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Anthropometrical Changes in Older Taiwanese and Diet and Exercise

  • Alan C. Tsai
Chapter

Abstract

The aging process involves changes in weight, height, body mass index (BMI), muscle mass, and a redistribution of body fat. These anthropometrical measures are closely related to nutrition, functional ability and health. However, most studies conducted on aging-associated anthropometrical changes so far involve Western populations. Knowledge on population-specific changes is necessary for understanding the population-related differences. This article aims to review anthropometrical changes important to geriatric nutritional assessment including weight, height, BMI, and mid arm (MAC) and calf circumferences (CC) in older Taiwanese. BMI is probably the most widely studied anthropometrical indicator but mid arm and CC have also received increasing attention in recent years. The pattern of age-associated anthropometrical changes in Taiwanese generally parallels the Western populations. BMI, an indicator of body weight relative to height, is often considered an indicator of body fatness. Currently, the World Health Organization (WHO) sets a uniform standard of BMI 25–29.9 kg/m2 for overweight and ≥30 for obesity. However, there is evidence that these thresholds may underestimate the prevalence of overweight and obesity in Taiwanese. The Department of Health of Taiwan has adopted modified thresholds of BMI 24–26.9 kg/m2 for overweight and ≥27 for obesity for Taiwanese. Similarly, because of stature differences, elderly Taiwanese appear to have different cut-points of MAC (22.5/21 cm for Taiwanese men/women vs. 21/21 cm for Western men/women) and CC (28/25 cm for Taiwanese men/women vs. 31/31 cm for Western men/women) for undernutrition. Several social, lifestyle and dietary factors have been observed to impact these indicators in older Taiwanese. Age has the strongest impact on BMI, MAC and CC. Routine physical exercise is associated with higher BMI, MAC and CC. Cigarette-smoking is associated with lower BMI and CC but not MAC. Consumption of dairy products is associated with lower BMI and MAC but not CC. Consumption of fruit is associated with greater BMI and CC but not MAC whereas consumption of tea is associated with greater BMI, MAC and CC. These anthropometrical indicators are useful nutritional and health indicators for old persons or hospitalized patients and are included in many major geriatric nutritional assessment tools. MAC and especially CC, in addition to reflecting general nutritional status, also reflect body muscle mass or the functional status in frail elderly. Understanding these aging-associated changes and the implication of these indicators as they relate to health is important to health care and support to elderly individuals.

Keywords

Body Mass Index Functional Ability Lower Body Mass Index Mini Nutritional Assessment Height Loss 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

BMI

Body mass index

CC

Calf circumference

MAC

Mid arm circumference

MNA

Mini Nutritional Assessment

MUST

Malnutrition Universal Screening Tool

SHLSET

Survey of Health and Living Status of the Elderly in Taiwan

WHO

World Health Organization

Notes

Acknowledgment

The author of this chapter wishes to express his appreciation to (a) Ms. Tsui-Lan Chang for performing most of the statistical analyses and (b) the Bureau of Health Promotion of the Department of Health, Taiwan for providing the SHLSET data set used in this chapter.

