Case-control study of anaemia among middle-aged and elderly women in three rural areas of China

Association between Dietary Patterns and Low HDL-C among Community-Dwelling Elders in North China

We aimed to investigate the association between dietary patterns and low HDL-C among the elderly population living in North China. The data were from a national cross-sectional survey conducted in 2015. General information in terms of living habits, health status, and food intake using 24 h dietary recall for three consecutive days was procured, and the weight of edible oil and condiments recorded. Anthropometric index, blood pressure, and fasting serum lipids were measured using standard methods. Dietary patterns were derived from food categories by exploratory factor analysis, and multivariate logistic regression was used to estimate the odds ratios of low HDL-C across quartiles of dietary patterns. Among 3387 elderly participants, 21.9% had low HDL-C levels. After adjusting for potential confounding factors, participants with highest score versus lowest score in the balanced dietary pattern had a decreased risk of low HDL-C (OR = 0.38, 95% CI: 0.16-0.88, p for trend = 0.013) in the group with a BMI of 27.1 kg/m² and above. Compared to the lowest quartile, there was a statistically significant negative association between the highest scores of the Western dietary pattern and low HDL-C (OR = 0.37, 95% CI: 0.17-0.82, p for trend = 0.018) in the group with a BMI of 21.6-24.8 kg/m². However, greater adherence to a thrifty dietary pattern (highest quartiles vs. lowest quartiles) was associated with increased risk of low HDL-C (OR = 3.31, 95% CI: 1.05-10.40, p for trend = 0.044), especially in the subgroup with a BMI of 21.6 kg/m² and below. The study revealed that it is urgent to develop district-specific dietary improvement plans for dyslipidemia based on the nutritional status of the elderly population in North China.

The Association with Dietary Patterns and Risk of Anemia in Japanese Elderly

Anemia is a risk factor for frailty. Although various factors can reduce the risk of anemia, information on dietary contributions is limited. This study aimed to evaluate the association between anemia and eating patterns in Japanese elderly. Our study included 6,864 elderly individuals, aged ≥65 y, whose data were obtained from the 2010-2015 National Health and Nutritional Survey, Japan. Anemia was defined as whole blood hemoglobin concentrations <13 g/dL in men, and <12 g/dL in women. We classified eating patterns into 33 food groups, using food items obtained from dietary records, and identified three dietary patterns using principal component analysis method. Participants were assigned and divided into quartiles according to pattern-specific factor scores. We calculated adjusted odds ratios (ORs) for anemia using multivariate logistic regression, and assigned the first quartile (minimum) as the reference. The overall prevalence of anemia was 17.1%. The meats and vegetables eating pattern was characterized by red meat and other vegetables, the Japanese eating pattern by rice and salted or pickled vegetables, and the fruits and vegetables eating pattern by fruits and green-yellow vegetables. Participants in the highest meats and vegetables eating pattern quartile had a 20% lower risk of anemia than those in the lowest quartile (OR 0.81; 95% confidence interval (CI) 0.66-1.00); the Japanese eating pattern participants had a 20% higher risk of anemia (OR 1.28; 95% CI 1.06-1.53). The fruits and vegetables eating pattern participants had no significant change in their risk of anemia. This study may indicate that consuming a high red meat diet prevents anemia in elderly Japanese individuals.

Are Routine Postoperative Laboratory Tests Necessary After Primary Total Hip Arthroplasty?

BACKGROUND

Recently, the practice of ordering routine postoperative laboratory tests in primary total hip arthroplasty (THA) has been challenged. This study aimed to evaluate the utility of routine postoperative laboratory tests after primary elective THA in an Asian population and identify the risk factors associated with abnormal postoperative laboratory test-related intervention.

METHODS

We retrospectively reviewed 395 consecutive patients who underwent primary elective THA at a single tertiary academic center. Patient clinical information and laboratory test results were collected for analysis.

RESULTS

A total of 349 (88.4%) patients had abnormal postoperative laboratory test results; most patients had anemia and hypoalbuminemia. Twenty-seven (6.8%) patients received clinical intervention. Of the 307 (77.7%) patients with postoperative anemia, 7 patients received blood transfusion. Factors associated with transfusion were female gender, low body mass index, long operation time, and low preoperative hemoglobin levels. Of the 149 (37.7%) patients with postoperative hypoalbuminemia, 16 received albumin supplementation. Factors associated with albumin supplementation were female gender, long operation time, and low preoperative albumin levels. Although 36 patients had abnormal postoperative creatinine, only 1 patient required specialist consultation. For electrolyte abnormalities, hyponatremia was noted; however, no patient received sodium supplementation. Moreover, 14 patients developed hypokalemia, of which 6 required potassium supplementation; 163 patients had hypocalcemia, of which 2 received calcium supplementation.

