Skip to main content
SpringerLink
Log in

Nutritional status of the elderly in rural North China: A cross-sectional study

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

This study aimed to describe the nutritional status of elderly people living in a rural area of North China.

Design

Community-based, cross-sectional prevalence survey.

Setting

3 rural towns of Lvliang City, Shanxi Province, China.

Participants

A sample of 1845 community residents (29.1% of those eligible) 55 years or older (birth before 1958-01-01).

Measurements

The participants were assessed regarding demographic characteristics, height, weight, as well as having a physical examination and blood sampling for serum cholesterol, total homocysteine (tHcy), folate, and vitamin B12 levels.

Results

991 (53.7%) were female and 139 (7.5%) did not complete the anthropometric measurement. Prevalence of underweight and obesity was 3.5% and 24.9% in men and 6.7% and 31.0% in women (P = 0.003, P = 0.005, respectively). Prevalence of hypercholesterolemia and hypocholesterolemia was 13.5% and 52.6% in men and 25.0% and 34.3% in women (P < 0.001, P < 0.001, respectively). Prevalence of high LDL-c concentrations was 8.8% in men and 16.8% in women (P < 0.001). The mean serum tHcy in men (28.8 ± 20.1 μmmol/l) was significantly higher than in women (21.0 ± 15.1 μmmol/L, P < 0.001). Prevalence of hyperhomocysteinemia (defined as > 15μmmol/L) was 79.7% in men and 65.5% in women (P < 0.001). Prevalence of low folate (defined as < 11 nmol/L) and vitamin B12 levels (defiend as < 185 pmol/L) was 70.8 % and 76.8% in men and 56.5% and 72.6% in women (P < 0.001, P = 0.036, respectively). Correlation coefficients between tHcy, folate, and vitamin B12 indicated an inverse linear correlation (r = −0.21, P < 0.001, r = −0.35, P < 0.001, respectively).

Conclusions

As China’s economic climate has developed, the nutritional status of elderly people in the rural parts of the country has improved in some aspects. However, the trend toward obesity will lead to a shift in the burden of obesity-related chronic diseases. In addition, rurally-located elderly people are at high risk of death that may be associated with abnormal serum cholesterol. The data also suggest that severe deficiencies in folate and vitamin B12 levels exist, as well as there being a high prevalence of hyperhomocysteinemia. Folate and vitamin B12 supplementation are necessary to prevent related diseases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Elia M: Guidelines for detection and management of malnutrition. Maidenhead: Standing Committee of BAPEN; 2000.

    Google Scholar 

  2. Ulger Z, Halil M, Cankurtaran M, Yavuz BB, Yesil Y, Kuyumcu ME, Gungor E, Izgi H, Iskit AT, Abbasoglu O et al: Malnutrition in Turkish nursing homes: a correlate of short term mortality. J Nutr Health Aging 2013,17(4):305–309.

    Article  CAS  PubMed  Google Scholar 

  3. Diet, nutrition and the prevention of chronic diseases. Geneva: World Health Organization, 2003. (Accessed February 2006, 2013, at http://whqlibdoc.who.int/trs/WHO_TRS_2916.pdf.)

  4. Caballero B: A nutrition paradox-underweight and obesity in developing countries. N Engl J Med 2005,352(15):1514–1516.

    Article  CAS  PubMed  Google Scholar 

  5. Monteiro CA, Conde WL, Popkin BM: The burden of disease from undernutrition and ovemutrition in countries undergoing rapid nutrition transition: a view from Brazil. Am J Public Health 2004,94(3):433–434.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Dearth-Wesley T, Wang H, Popkin BM: Under- and ovemutrition dynamics in Chinese children and adults (1991–2004). Eur J Clin Nutr 2008,62(11):1302–1307.

    Article  CAS  PubMed  Google Scholar 

  7. Alam I, Pawelec G: Aging, nutrition and immunity — their Relationship and interaction. Nutr & Aging 2012,1((3–4)):151–165.

    Google Scholar 

  8. Keeping fit for life: meeting the nutritional needs of older persons. Geneva: World Health Organization, 2002. (Accessed February 2006, 2013, at http://whqlibdoc.who.int/publications/9241562102.pdf.)

  9. Du S, Mroz TA, Zhai F, Popkin BM: Rapid income growth adversely affects diet quality in China-particularly for the poor! Soc Sci Med 2004, 59(7): 1505–1515.

    Article  PubMed  Google Scholar 

  10. Verschuren WM, Jacobs DR, Bloemberg BP, Kromhout D, Menotti A, Aravanis C, Blackburn H, Buzina R, Dontas AS, Fidanza F et al: Serum total cholesterol and long-term coronary heart disease mortality in different cultures. Twenty-five-year follow-up of the seven countries study. JAMA 1995, 274(2):131–136.