References

  1. Adams KF, Schatzkin A, Harris TB, Kipnis V. Mouw T. Ballard-Barbash R, Hollenbeck A, Leitzmann MF. Smoking impairs muscle protein synthesis and increases the expression of myostatin and MAFbx in muscle. New Eng J Med. 2006;355:763–8.PubMedCrossRefGoogle Scholar
  2. Chiu HC, Chang.HY, Mau LW, Lee TK, Liu HW. Height, weight, and Body Mass Index of elderly persons in Taiwan. J Gerontol Med Sci. 2000;55A:M684–90.CrossRefGoogle Scholar
  3. Chumlea WC. Is the MNA valid in different populations and across practice settings? J Nutr Health Aging. 2006;6:524–33.Google Scholar
  4. Coelho AK, Rocha FL, Fausto MA. Prevalence of undernutrition in elderly patients hospitalized in a geriatric unit in Belo Horizonte, MG, Brazil. Nutrition. 2006;22:1005–11.PubMedCrossRefGoogle Scholar
  5. Cope MB, Erdman JW, Allison DB. The potential role of soyfoods in weight and adiposity reduction: an evidence-based review. Obes Rev. 2008;9:219–35.PubMedCrossRefGoogle Scholar
  6. Davison KK, Ford ES, Cogswell ME, Dietz WH. Percentage of body fat and body mass index are associated with mobility limitations in people aged 70 and older from NHANES III. J Am Geriatr Soc. 2002;50:1802–9.PubMedCrossRefGoogle Scholar
  7. Donini LM, Savina A, Rosano A, Canella C. Systematic review of nutritional status evaluation and screening tools in the elderly. J Nutr Health Aging. 2007;11:421–32.PubMedGoogle Scholar
  8. Guigoz Y, Lauque S, Vellas BJ. Identifying the elderly at risk for malnutrition. The Mini Nutritional Assessment. Clin Geriatr Med. 2002;18:737–57.PubMedCrossRefGoogle Scholar
  9. Mason C, Craig CL, Katzmarzyk PT. Influence of central and extremity circumferences on all-cause mortality in men and women. Obesity. 2008;16:2690–5.PubMedCrossRefGoogle Scholar
  10. Munafo MR, Tilling K, Ben-Shlomo Y. Smoking status and body mass index: a longitudinal study. Nicotine Tob Res. 2009;11:765–71.PubMedCrossRefGoogle Scholar
  11. Petersen AM, Magkos F, Atherton P, Selly A, Smith K, Rennie MJ, Pedersen BK, Mittendorfer B. Smoking impairs muscle protein synthesis and increases the expression of myostatin and MAFbx in muscle. Am J Physiol Endocrinol Metab. 2007;293:E843–8.PubMedCrossRefGoogle Scholar
  12. Reid KF, Naumova EN, Carabello RJ, Phillips EM, Fielding RA. Lower extremity muscle mass predicts functional performance in mobility-limited elders. J Nutr Health Aging. 2008;12:493–8.PubMedCrossRefGoogle Scholar
  13. Scott A. Screening for malnutrition in the community: the MUST tool. Br J Com Murs. 2008;13:406–12.Google Scholar
  14. Seidell JC, Flegal KM. Assessing obesity: classification and epidemiology. Br Med Bull. 1997;53:238–52.PubMedCrossRefGoogle Scholar
  15. Sorkin JD, Muller DC, Andres R. Longitudinal change in height of men and women: implications for interpretation of the body mass index: the Baltimore Longitudinal Study of Aging. Am J Epidemiol. 1999;150:969–77.PubMedCrossRefGoogle Scholar
  16. Stavropoulos-Kalinoglou A, Metsios GS, Panoulas VF, Douglas KM, Nevill AM, Jamurtas AZ, Kita M, Koutedakis Y, Kitas GD. Cigarette smoking associates with body weight and muscle mass of patients with rheumatoid arthritis: a cross-sectional, observational study. Arthritis Res Ther. 2008;10:R59. doi:10.1186/ar2429.PubMedCrossRefGoogle Scholar
  17. St Once M, Claps N, Wolper C, Heymsfield SB. Supplementation with soy-protein-rich foods does not enhance weight loss. J Am Diet Assoc. 2007;107:500–5.CrossRefGoogle Scholar
  18. Tsai AC, Ku PY. Population-specific Mini Nutritional Assessment effectively predicts the nutritional state and follow-up mortality of institutionalized elderly Taiwanese regardless of cognitive status. Br J Nutr. 2007;100:152–8.PubMedGoogle Scholar
  19. Tsai AC, Ku PY, Tsai JD. J. Population-specific anthropometric cutoff standards improve the functionality of the Mini Nutritional Assessment without BMI in institutionalized elderly in Taiwan. Nutr Health Aging. 2008a;12:696–700.Google Scholar
  20. Tsai AC, Ho CS, Chang MC. Population-specific anthropometric cut-points improve the functionality of the Mini Nutritional Assessment (MNA) in elderly Taiwanese. Asia Pac J Clin Nutr. 2007a;16:656–62.PubMedGoogle Scholar
  21. Tsai AC, Liou JC, Chang MC, Chuang YL. Nutr Res. 2007b;27:245–51.CrossRefGoogle Scholar
  22. Tsai AC, Ho CS, Chang MC. Assessing the prevalence of malnutrition with the Mini Nutritional Assessment (MNA) in a nationally representative sample of elderly Taiwanese. J Nutr Health Aging. 2008b;12:239–43.PubMedCrossRefGoogle Scholar
  23. Tsai AC, Chang TL, Chen JT, Yang TW. Population-specific modifications of the short-form Mini Nutritional Assessment and Malnutrition Universal Screening Tool for elderly Taiwanese. Int J Nurs Stud. 2009a;46:1432–8.Google Scholar
  24. Tsai AC, Chang TL, Yang TW, Chang-Lee SN, Tsay SF. A modified mini nutritional assessment without BMI predicts nutritional status of community-living elderly in Taiwan. J Nutr Health Aging. 2010a;14:183–9.Google Scholar
  25. Tsai AC, Chang TL, Wang YC, Liao CY. Population-specific short-form mini nutritional assessment with body mass index or calf circumference can predict risk of malnutrition in community-living or institutionalized elderly people in Taiwan. J Am Diet Assoc. 2010b;110:1328–34.Google Scholar
  26. Wen CP, Cheng TYD, Tsai SP, Chan HT. Are Asians at greater mortality risks for being overweight than Caucasians? Redefining obesity for Asians. Pub Health Nutr. 2008;12:497–506.CrossRefGoogle Scholar
  27. Woo J, Ho SC, Shan A. Longitudinal changes in Body Mass Index and body composition over 3 years and relationship to health outcomes in Hong Kong Chinese age 70 and older. J Am Geriatr Soc. 2001;49:737–46.PubMedCrossRefGoogle Scholar
  28. Zemel MB. The role of dairy foods in weight management. J Am Col Nutr. 2005;24:537S–46S.Google Scholar
  29. Zemel MB, Thompson W, Milstead A, Morris K, Campbell P. Calcium and dairy acceleration of weight and fat loss during energy restriction in obese adults. Obs Res. 2004;12:582–90.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Healthcare AdministrationAsia UniversityTaichungTaiwan
  2. 2.Department of Health Services Management, School of Public HealthChina Medical UniversityTaichungTaiwan
  3. 3.Department of Environmental Health Sciences, School of Public HealthUniversity of MichiganAnn ArborUSA

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