Prevalence of malnutrition and associated metabolic risk factors for cardiovascular disease in older adults from Northwest Mexico

Perspective on Emerging Micronutrient Deficiencies in Latin America and the Caribbean

The moral imperative of public health systems is to maximize the health and welfare of the population to the extent possible. Constraints often include a lack of resources, political will, popular acceptance, or an acceptable safety margin. Major agencies have established iron, iodine, and vitamin A as the principal elements for micronutrients, with folate and zinc on the second plane. As the armamentarium of interventions to favor micronutrient nutrition, for example, preventive health measures, dietary improvement, forms of fortification, and nutrient supplements, is offered in public health policy. The utility of their merger with other nutrients, emergent nutrients, has been considered. The Latin America and Caribbean Region has unique characteristics. The scientific and epidemiology considerations for action in the Region's health concern on 4 emergent nutrient deficiencies of public health-vitamins D and E, essential fatty acids, and choline-are reviewed.

Factors Associated with Malnutrition Risk in Residents of Long-Term Care Facilities in Mexico

OBJECTIVE

To investigate factors associated with the nutritional status in institutionalized Mexican older adults.

MATERIAL AND METHODS

In this cross-sectional study of residents in three long-term care facilities (LTCFs) in Monterrey, Mexico, a medical history, Mini-Mental State Examination, Barthel index, and geriatric depression scale, and Mini Nutritional Assessment (MNA) were performed. Risk of malnutrition and malnutrition status were defined as MNA 17-23.5 and <17, respectively.

RESULTS

Residents (n = 280) had a median age of 85 years and 72.1% were female. A total of 116 (41.4%) were at risk of malnutrition and 35 (12.5%) were malnourished. Having malnutrition or being at risk of malnutrition was associated with age (OR = 1.048), functional dependence (OR = 8.376), body mass index (BMI) <22 (OR = 7.518), cognitive impairment (OR = 2.210), urinary incontinence (OR = 2.397), previous stroke (OR = 2.870), Parkinson's disease (OR = 5.193), use of calcium channel blockers (OR = 3.706), and use of atypical antipsychotics (OR = 2.277). Having benign prostatic hyperplasia (OR = 0.067) or the use of angiotensin II receptor blockers (OR = 0.038) were related to being well-nourished.

CONCLUSIONS

In a population of residents of three LTCFs in Mexico, we found a high prevalence of malnutrition or being at risk of malnutrition. This underscores the need to implement guidelines for the prompt identification of this condition and further explanation of the factors identified as possibly related to malnutrition.

Malnutrition Risk among Older Mexican Adults in the Mexican Health and Aging Study

Few studies assess the malnutrition risk of older Mexican adults because most studies do not assess nutritional status. This study proposes a modified version of the Mini Nutritional Assessment (MNA) to assess the risk of malnutrition among older Mexicans adults in the Mexican Health and Aging Study (MHAS). Data comes from the 2012, 2015, and 2018 waves of the MHAS, a nationally representative study of Mexicans aged 50 and older. The sample included 13,338 participants and a subsample of 1911 with biomarker values. ROC analysis was used to calculate the cut point for malnutrition risk. This cut point was compared to the definition of malnutrition from the ESPEN criteria, BMI, low hemoglobin, or low cholesterol. Logistic regression was used to assess predictors of malnutrition risk. A score of 10 was the optimal cut point for malnutrition risk in the modified MNA. This cut point had high concordance to identify malnutrition risk compared to the ESPEN criteria (97.7%) and had moderate concordance compared to BMI only (78.6%), and the biomarkers of low hemoglobin (56.1%) and low cholesterol (54.1%). Women, those older than 70, those with Seguro Popular health insurance, and those with fair/poor health were more likely to be malnourished. The modified MNA is an important tool to assess malnutrition risk in future studies using MHAS data.

Plasma total cholesterol level and some related factors in northern Iranian people

BACKGROUND

In middle age people, hypercholesterolemia (HC) has been included as a risk factor for cardiovascular disease.

OBJECTIVES

The main objective of this study was to evaluate the prevalence of HC and some related factors in the north of Iran.

MATERIALS AND METHODS

This was a population-based cross-sectional study that enrolled 1995 subjects (997 males and 998 females) in 25-65 year age using stratified cluster sampling. Interviewers recorded the data using a multidimensional questionnaire including anthropometric indexes. Plasma cholesterol was measured in the morning after a 12-hour fast and determined by an auto-analyzer. HC was defined by a total plasma total cholesterol level over 200 mg/dl. The SPSS.16 software was used to analyze data.

RESULTS

The mean age of the participant was 44.2 years and mean ± SD plasma total cholesterol level in men and women was 196.7 ± 39.11 and 209.4 ± 42.9, respectively. Generally, the prevalence of HC was 50.4% with a significant differences between men (44.7%) and women (57%) (P < 0.05). The mean plasma total cholesterol levels were significantly differenced among age groups, location area, BMI, and waist circumferences (P < 0.001). Women gender (OR = 1.64), 55-65 years old (OR = 2.79), BMI ≥40 kg/m(2) (OR = 10.0), and abdominal obesity (OR = 2.47) were associated with increased risk of HC (P = 0.001 and 95%CI for all).

