© Borgis - New Medicine 1/2005, s. 5-8
Ewelina Spochacz-Przygodnicka, Wojciech Chalcarz
A vitamin content in daily food rations of the residents in homes for the elderly in the Wielkopolska region
Departament of Food and Nutrition, University School of Physical Education Poznań, Poland
Head of Departament: Prof. Wojciech Chaclarz, MD, PhD
Summary
The aim of the study was to assess vitamin content in daily food rations in different homes for the elderly (HE), with a special focus on the HE-gender interaction. The vitamin intake was evaluated in 106 residents over 70 years of age living in three homes for the elderly in Poznań and its vicinity. The intake was calculated from a current recording carried out over three days: two weekdays and one holiday. The results were analysed using computer software SPSS 11.5 PL for Windows. The analysis showed statistically significant differences in vitamin content in daily food rations in 11 of 12 vitamins assessed and in distribution of dietary allowances of seven vitamins. Men were found to have a higher vitamin intake in their daily food rations than women. The average intake of vitamin A, thiamine and vitamin B12 in the residents in all the assessed homes was higher than their recommended daily allowances (RDAs) whereas the average intake of vitamin E, D, riboflavin, vitamin B6, folates and vitamin C was lower than RDAs. It seems crucial to assess the HE menus in order to increase the quantity of nutrients which are rich vitamin sources. Apart from that, the elderly residents should also be encouraged to take vitamin supplements.
INTRODUCTION
The diet of the elderly should not differ significantly from that in the remaining age groups. However, since ageing generates multiple adverse effects, it is vital to balance their diet with all the macro- and micronutrients [14, 20]. Vitamins are of special significance, particularly antioxidative vitamins which prevent non-infectious diet-dependent diseases and have a beneficial effect upon health [8, 18].
Adequate vitamin intake in daily food rations is particularly important in the elderly, since 81,000 of them have been residents of homes for the elderly. In their reports, the authors assessed vitamin intake either in individual or several homes with a special focus upon the effect of only one parameter, i.e. most frequently, gender, age or home [6, 11, 12]. There are no available data comparing the vitamin intake in men and women in different homes. It is an important issue since the reports have shown significant differences in the diets provided to the residents of different HE [1, 12, 16]. The aim of the present study was to assess vitamin intake in daily food rations of residents in different homes for the elderly (HE) with a focus on the HE-gender interaction.
METHODS
The vitamin intake in 106 residents aged over 70 years, living in homes for the elderly in the Wielkopolska region, was calculated from current diet recording performed for three days, including two weekdays and one holiday. The residents were also requested to provide information on their socio-demographic status.
The vitamin content in daily food rations was measured by means of computer software Diet 2. The vitamin intake was determined at safe levels, except for folates: their intake was estimated with reference to recommended dietary allowances (RDAs) [20]. The average allowance percentage was assumed for the values 100+ 10%. Statistical analysis was done with software SPSS 11.5 PL for Windows.
All the residents agreed to participate in the study as volunteers. The consent for the study was granted by the Bioethics Committee.
RESULTS AND DISCUSSION
Socio-demographics
The study group included 106 residents of homes for the elderly: 79 women (74.5%) and 27 men (25.5%). The mean age was 80.3 + 6.2 years; the youngest persons were 70 years of age and the oldest person was at the age of 95 years.
The residents with a primary education level accounted for 37.7% of the study group; 29.2% of the participants were secondary school graduates. The group with incomplete primary education as well as graduates of vocational schools were represented by 12.3% respectively. The group with the university education level consisted of 8.4% residents, including one person with a PhD degree (0.9%).
As many as 68.9% of the study participants were widowed; 15.1% of the participants were single. Nine persons (8.5%) were married; women and men who had never been married accounted for 7.5% of the study group.
Vitamin intake
Table 1 includes an average vitamin content in the daily food rations of the residents of homes for the elderly in the Wielkopolska region.
