acta 53, 194–198.CrossRefGoogle Scholar
National Center for Health Statistics (2004) Health, United States 2004 with Chartbook on Trends in the Health of Americans. Hyattsville, MA: National Center for Health Statistics.Google Scholar
Olson, AD & Hamlin, WB (1969) A new method for serum iron and total iron-binding capacity by atomic absorption spectrophotometry. Clin Chem 15, 438–444.CrossRefGoogle ScholarPubMed
Park, YW, Zhu, S, Palaniappan, L, Heshka, S, Carnethon, MR & Heymsfield, SB (2003) The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988–1994. Arch Intern Med 163, 427–436.CrossRefGoogle ScholarPubMed
Pepersack, T, Rotsaert, P, Benoit, F, Willems, D, Fuss, M, Bourdoux, P & Duchateau, J (2001) Prevalence of zinc deficiency and its clinical relevance among hospitalised elderly. Arch Gerontol Geriatr 33, 243–253.CrossRefGoogle ScholarPubMed
Reynolds, RD (1987) Vitamin B 6. In Methods in Clinical Chemistry, pp. 558–568 [Pesce, AJ and Kaplan, LA, editors]. Washington, DC: C.V. Mosby Co.Google Scholar
Sauberlich, HE (1990) Evaluation of Folate Nutrition in Population Groups. New York: Wiley and Sons.Google Scholar
Selhub, J & Rosenberg, IH (1996) Folic acid. In Present Knowledge in Nutrition, 7th ed., pp. 206–219 [Ziegler, EE and Filer, LJ, editors]. Washington, DC: ILSI Press.Google Scholar
Sempertegui, F, Estrella, B, Correa, E, Aguirre, L, Saa, B & Torres, M (1996) Effects of short-term zinc supplementation on cellular immunity, respiratory symptoms, and growth of malnourished Equadorian children. Eur J Clin Nutr 50, 42–46.Google ScholarPubMed
Sempértegui, F, Estrella, B, Elmieh, N, Jordan, M, Ahmed, T, Rodríguez, A, Tucker, KL, Hamer, DH & Meydani, SN (2004) Nutritional, immunological, and health status of the elderly population living in poor neighborhoods of Quito, Ecuador: a preliminary report. FASEB J 18, A899.Google Scholar
Smith, JC, Butrimovitz, GP & Purdy, WC (1979) Direct measurement of zinc in plasma by atomic absorption spectroscopy. Clin Chem 25, 1487–1491.CrossRefGoogle ScholarPubMed
Spayd, RW, Bruschi, B, Burdick, BA, Dappen, GM, Eikenberry, JN, Esders, TW, Figueras, J, Goodhue, CT, LaRossa, DD, Nelson, RW, Rand, RN & Wu, TW (1978) Multilayer film elements for clinical analysis: applications to representative chemical determinations. Clin Chem 24, 1343–1350.CrossRefGoogle ScholarPubMed
Sundaresan, PR & Coursin, DB (1970) Microassay of pyridoxal phosphate using L-tyrosine 1- 14 C and tyrosine apodecarboxylase. Methods Enzymol 18, 509–512.CrossRefGoogle Scholar
Tietz, NW (1986) Textbook of Clinical Chemistry. Philadelphia, PA: W.B. Saunders Company.Google Scholar
Trinder, P (1969) Determination of blood glucose using an oxidase-peroxidase system with a non-carcinogenic chromogen. J Clin Pathol 22, 158–161.CrossRefGoogle ScholarPubMed
Tucker, KL, Rich, S, Rosenberg, I, Jacques, P, Dallal, G, Wilson, PW & Selhub, J (2000) Plasma vitamin B-12 concentrations relate to intake source in the Framingham Offspring study. Am J Clin Nutr 71, 514–522.CrossRefGoogle ScholarPubMed
United Nations (2001) Comprehensive tables. In World Population Prospects, the 2000 Revision, vol. 1. New York: UN.Google Scholar
United Nations (2005) Population Newsletter vol. 79, june 2005, pp 1–5. New York: UN.Google Scholar
United States Department of Agriculture Agricultural Research Service. (2004). USDA National Nutrient Database for Standard Reference, release 17. Nutrient Data Laboratory. http://www.nal.usda.gov/fnic/foodcomp.Google Scholar
United States Department of Agriculture Agricultural Research Service (2006) USDA National Nutrient Database for Standard Reference, release 18. Nutrient Data Laboratory. Accessed 16 May 2006. http://www.nal.usda.gov/fnic/foodcomp/search/.Google Scholar
Warnick, GR, Benderson, J & Albers, J (1982) Dextran sulfate-Mg 2+ precipitation procedure for quantitation of high density lipoprotein cholesterol. Clin Chem Acta 28, 1379–1388.CrossRefGoogle Scholar
Wolters, M, Strohle, A & Hahn, A (2004) Cobalamin: a critical vitamin in the elderly. Prev Med 39, 1256–1266.CrossRefGoogle ScholarPubMed
Zamora, RM & Valverde, V (1983) The dietary score as a simplified methodology in processing and analyzing food consumption data (article in Spanish). Arch Latinoam Nutr 33, 843–860.Google Scholar