Geographical inequalities in nutrient status and risk of malnutrition among English people aged 65 y and older

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Vol. 21; no. 11; pp. 1100 - 1106
• Main Authors: Elia, Marinos, Stratton, Rebecca J.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2005; Elsevier; Elsevier Limited
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Blood; Carotenoids; Cross-Sectional Studies; Developed countries; Diet Surveys; Disease; Elderly; elderly nutrition; Energy; England - epidemiology; Feeding. Feeding behavior; Female; Food; Fruit; Fruits; Fundamental and applied biological sciences. Psychology; geographical variation; Geography; Geriatric Assessment; health status; Health Surveys; Humans; Industrialized nations; Inequalities; kwashiorkor; Life expectancy; Male; Malnutrition; Malnutrition Universal Screening Tool; Micronutrients - blood; morbidity; Mortality; Nutrient status; Nutrients; Nutrition; Nutrition Assessment; Nutrition surveys; Nutritional Status; Older people; Protein-Energy Malnutrition - epidemiology; Risk Factors; Screening; Secondary analysis; Selenium; Social Class; Socioeconomic Factors; Socioeconomics; Vegetables; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vitamin C; Vitamin D; Vitamins - blood; England; United Kingdom > UK; Malnutrition Universal Screening Tool; Screening; Nutrients; Malnutrition; Elderly; Inequalities; Human; Nutrition disorder; Medical screening; English; Vertebrata; Mammalia; Risk factor; Nutrient; Nutritional status
• ISSN: 0899-9007; 1873-1244
• DOI: 10.1016/j.nut.2005.03.005

Geographical inequalities in health continue to be a problem within developed countries. This study investigated whether there were north-south geographical inequalities among older people living in England with respect to risk of protein-energy malnutrition and status of nutrients, particularly those derived from fruit and vegetables. A secondary analysis of data collected prospectively by the National Diet and Nutrition Survey of people aged 65 y and older was undertaken to assess geographical prevalence of risk of protein-energy malnutrition (1155 subjects) and nutrient status (881 to 1046 subjects). A north-south gradient was found in risk of protein-energy malnutrition (19.4%, 12.3%, and 11.2% in the northern, central, and southern regions, respectively; P = 0.013, P for trend = 0.002). This was accompanied by a north-south gradient in the status of vitamin C (30, 38, and 46 μmol/L in the respective regions, P < 0.001), which was associated with deficiency (<11 μmol/L) in a third of subjects in the northern region, a range of carotenoids ( P = 0.023 to <0.001), vitamin D ( P < 0.001), and selenium ( P < 0.001). These inequalities were accompanied by gradients in indices of health status and socioeconomic status, which could account only partly for the “geographical” inequalities. Circulating vitamin C and carotenoid concentrations were related to the intake of fruit and vegetables. This study suggests there is a north-south divide in the risk of protein-energy malnutrition and a range of nutrients, which have been implicated in the development of common chronic diseases.