Table 1. An average vitamin content in daily food rations of the residents in homes for the elderly in Wielkopolska.
| Vitamins | HE 1 | HE 2 | HE 3 | Altogether |
| Women | Men | Women | Men | Women | Men |
| N=21 | N=7 | N=24 | N=9 | N=34 | N=11 | N=106 |
| Vitamin A [?g] | 790 ? 132 A | 888 ? 241 | 810 ? 194 B | 796 ? 120 C | 1003 ? 215 | 1046 ? 253 A, B, C | 896?217 |
| Vitamin E [mg] | 6.51 ? 1.53 A | 7.84 ? 0.38 B,F | 6.43 ? 1.55 C | 7.10 ? 1.09 D,E | 4.79 ? 1.03 A,B,C,D | 5.44 ? 0.96 E,F | 5.97 ? 1.55 |
| Vitamin D [?g] | 2.82 ? 0.55 B | 3.06 ? 0.45 D,E | 2.74 ? 0.60 A | 2.82 ? 0.53 | 1.78 ? 0.54 A,B,C,D | 2.41 ? 0.66 C,E | 2.44 ? 0.73 |
| Thiamine [mg] | 1.439 ? 0.324 B | 1.826 ? 0.296 D | 1.446 ? 0.296 C | 1.651 ? 0.412 | 1.380 ? 0.383 A,D | 1.916 ? 0.349 A,B,C | 1.515 ? 0.384 |
| Riboflavin [mg] | 1.400 ? 0.312 | 1.714 ? 0.160 A | 1.477 ? 0.295 | 1.544 ? 0.275 | 1.317 ? 0.293 A, B | 1.732 ? 0.527 B | 1.460 ? 0.344 |
| Vitamin B6 [mg] | 1.60 ? 0.34 | 2.03 ? 0.24 B,C | 1.67 ? 0.34 | 1.78 ? 0.38 | 1.43 ? 0.39 A,B | 1.95 ? 0.40 A | 1.64 ? 0.40 |
| Vitamin B12 [?g] | 2.44 ? 0.52 | 2.79 ? 0.40 A | 2.56 ? 0.50 | 2.61 ? 0.50 | 2.08 ? 0.54 A,B | 2.99 ? 1.13 B | 2.45 ? 0.66 |
| Niacyn [mg] | 16.84 ? 3.55 | 19.07 ? 2.76 A | 16.51 ? 3.24 | 17.86 ? 4.02 | 14.43 ? 4.66 A | 17.97 ? 2.50 | 16.34 ? 4.00 |
| Folates [?g] | 228 ? 38 | 270 ? 23 A | 225 ? 43 | 244 ? 39 | 208 ? 54 A | 220 ? 54 | 224 ? 48 |
| Vitamin C [mg] | 44.1 ? 12.5 | 43.3 ? 6.0 | 47.5 ? 15.1 | 44.4 ? 15.4 | 47.6 ? 20.8 | 43.3 ? 15.8 | 45.9 ? 16.2 |
Importance in Tukey´s test when p<0.05 is showed in bold and with letters.
The statistical analysis demonstrated a significant effect of the HE-gender interaction upon the dietary intake of 11 of 12 vitamins assessed. Only the intake of vitamin C did not show any significant difference.
The average intake of vitamin A, thiamine and vitamin B12 in diet of the residents of all the assessed homes was higher than the recommended daily allowances + 10%. That was due to a large proportion of animal products in the daily food rations. A high intake of vitamin A is compatible with earlier reports on the nutritional habits of the elderly population [5, 13], however, excluding women with somatic disease [4]. Average intakes of vitamins E, D, riboflavin, vitamin B6, folates and vitamin C were lower than the recommended daily allowances + 10% [20] except for the intake of vitamin E and B6 in men from HE 1. Low intakes of those vitamins had been confirmed in earlier reports on nutrition in the elderly Polish population [4, 5, 6, 11, 12, 13, 19]. Only the diet in elderly women attending the open university contained antioxidative vitamin intake compatible with RDAs, but an inadequate amount of vitamin D [16]. The effects of nutrition in the Polish elderly population show low serum vitamin concentrations [2, 15]. No such correlation was noted in the elderly Czek population [9]. It is worth emphasising that in the German elderly population an average intake of vitamins, apart from folates and vitamin B12, was comparable to that in the adult population [17].
Niacin intake in daily food rations, both in the HE women and men, satisfied the recommended daily requirements criteria + 10% [20].
Distribution of RDAs in the residents of the Wielkopolska homes for the elderly is shown in Table 2.
