Assessment Of Diet Quality And Exploration Of Computation Of Dietary Standards For The Elderly Adults For Thiamin And Riboflavin

Objective:To discover the weakness of nutrient intake of the elderly living in facilities for the elderly, and develop the corresponding composite assessment instructment of diet,the solutions were presented to promote adequate nutrition for them.To elaborate the implications underlying among energy intake,energy and body mass index,the reasonable advice was given for the elderly to acquire an ideal body weight.Thiamin requirement and riboflavin requirement of the elderly adults at an advanced age were studied as the basis of development of dietary reference intakes for thiamin and riboflavin.Methods:A detailed 3-day dietary survey using a weighed-food recording on each subject was conducted for 177 elderly persons over the age of 60,independent of activities of daily living, in 4 resthomes in a Shanghai municipal district for the elderly by stratified sampling.Aimed at characteristics of nutrition requirement for the older adults,the approached DBI for the Chinese elderly persons,of which the validity was identified,was adapted from selection food components and scoring schemes of 2005 Chinese DBI.35 older individuals over the age of 65,whose cognitive performance and antioxidant capabilities were assessed by using the mini-mental status examination of Chinese version and determining plasma levels of malondialdehyde(MDA),total superoxide dismutase (T-SOD),copper-zinc superoxide dismutase(CuZn-SOD) and manganese superoxide dismutase(Mn-SOD),were applied to conduct a nutritional survey and estimate energy expenditure in a resthome for the elderly by a weighed-food recording and anthropometry on each subject and factorial calculation.The studies of thiamin and riboflavin requirement for 14 days were conducted for 35 subjects in older age above mentioned by using linear and nonlinear regression analyses, regression prediction and residual analyses of indices about thiamin and riboflavin excretion in 4 hours urine after loading and blood glutathione reductase activity coefficient(BGRAC), and so on.Results:The diet pattern in 177 elderly people investigated was lack in coarse grain, tubers,milk,nuts and seeds,and so on.Intakes of most of nutrients were indicated inadequate, especially such as vitamin B₁,vitamin B₂,vitamin C,folic acid,iodine,zinc and selenium. Intakes of energy and the majority of nutrients were significantly correlated negatively with the expenditure of money on the subjects'diet.The intakes of all nutrients of subjects barely exceeded the ULs,nevertheless there were many of individuals with intakes of fat and sodium above the upper limit of the AI values.The constituent ratios of food sources of protein and fat were better,but those of calcium and iron were poor.The fraction of energy from saturated fat was excessive,and that of monounsaturated was inadequate,and the energy-yielding proportions from carbohydrate and protein were insufficient whereas that from fat was too much,but the proportion of energy from breakfast was fractionally low.The DBI scoring and evaluating system could summarily embody the actual intake of most food groups and nutrient components,and synthetically reflect the direction and degrees of deficient intake,excessive intake and inbalanced status of nutrient intake.On the whole, intakes of diets of sample subjects were inadequate.Gender,age and fare expenses could affect the diet quality,and the leading impact factors of food groups on diet quality of subjects occurred for dairy products,legumes,vegetables,fruits,edible oil and animal foods.Intakes of energy,carbohydrate,protein,fat,thiamine and riboflavin of 35 older adults at an advanced age at baseline were(5.63±1.32)MJ,(193.8±51.3)g,(45.2±9.9)g,(43.3±11.6) g,(0.82±0.25) mg and(0.46±0.15) mg,respectively.The sample fraction of inadequate intakes of energy,protein,thiamine and riboflavin was 88.6%,77.1%,88.6% and 100%,respectively.Total energy expenditure was(4.90±1.26)MJ.The physical activity level(PAL) was 1.12.The proportion of overweight and obesity for BMI was 48.6%.Changes such as improvement in capabilities of antioxidation and decline in levels of lipid peroxide and a rise in the MMSE score,occurred after 35 subjects at an advanced age receiving riboflavin supplements.The computing EAR value and the computing RNI value for thiamin were 1.26mg and 1.48mg,respectively.Meanwhile,the computing EAR value and the computing RNI value for riboflavin were 1.35mg and 1.63mg,respectively.Conclusions:These findings indicate that the major nutrition problems of 177 subjects in question are inadequacy of dietary nutrition.It is suggested that consumption of food rich in sodium,saturated fat and cholesterol should be reduced,meanwhile intakes of foods from breakfast is to the contrary.The DBI assessment system developed for the Chinese elderly adults could summarily reflect the diet quality of the subjects,and find the major problems of the dietary pattern presented herein.The level of average physical activity level and nutritional status for 35 older adults is low, and the average energy intake exceeds the average energy expenditure among the sampling subjects,whose capabilities of antioxidation and the cognitive score improve,but levels of lipid peroxidate decline after supplement of riboflavin.These preliminary results from the current studies show that for the elderly over 65 years of age the EAR and the RNI for thiamin are 1.26mg and 1.48mg,respectively,and the EAR and the RNI for riboflavin are 1.35mg and 1.63mg,respectively.