Dataset Information

Vitamin Status and Diet in Elderly with Low and High Socioeconomic Status: The Lifelines-MINUTHE Study.

ABSTRACT: Socioeconomic health inequalities are an important global public health problem. However, it is not well known to what extent socioeconomic inequalities culminate in impaired vitamin status and whether this is mediated by diet. We, therefore, aimed to assess vitamin status in a population already at increased risk of micronutrient deficiency, i.e., elderly with high and low socioeconomic status (SES), and to investigate whether potential differences therein were mediated by diet quality. Vitamin status in 1605 individuals (60-75 years) from the Lifelines- Micronutrients and Health inequalities in Elderly (MINUTHE) Study was assessed by measuring folic acid and the vitamins B6, B12, D, A, E, and K. Multinomial logistic and linear regression analyses were applied to test the associations between SES and vitamin status. Mediation analysis was used to explore the interrelationship between SES, diet quality, and vitamin status. Low SES was associated with poorer status of vitamin B6, vitamin B12, and, notably, folic acid. Moreover, multivitamin deficiencies were more prevalent in the low SES group. Diet quality was found to mediate the associations of SES with folic acid (for 39.1%), vitamin B6 (for 37.1%), and vitamin B12 (for 37.2%). We conclude that low SES is a risk factor for a spectrum of vitamin deficiencies. Diet quality can partially explain the socioeconomic differences in vitamin status, suggesting that policymakers can mitigate socioeconomic inequality in nutritional status through improving diet quality.

SUBMITTER: Zhu Y

PROVIDER: S-EPMC7551314 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Vitamin Status and Diet in Elderly with Low and High Socioeconomic Status: The Lifelines-MINUTHE Study.

Zhu Yinjie Y Minović Isidor I Dekker Louise H LH Eggersdorfer Manfred L ML van Zon Sander K R SKR Reijneveld Sijmen A SA Kootstra-Ros Jenny E JE Kema Ido P IP Bakker Stephan J L SJL Navis Gerjan J GJ Riphagen Ineke J IJ

Nutrients 20200831 9

Socioeconomic health inequalities are an important global public health problem. However, it is not well known to what extent socioeconomic inequalities culminate in impaired vitamin status and whether this is mediated by diet. We, therefore, aimed to assess vitamin status in a population already at increased risk of micronutrient deficiency, i.e., elderly with high and low socioeconomic status (SES), and to investigate whether potential differences therein were mediated by diet quality. Vitamin ...[more]

PMID: 32878227

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Project description:Background and objectiveThree screening approaches were compared for their ability to detect CKD cases, and identify patients with CKD who have a higher rate of incident cardiovascular disease (CVD) events and renal function decline. Approach 1 was the traditional CKD screening approach, targeting only individuals with known diabetes, hypertension, or CVD history. Approach 2 was defined as Approach 1+elderly, and Approach 3 as Approach 1+low-socioeconomic status (SES) individuals.Design, setting, participants, & measurementsData on 3411 individuals from the general population in The Netherlands were examined. Individuals aged >60 years were classified as elderly. Persons with low SES was defined as those with primary school or below primary school education. CKD was diagnosed during outpatient clinic visits. Individuals were followed for 9.4±2.6 years during four screening rounds.ResultsAt baseline, 16%, 29%, and 25% of the general population was to be screened and 36%, 59%, and 51% of the CKD (n=263) cases were detected in Approaches 1, 2, and 3, respectively. The numbers of individuals needed to screen to detect one CKD case were 5.6 in Approach 1 and 6.5 each in Approach 2 and 3. In Approach 2 the hazard ratio for incident CVD events was 1.87 (95% confidence interval [95% CI], 1.35 to 2.61) in detected and 1.92 (95% CI, 1.01 to 3.64) in undetected CKD cases compared with persons without CKD, whereas in Approach 3 these values were 2.31 (95% CI, 1.64 to 3.25) and 1.28 (95% CI, 0.77 to 2.13), respectively. In Approach 2, the rate of renal function decline was -1.37 ml/min per 1.73 m(2) per year in detected and -1.13 ml/min per 1.73 m(2) per year in undetected CKD cases. In Approach 3, these figures were -1.41 and -1.14 ml/min per 1.73 m(2) per year, respectively.ConclusionsAdding persons with low SES, rather than adding elderly persons, to the traditional high-risk groups may help detect more persons with CKD who have a higher rate of future CVD events and renal function decline.

Project description:ObjectiveThe role of diet quality and nutrient adequacy in the etiology of childhood obesity is poorly understood. The specific aims of these analyses were to assess overall diet quality and nutrient adequacy, and test for association between weight status and diet in children from low socioeconomic status (SES) Hispanic families at high risk for obesity.DesignA cross-sectional study design was used to assess dietary intake in low-SES Hispanic children with and without overweight who were enrolled in the Viva la Familia Study. Multiple-pass 24-hour dietary recalls were recorded on two random, weekday occasions. Diet quality was evaluated according to the Dietary Guidelines for Americans. Nutrient adequacy was assessed using z scores based on estimated average requirement or adequate intake.Subjects/settingThe study included 1,030 Hispanic children and adolescents, aged 4 to 19 years, in Houston, TX, who participated between November 2000 and August 2004.Statistical analysisSTATA software (version 9.1, 2006, STATA Corp, College Station, TX) was used for generalized estimating equations and random effects regression.ResultsDiet quality did not adhere to the Dietary Guidelines for Americans for fat, cholesterol, saturated fatty acids, fiber, added sugar, and sodium. Although energy intake was significantly higher in children with overweight, food sources, diet quality, macro- and micronutrient composition were similar between non-overweight and overweight children. Relative to estimated average requirements or adequate intake levels, mean nutrient intakes were adequate (70% to 98% probability) in the children without and with overweight, except for vitamins D and E, pantothenic acid, calcium, and potassium, for which z scores cannot be interpreted given the uncertainty of their adequate intake levels.ConclusionsWhereas the diets of low-SES Hispanic children with and without overweight were adequate in most essential nutrients, other components of a healthful diet, which promote long-term health, were suboptimal. Knowledge of the diets of high-risk Hispanic children will inform nutritional interventions and policy.

Dataset Information

Vitamin Status and Diet in Elderly with Low and High Socioeconomic Status: The Lifelines-MINUTHE Study.

Publications

Vitamin Status and Diet in Elderly with Low and High Socioeconomic Status: The Lifelines-MINUTHE Study.

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