    Article  CAS  PubMed  Google Scholar 

  11. Stamler J, Daviglus ML, Garside DB, Dyer AR, Greenland P, Neaton JD: Relationship of baseline serum cholesterol levels in 3 large cohorts of younger men to long-term coronary, cardiovascular, and all-cause mortality and to longevity. JAMA 2000, 284(3):311–318.

    Article  CAS  PubMed  Google Scholar 

  12. Bikbov B, Perico N, Remuzzi G: Mortality landscape in the Global Burden of Diseases, Injuries and Risk Factors Study. Eur J Intern Med 2013.

    Google Scholar 

  13. McLean E, de Benoist B, Allen LH: Review of the magnitude of folate and vitamin B12 deficiencies worldwide. Food Nutr Bull 2008, 29(2 Suppl):S38–51.

    PubMed  Google Scholar 

  14. Wang Y, Li X, Qin X, Cai Y, He M, Sun L, Li J, Zhang Y, Tang G, Wang B et al: Prevalence of hyperhomocysteinaemia and its major determinants in rural Chinese hypertensive patients aged 45–75 years. Br J Nutr 2013, 109(7):1284–1293.

    Article  CAS  PubMed  Google Scholar 

  15. Faraci FM: Hyperhomocysteinemia: a million ways to lose control. Arterioscler Thromb Vasc Biol 2003, 23(3):371–373.

    Article  CAS  PubMed  Google Scholar 

  16. Reginal development and life index reports of 2011. Beijing: National Bureau of Statistics of China, 2013. (Accessed February 2018, 2013, at http://www.stats.gov.cn/tjshujia/dysj/t20130325_402883270.htm.)

  17. Li Z, Ren A, Zhang L, Ye R, Li S, Zheng J, Hong S, Wang T: Extremely high prevalence of neural tube defects in a 4-county area in Shanxi Province, China. Birth Defects Res A Clin Mol Teratol 2006, 76(4):237–240.

    Article  CAS  PubMed  Google Scholar 

  18. Berry RJ, Li Z, Erickson JD, Li S, Moore CA, Wang H, Mulinare J, Zhao P, Wong LY, Gindler J et al: Prevention of neural-tube defects with folic acid in China. China-U.S. Collaborative Project for Neural Tube Defect Prevention. N Engl J Med 1999, 341(20):1485–1490.

    Article  CAS  PubMed  Google Scholar 

  19. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001,285(19):2486–2497.

    Article  Google Scholar 

  20. Neaton JD, Blackburn H, Jacobs D, Kuller L, Lee DJ, Sherwin R, Shih J, Stamler J, Wentworth D: Serum cholesterol level and mortality findings for men screened in the Multiple Risk Factor Intervention Trial. Multiple Risk Factor Intervention Trial Research Group. Arch Intern Med 1992,152(7):1490–1500.

    Article  CAS  PubMed  Google Scholar 

  21. Forette B, Tortrat D, Wolmark Y: Cholesterol as risk factor for mortality in elderly women. Lancet 1989, 1(8643):868–870.

    Article  CAS  PubMed  Google Scholar 

  22. Refsum H, Nurk E, Smith AD, Ueland PM, Gjesdal CG, Bjelland I, Tverdal A, Tell GS, Nygard O, Vollset SE: The Hordaland Homocysteine Study: a community-based study of homocysteine, its determinants, and associations with disease. J Nutr 2006, 136(6 Suppl):1731S–1740S.

    CAS  PubMed  Google Scholar 

  23. Selhub J, Jacques PF, Rosenberg IH, Rogers G, Bowman BA, Gunter EW, Wright JD, Johnson CL: Serum total homocysteine concentrations in the third National Health and Nutrition Examination Survey (1991–1994): population reference ranges and contribution of vitamin status to high serum concentrations. Ann Intern Med 1999,131(5):331–339.

    Article  CAS  PubMed  Google Scholar 

  24. Fakhrzadeh H, Ghotbi S, Pourebrahim R, Nouri M, Heshmat R, Bandarian F, Shafaee A, Larijani B: Total plasma homocysteine, folate, and vitamin B12 status in healthy Iranian adults: the Tehran homocysteine survey (2003–2004)/a cross-sectional population based study. BMC Public Health 2006,6:29.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Hao L, Ma J, Zhu J, Stampfer MJ, Tian Y, Willett WC, Li Z: High prevalence of hyperhomocysteinemia in Chinese adults is associated with low folate, vitamin B-12, and vitamin B-6 status. J Nutr 2007,137(2):407–413.