Table 2. Distribution of RDAs in thr residents of the Wielkopolska homes for the elderly [%].
| Vitamins | HE 1 | HE 2 | HE 3 | Altogether |
| Women | Men | Women | Men | Women | Men |
| N=21 | N=7 | N=24 | N=9 | N=34 | N=11 | N=106 |
| Vitamin A | Below normal | 0.0 | 0.0 | 33.3 | 44.4 | 0.0 | 0.0 | 11.4 |
| Normal | 23.8 | 57.1 | 25.0 | 0.0 | 2.9 | 9.1 | 16.0 |
| Above normal | 76.2 | 42.9 | 41.7 | 55.6 | 97.1 | 90.9 | 72.6 |
| Vitamin E | Below normal | 76.2 | 0.0 | 91.6 | 88.9 | 97.1 | 90.9 | 84.0 |
| Normal | 23.8 | 100.0 | 4.2 | 11.1 | 2.9 | 9.1 | 15.1 |
| Above normal | 0.0 | 0.0 | 4.2 | 0.0 | 0.0 | 0.0 | 0.9 |
| Thiamine | Below normal | 14.3 | 0.0 | 29.2 | 11.1 | 23.5 | 0.0 | 17.9 |
| Normal | 28.6 | 14.3 | 45.8 | 55.6 | 32.4 | 0.0 | 32.1 |
| Above normal | 57.1 | 85.7 | 25.0 | 33.3 | 44.1 | 100.0 | 50.0 |
| Riboflavin | Below normal | 76.2 | 71.4 | 87.5 | 77.8 | 79.4 | 72.7 | 79.2 |
| Normal | 14.3 | 28.6 | 12.5 | 22.2 | 20.6 | 9.1 | 17.0 |
| Above normal | 9.5 | 0.0 | 0.0 | 0.0 | 0.0 | 18.2 | 3.8 |
| Vitamin B6 | Below normal | 76.2 | 28.6 | 83.3 | 66.7 | 88.2 | 63.6 | 76.4 |
| Normal | 14.3 | 71.4 | 16.7 | 22.2 | 8.8 | 18.2 | 17.9 |
| Above normal | 9.5 | 0.0 | 0.0 | 11.1 | 2.9 | 18.2 | 5.7 |
| Vitamin B12 | Below normal | 9.5 | 0.0 | 8.3 | 0.0 | 35.3 | 0.0 | 15.1 |
| Normal | 19.0 | 14.3 | 29.2 | 0.0 | 26.5 | 9.1 | 20.8 |
| Above normal | 71.5 | 85,7 | 62,5 | 100.0 | 38.2 | 90.9 | 64.2 |
| Niacyn | Below normal | 38.1 | 14.2 | 62.5 | 33.3 | 50.0 | 18.2 | 43.4 |
| Normal | 14.3 | 42.9 | 37.5 | 66.7 | 32.4 | 63.6 | 36.8 |
| Above normal | 47.6 | 42.9 | 0.0 | 0.0 | 17.6 | 18.2 | 19.8 |
| Vitamin C | Below normal | 71.4 | 100.0 | 29.2 | 11.1 | 73.5 | 81.8 | 60.4 |
| Normal | 23.8 | 0.0 | 12.5 | 11.1 | 11.8 | 0 | 12.3 |
| Above normal | 4.8 | 0.0 | 58.3 | 77.8 | 14.7 | 18.2 | 27.4 |
Importance in Pearson´s test is showed in bold when p<0.05.
The statistical analysis demonstrated a significant impact of the HE-gender interaction upon the distribution of the RDAs of seven vitamins in the home residents.
The intake of vitamin A and thiamine in all the residents of home 1 and home 3 satisfied or exceeded the RDAs +10%.
A similar situation was noted in the intake of vitamin E, thiamine and vitamin B12 in male residents of home 2, and that of thiamine and vitamin B12 in male residents of home 3. Unfortunately, in all the study residents the vitamin D content was below the normal range; 96.3% of the residents had decreased folate levels. The nutritional status of approximately 80% of the assessed population showed decreased vitamin E, B2 and B6 contents; in the case of vitamin C, the percentage was found to be 60.4%. Similar trends were noted in earlier reports [3, 7, 11].
CONCLUSIONS
1. The nutritional analysis showed low contents of vitamins E, D, B2, B6, folates and vitamin C in a significant percentage of residents of homes for the elderly.
2. It seems vital to carry out the assessment of menus offered in homes for the elderly in order to increase the content of nutrients which are rich sources of those vitamins.
3. It might also be vital to encourage the elderly residents to take vitamin supplements.
Piśmiennictwo
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