ASSESSMENT OF RISK FACTORS OF OSTEOPOROSIS IN POSTMENOPAUSAL WOMAN

Background: To determine the usefulness of risk assessment and screening for osteoporosis in a hospital based population of postmenopausal women. Methods: 100 women with post-menopausal women, age more than 40 yrs, cessation of period more than 1yr were included in the study. Result: 17 (17.0%) were more than 65 years of age. Low body weight, inadequate dietary intake of calcium and decreased physical activity were most commonly associated risk factor. 4 (4.0%) women were smokers, women had history of oral steroid intake for >3 months for various medical illnesses. Conclusion: Evaluation of postmenopausal women by screening for risk factors was found to be a powerful tool to define the risk status for osteoporosis. Low body weight and poor dietary calcium are modifiable risk factors for developing osteoporosis. Keywords: Osteoporosis, Post-Menopausal, Prevalence

Neurologic Complications of Nutritional Disorders

A number of medical and neurologic conditions may result from inadequate ingestion, absorption, transport, or storage of critical vitamins and micronutrients. Individuals at risk for inadequate dietary intake include those who are receiving prolonged parenteral nutrition for various chronic medical conditions, those who have eating disorders or chronic alcoholism, and those who are part of a resource-limited population. Malabsorption may result from several conditions, including chronic gastrointestinal disorders and gastrointestinal surgeries. Excessive intake of vitamins such as vitamin B6 may directly cause neurotoxicity, and copper deficiency myeloneuropathy may result from excessive ingestion of zinc (often in the form of denture cream aggressively used for loose-fitting dentures), which competes with copper for absorption within the gastrointestinal tract.

Physical Frailty/Sarcopenia as a Key Predisposing Factor to Coronavirus Disease 2019 (COVID-19) and Its Complications in Older Adults

The tremendously rising numbers of aged populations are associated with a heightened risk for motor and functional declines. Sarcopenia is an active age-related process that involves progressive losses of skeletal muscle mass, muscle strength, and muscle function. Muscle failure is a major cause of frailty, disability, falls, hospitalization, dependency, institutionalization, and low quality of life in older seniors. Therefore, sarcopenia considerably heightens the annual cost of care worldwide. This narrative review elaborates on sarcopenia as a deleterious condition in old age while spotting the light on its association with the coronavirus disease 2019 (COVID-19). It discusses its pathophysiology and the most possible options for preventing and treating sarcopenia. The literature shows that the dynamic of sarcopenia is complex, involving multifaceted physiological alterations relevant to aging, unhealthy behaviors (e.g., undernutrition or inadequate dietary intake and physical inactivity/immobility or sedentary lifestyle), and multiple pathogenic conditions such as metabolic, inflammatory, and endocrinal disorders. Frail individuals express nutritional deficiencies, immune deficit, oxidative stress, metabolic alterations, gut microbial alterations, neurological insult, etc. Such physiological dysfunctions are closely linked to increased vulnerability to COVID-19 among older adults and people with non-communicable diseases such as diabetes mellitus, cardiovascular disorders, and obesity. Available studies report higher occurrence of severe COVID-19 and COVID-19-related complications (ICU admission, mechanical ventilation, and in-hospital mortality) among frail compared with non-frail and prefrail individuals. Effective pharmacological treatments of sarcopenia are not currently available. However, physical activity and nutritional interventions (e.g., fast digestive proteins, vitamin D, and natural products such as bee products) may prevent the development of sarcopenia in early stages of the disease or limit disease progress. Such interventions may also lower vulnerability to COVID-19.

Perspective: Practical Approach to Preventing Subclinical B12 Deficiency in Elderly Population

Vitamin B12 (also known as cobalamin) is an essential water-soluble vitamin that plays a pivotal role for several physiologic functions during one’s lifespan. Only certain microorganisms are able to synthetize B12, thus humans obtain cobalamin exclusively from their diet, specifically from animal-derived foods. Specific sub-group populations are at risk of vitamin B12 subclinical deficiency due to different factors including poor intake of animal source foods and age-dependent decrease in the capacity of intestinal B12 uptake. Consumption of animal products produces some negative health issues and negatively impacts sustainability while a plant-based diet increases the risk of B12 deficiency. Taking a cue from the aforementioned considerations, this narrative review aims to summarize facts about B12 deficiency and the burden of inadequate dietary intake in elderly population, as well as to discuss sustainable approaches to vitamin B12 deficiency in aging population.

Taste Sensitivity of Elderly People Is Associated with Quality of Life and Inadequate Dietary Intake

Aging has been implicated in the alteration of taste acuity. Diet can affect taste sensitivity. We aimed to investigate the types of tastes altered in elderly Korean people and factors associated with taste alteration in relation to dietary intake and other factors. Elderly participants (≥65 years) and young adults were assessed to determine their recognition thresholds (RT) for sweet, salty, bitter, sour, and umami tastes. Elderly participants were further surveyed for dietary intake and non-nutritional factors. Five taste RTs were correlated with age, but only four taste RTs, except sweetness, differed between the elderly participants and young adults. Inadequate intake of iron, thiamin, folic acid, zinc, and phosphorus among the elderly participants was related to elevated taste RT levels, except for bitter taste. In both correlation and regression analyses, only salty and sour RTs were associated with energy, iron, thiamin, fiber, vitamin C, and riboflavin levels in the elderly participants. The elderly participants’ taste RTs exhibited strong associations with quality of life (QOL) but showed partial relationships with physical activity, number of medicine intakes, social gatherings, and education. Taste sensitivity may decrease with age, which is further influenced by insufficient dietary intake, especially iron and thiamin, and QOL.