    CAS  PubMed  Google Scholar 

  26. Stookey jd, Zha F, Zohoori N, Popkin BM: Nutrition of elderly people in China. Asia Pacific J Clin Nutr 2000,9(4):243–251.

    Article  CAS  Google Scholar 

  27. Schooling CM, Lam TH, Li ZB, Ho SY, Chan WM, Ho KS, Tham MK, Cowling BJ, Leung GM: Obesity, physical activity, and mortality in a prospective Chinese elderly cohort. Arch Intern Med 2006,166(14): 1498–1504.

    Article  PubMed  Google Scholar 

  28. Yu NW, Chen CY, Liu CY, Chau YL, Chang CM: Association of body mass index and depressive symptoms in a Chinese community population: results from the Health Promotion Knowledge, Attitudes, and Performance Survey in Taiwan. Chang Gung Med J 2011,34(6):620–627.

    CAS  PubMed  Google Scholar 

  29. Ho RC, Niti M, Kua EH, Ng TP: Body mass index, waist circumference, waist-hip ratio and depressive symptoms in Chinese elderly: a population-based study. Int J Geriatr Psychiatry 2008,23(4):401–408.

    Article  PubMed  Google Scholar 

  30. Woo J, Leung J, Kwok T: BMI, body composition, and physical functioning in older adults. Obesity (Silver Spring) 2007,15(7):1886–1894.

    Article  Google Scholar 

  31. Hulley SB, Walsh JM, Newman TB: Health policy on blood cholesterol. Time to change directions. Circulation 1992,86(3):1026–1029.

    Article  CAS  PubMed  Google Scholar 

  32. He J, Gu D, Reynolds K, Wu X, Muntner P, Zhao J, Chen J, Liu D, Mo J, Whelton PK: Serum total and lipoprotein cholesterol levels and awareness, treatment, and control of hypercholesterolemia in China. Circulation 2004,110(4):405–411.

    Article  CAS  PubMed  Google Scholar 

  33. Jacques PF, Rosenberg IH, Rogers G, Selhub J, Bowman BA, Gunter EW, Wright JD, Johnson CL: Serum total homocysteine concentrations in adolescent and adult Americans: results from the third National Health and Nutrition Examination Survey. Am J Clin Nutr 1999,69(3):482–489.

    CAS  PubMed  Google Scholar 

  34. Refsum H, Yajnik CS, Gadkari M, Schneede J, Vollset SE, Orning L, Guttormsen AB, Joglekar A, Sayyad MG, Ulvik A et al: Hyperhomocysteinemia and elevated methylmalonic acid indicate a high prevalence of cobalamin deficiency in Asian Indians. Am J Clin Nutr 2001,74(2):233–241.

    CAS  PubMed  Google Scholar 

  35. Folate and vitamin B12 deficiencies: proceedings of a WHO technical consultation held 18–21 October, 2005, in Geneva, Switzerland. Introduction. Food Nutr Bull 2008,29(2 Suppl):S3–4.

    Google Scholar 

  36. Wang B, Huo J, Huang J, Sun J: [Total diet study on certain nutrients in Shanxi regions with a high incidence of birth defects]. Wei Sheng Yan Jiu 2008, 37(6):702–706.

    PubMed  Google Scholar 

  37. Hao L, Ma J, Zhu J, Stampfer MJ, Tian Y, Willett WC, Li Z: Vitamin B-12 deficiency is prevalent in 35- to 64-year-old Chinese adults. J Nutr 2007, 137(5):1278–1285.

    CAS  PubMed  Google Scholar 

  38. Wang ZP, Shang XX, Zhao ZT: Low maternal vitamin B(12) is a risk factor for neural tube defects: a meta-analysis. J Matern Fetal Neonatal Med 2012, 25(4):389–394.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, First Hospital of Shanxi Medical University, No. 85, Jiefang Nan Street, Yingze District, Taiyuan City, PRC

    W. Zhang, Y. Li, T. D. Wang, H. -X. Meng, G. -W. Min, Y. -L. Fang, Xiao-Yuan Niu, L. -S. Ma, J. -H. Guo, J. Zhang, M. -Z. Sun & C. -X. Li

Authors
  1. W. Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Y. Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T. D. Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H. -X. Meng
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G. -W. Min
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Y. -L. Fang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Xiao-Yuan Niu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. L. -S. Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. J. -H. Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. J. Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. M. -Z. Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. C. -X. Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Xiao-Yuan Niu.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, W., Li, Y., Wang, T.D. et al. Nutritional status of the elderly in rural North China: A cross-sectional study. J Nutr Health Aging 18, 730–736 (2014). https://doi.org/10.1007/s12603-014-0537-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-014-0537-x

Key words

Search

Navigation