CONCLUSION

HC is one of the most health problems in the northern Iran and it is more common in women than in men. General and abdominal obesity are the most common risk factors for HC.

Malnutrition risk factors among the elderly from the US-Mexico border: the "one thousand" study

BACKGROUND

The Mexican population is aging, which makes the fact that there is no regional information on the health of the elderly, including those in the northern region of the country.

OBJECTIVE

To examine nutritional, functional, and cognitive impairments, as well as depression, in non-institutionalized elderly Mexicans along Mexico's northern border.

DESIGN

Observational, descriptive and cross-sectional study.

PARTICIPANTS AND MEASUREMENTS

Demographic and anthropometric measurements were screened and the following scales were applied among 760 elderly individuals in Chihuahua, Mexico: Katz index (for activities of daily living, ADL), the Mini Nutritional Assessment (MNA), the Yesavage (depression), and the Pffeifer (cognitive decline).

RESULTS

7% prevalence of malnutrition, a 18% prevalence of functional disability, a 44% prevalence of depressive symptoms, a 33% prevalence of cognitive impairment, and a risk of disease in almost half the population, without differences between genders. Malnutrition, functional disability, and cognitive impairment increased with age (P <0.001). Functional disability, depression, and cognitive impairment also increased the risk of malnutrition 3.0, 2.9 and 1.4 times (P <0.005). Other factors that may affect nutritional status included isolated living and illiteracy.

CONCLUSION

Levels of malnutrition, functional disability, depression and cognitive impairment are higher than those reported previously and are closely related to one another, so detecting alterations in primary care is important in order to improve quality of life and reduce complications.

Cardiovascular and metabolic effects of intensive Hatha Yoga training in middle-aged and older women from northern Mexico

Background:

Hatha Yoga (HY) can be an alternative to improve physical activity in middle-aged and older women. However, conventional HY (CHY) exercising may not result in enough training stimulus to improve cardiovascular fitness. The purpose of this study was to evaluate the effect of an intensive HY intervention (IHY) on cardiovascular risk factors in middle-aged and older women from Northern Mexico.

Materials and Methods:

In this prospective quasiexperimental design, four middle-aged and nine older CHY practicing females (yoginis) were enrolled into an 11-week IHY program consisting of 5 sessions/week for 90 min (55 sessions). The program adherence, asana performance, and work intensity were assessed along the intervention. Anthropometric [body mass index (BMI), % body fat and Σ skin folds], cardiovascular fitness [maximal expired air volume (VE_max), maximal O₂ consumption (VO_2max), maximal heart rate (HR_max), systolic (BPs) and diastolic blood pressure (BPd)], biochemical [glucose, triacylglycerols (TAG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C)], and dietary parameters were evaluated before and after IHY.

Results:

Daily caloric intake (~1,916 kcal/day), program adherence (~85%), and exercising skills (asana performance) were similar in both middle-aged and older women. The IHY program did not modify any anthropometric measurements. However, it increased VO_2max and VE_max and HDL-C while TAG and LDL-C remained stable in both middle-aged and older groups (P < 0.01).

Conclusions:

The proposed IHY program improves different cardiovascular risk factors (namely VO_2max and HDL-C) in middle-aged and older women.

Prediction of fat-free mass by bioelectrical impedance analysis in older adults from developing countries: a cross-validation study using the deuterium dilution method

OBJECTIVE

Several limitations of published bioelectrical impedance analysis (BIA) equations have been reported. The aims were to develop in a multiethnic, elderly population a new prediction equation and cross-validate it along with some published BIA equations for estimating fat-free mass using deuterium oxide dilution as the reference method.

DESIGN AND SETTING

Cross-sectional study of elderly from five developing countries.

METHODS

Total body water (TBW) measured by deuterium dilution was used to determine fat-free mass (FFM) in 383 subjects. Anthropometric and BIA variables were also measured. Only 377 subjects were included for the analysis, randomly divided into development and cross-validation groups after stratified by gender. Stepwise model selection was used to generate the model and Bland Altman analysis was used to test agreement.

RESULTS

FFM = 2.95 - 3.89 (Gender) + 0.514 (Ht2/Z) + 0.090 (Waist) + 0.156 (Body weight). The model fit parameters were an R2, total F-Ratio, and the SEE of 0.88, 314.3, and 3.3, respectively. None of the published BIA equations met the criteria for agreement. The new BIA equation underestimated FFM by just 0.3 kg in the cross-validation sample. The mean of the difference between FFM by TBW and the new BIA equation were not significantly different; 95% of the differences were between the limits of agreement of -6.3 to 6.9 kg of FFM. There was no significant association between the mean of the differences and their averages (r= 0.008 and p= 0.2).

CONCLUSIONS

This new BIA equation offers a valid option compared with some of the current published BIA equations to estimate FFM in elderly subjects from five developing countries.