Prevalence of Zinc Deficiency in Japanese Patients on Peritoneal Dialysis: Comparative Study in Patients on Hemodialysis

Background: It is known that patients on hemodialysis (HD) are prone to developing zinc deficiency due to removal of zinc by HD, inadequate dietary intake, and reduced gastrointestinal zinc absorption. However, the prevalence of zinc deficiency in patients on peritoneal dialysis (PD) has not been well established. Methods: Serum zinc levels were compared between 47 patients on PD and 47 patients on HD matched for age, sex, and duration of dialysis. A serum zinc level < 60 μg/dL was defined as clinical zinc deficiency and a level of 60–80 μg/dL as subclinical zinc deficiency. The prevalence of zinc deficiency and associated clinical factors were determined in both groups. Results: Clinical zinc deficiency was found in 59.6% of the PD group and 70.2% of the HD group (p = 0.391). Subclinical zinc deficiency was found in 40.4% of the PD group and 29.8% of the HD group. Age, body mass index, and serum albumin level were identified as independent predictors of zinc deficiency in the PD group by multivariate analysis. Conclusions: A higher prevalence of clinical and subclinical zinc deficiency was found in patients on PD. The rates were comparable between patients on PD and those on HD after adjustment for confounding factors.

“I Feel like I’m Eating Rice 24 Hours a Day, 7 Days a Week”: Dietary Diversity among Asylum Seekers Living in Norway

Food insecurity is widespread among asylum seekers resettled in Western countries. Limited information exists on the quality of food intake in this population. The aim of this study was to investigate dietary quality among asylum seekers living in Norwegian reception centers. This study has a cross-sectional research design. Dietary intake was assessed through a qualitative 24-hour dietary recall, and the dietary diversity score (DDS) was calculated. This study was conducted in eight Norwegian reception centers. A total of 205 adult asylum seekers (131 men and 74 women) participated in the study. The asylum seekers ate on average two meals per day, and one-third ate their first meal after noon. Mean (SD) DDS was 4.0 (1.6) and 2/3 had low dietary diversity, eating from fewer than five food groups. Women had a significantly higher mean DDS (4.5) than men (3.8) (β (95% CI): 0.47 (0.00, 0.95) and a higher consumption of vegetables and fruits. The longer the period of residence in Norway, the higher the DDS, β (95% CI): 0.01 (0.00, 0.02). The asylum seekers’ inadequate dietary intake reveals new forms of poverty and social exclusion in Europe. An inadequate dietary intake may increase the magnitude of difficulty involved in the settlement process and contribute to poorer health.

Breast Milk Content of Vitamin A and E from Early- to Mid-Lactation Is Affected by Inadequate Dietary Intake in Brazilian Adult Women

Our aims were to investigate vitamin A and E status during lactation and the determinants of breast milk content for the appropriate nutrition of the infant in a study with nursing Brazilian women. We hypothesized that both inadequate intake and the lipoprotein distribution of vitamin A and E during lactation could have an impact on their breast milk levels from early- to mid-lactation. Nineteen adult lactating women participated in this longitudinal observational study, in which dietary records, blood and mature breast milk samples were collected for the analysis of vitamin A and E, and carotenoids in early- (2nd to 4th week) and mid-lactation (12th to 14th week). Nutrient intake was balanced by the Multiple Source Method (MSM), and the intake of vitamin A and E was inadequate in 74 and 100% of the women, respectively. However, these results were not reflected in low serum concentrations of retinol and only 37% of the volunteers were vitamin E deficient according to the blood biomarker. As lactation progressed, vitamin A and E status worsened, and this was clearly observed by the decrease in their content in breast milk. The reduced content of vitamin A and E in the breast milk was not related to their distribution in lipoproteins. Taken together, the contents of vitamin A and E in breast milk seemed to be more sensitive markers of maternal nutrition status than respective blood concentrations, and dietary assessment by the MSM in early lactation was sensitive to indicate later risks of deficiency and should support maternal dietary guidance to improve the infant’s nutrition.

Multifocal Assessment Reveals Anemia-related Program Gaps and Implementation Challenges in Ghana (P10-088-19)

Objectives Despite existing program efforts in Ghana, incidence of childhood anemia remain high. This study describes existing childhood anemia prevention and treatment strategies and assessed implementation gaps. Methods A cross-sectional study using purposive sampling/snowballing technique identified organizations implementing childhood anemia prevention and treatment programs. Interview guides constructed around UNICEF's conceptual framework of malnutrition identified programs addressing each cause of anemia. Interviews were administered via in-person and phone in August 2018. Interviews were audio-recorded, transcribed, and coded/analyzed using Dedoose software version 8.1.8. Results Twenty-five officials from Universities (n = 2), local non-governmental (n = 4), government departments (n = 6) and international (n = 2) agencies completed interviews. Reported contextual immediate causes of anemia were malaria, diarrhea, worm infestation and inadequate dietary intake. All organizations implemented programs addressing ≥1 of the immediate causes, with many overlapping programs from different organizations addressing inadequate dietary intake in the same district. Government-assisted programs and Universities reported national scope; non-governmental/private organizations had regional/district focus. The contextual underlying causes reported were inadequate nutrition knowledge, food safety and environmental hygiene, food insecurity and health services. All organizations were implementing programs addressing ≥1 of these underlying causes. Few programs addressed the reported basic causes namely, inadequate human resources (n = 5) and housing/water/toilet facilities (n = 3) and poverty/financial resources (n = 2). Reported program gaps included inadequate human resources and scarce funding for projects. The main observed gap was insufficient communication and integration between programs implementer. Conclusions Multiple programs, sometimes with overlapping focus in the same region were addressing anemia. Re-designing programs to prioritize communication between current program may result in efficient use of limited funding and human resources. New programs may focus on improving financial investment in programs and more personnel. Funding Sources RIT Miller Chair Grant for Global Experiential Research.