CONCLUSION

Routine laboratory tests after primary elective THA are unnecessary for most of the patients in modern clinical practice. However, for those with identified risk factors, postoperative laboratory tests still should be performed.

Iron status in the elderly: A review of recent evidence

A comprehensive literature review of iron status in the elderly was undertaken in order to update a previous review (Fairweather-Tait et al, 2014); 138 summarised papers describe research on the magnitude of the problem, aetiology and age-related physiological changes that may affect iron status, novel strategies for assessing iron status with concurrent health conditions, hepcidin, lifestyle factors, iron supplements, iron status and health outcomes (bone mineral density, frailty, inflammatory bowel disease, kidney failure, cancer, cardiovascular, and neurodegenerative diseases). Each section of this review concludes with key points from the relevant papers. The overall findings were that disturbed iron metabolism plays a major role in a large number of conditions associated with old age. Correction of iron deficiency/overload may improve disease prognosis, but diagnosis of iron deficiency requires appropriate cut-offs for biomarkers of iron status in elderly men and women to be agreed. Iron deficiency (with or without anemia), anemia of inflammation, and anemia of chronic disease are all widespread in the elderly and, once identified, should be investigated further as they are often indicative of underlying disease. Management options should be reviewed and updated, and novel therapies, which show potential for treating anemia of inflammation or chronic disease, should be considered.

Dietary Intake, Prevalence, and the Effect of Anemia on Various Morphophysiological Variables of Postmenopausal Women of North India

CONTEXT

Anemia has a high prevalence among postmenopausal Indian females.

AIM AND OBJECTIVE

The aim of this study was to evaluate dietary intake, prevalence, and the effect of anemia on various morphophysiological variables among postmenopausal women.

SETTING AND DESIGN

This was a community-based sample survey.

MATERIALS AND METHODS

A total of 250 postmenopausal women aged 45-80 years from various parts of North India participated in the study. Anthropometric measurements, hemoglobin concentration, and bone mineral density (BMD) (using dual-energy X-ray absorptiometry) of each participant were assessed. A 24-h dietary recall method for three consecutive days was employed.

STATISTICAL ANALYSIS

The Statistical Package for the Social Sciences version 20 was used for statistical considerations.

RESULTS

An age-associated decline in the mean values of hemoglobin concentration and the prevalence of anemia was reported to be 85.2% among postmenopausal women. Anemic women were lighter and had lesser circumferential measurements as well as lower BMD than their nonanemic counterparts. The intake of nutrients such as protein, calcium, and iron and energy was lower among anemic women than nonanemic women. Binary logistic regression analysis identified age (odds ratio = 1.04, 95% confidence interval = 1.00-1.09)* as the possible predictor of anemia.

CONCLUSIONS

Anemia was not only the result of aging process but also inadequate and unbalanced dietary intake.

Dietary Balance Index-07 and the Risk of Anemia in Middle Aged and Elderly People in Southwest China: A Cross Sectional Study

A balanced diet is essential to achieve and maintain good health. In this study, we assessed diet quality of middle aged and elderly people based on Chinese Diet Balance Index-07 (DBI-07) and explored the associations between DBI-07 and anemia. Data analyzed for this study was from the 2010–2012 National Nutrition and Health Survey in Yunnan province, southwest China (n = 738, aged 50–77 years). Dietary recalls over there consecutive days were done in a face-to-face interview. The scores of DBI-07 for each component and three DBI-07 indicators ((Lower Bound Score (LBS), Higher Bound Score (HBS), Diet Quality Distance (DQD)) were calculated according to compliance with the Dietary Guidelines for Chinese residents. Hemoglobin (Hb) concentration was determined using the cyanmethemoglobin method. Univariate and multivariate linear regression models were used to explore the associations between DBI-07 indicators and anemia, as well as scores of DBI-07 components and Hb level. The sample included 336 men and 402 women. Inadequate intakes of vegetables, fruits, dairy, soybean, eggs, fish and excessive intakes of cereals, meat, cooking oil, salt were both common. 91.3% of the participants had moderate or high levels of inadequate food intake, while 37.7% had moderate or high levels of excessive food intake. The mean Hb was 14.2 ± 1.7 g/dL, with a prevalence of anemia of 13.0%. Subjects with high LBS and DQD were more likely to be anemic (all p < 0.05). After adjustment for potential confounders, there were positive correlations between Hb level and the intakes of vegetables and soybean (β_vegetables = 1.04, p < 0.01; β_soybean = 0.82, p = 0.04). In conclusion, dietary imbalance and anemia are common in middle aged and elderly population in southwest China and inadequate intakes of vegetables and soybean may increase the risk of anemia.