Protein-energy malnutrition in low income elderly Nairobi women

Abstract

Nutritional data for two groups of low income elderly women (chi = 64, range 57-74 years) in Nairobi, Kenya were compared. Group I (n = 113), slum dwellers, had an income of < or = $20 Cd per month; Group II (n = 88), poor urban area inhabitants, had an income of < or = $170 Cd per month. Dietary intakes were assessed quantitatively by four 24-h dietary recalls; anthropometric and biochemical data were obtained. Twenty-one women (16% of Group I; 3% of Group II) were classified as having protein-energy malnutrition (PEM) based on abnormal anthropometric measurements or low serum albumin concentration. The malnutrition was marasmic-like; the anthropometric measurements (body weight, triceps, skinfold thickness (TSF), mid-arm muscle circumference (MAMC) of the PEM Group were lower (P < or = 0.05) than those of Groups I and II. The PEM Group was older (chi = 68 years), had lost more teeth, and had more subnormal values than Groups I and II for: serum albumin, hemoglobin, hematocrit, MCHC, MCH, serum transferrin and serum iron. Inferior diets were a contributing factor. Mean energy and protein intakes of the PEM Group were low: 1471 kcal day(-1) (26 kcal kg(-1)) and 42 g day(-1) (0.79 g kg(-1)) respectively. The main protein sources were vegetables (48%) and cereals (36%); only 6 g protein was of high quality. Group II mean protein and energy intakes were greater (P < or = 0.05, P < or = 0.01) than those of the PEM Group and mean dairy product intake was higher (P < or = 0.001). The PEM Group and Group I had low mean energy intakes and an unsatisfactory dietary pattern; they consumed less meat (P < or = 0.01) and less fat (P < or = 0.001) than Group II. For the PEM Group dietary intakes of energy, fat and sugar were significantly correlated with TSF and MAMC; for the PEM Group monthly income was significantly correlated with weight, BMI, TSF and MAMC. Data suggest that elderly women living in Nairobi slums are at high risk of malnutrition, one of the factors contributing to the problem is inadequate food intake.

Anthropometric characteristics of older people in rural Malawi

“…The pattern revealed is similar to patterns reported in other African countries (Ndaba & O'Keefe, 1985;Thoner, 1993;Aspray et al, 1994;Ethangatta et al, 1996;Pieterse, 1997) as well as in other developing countries such as India (Marlow et al, 1996;Manandhar et al, 1997b), Sarawak (Strickland & Ulijaszek, 1993) and China (Side et al, 1991). The Asians however, were slightly shorter than Malawians re¯ecting either genetic or urban±rural differences since most of the Asian studies were conducted in urban areas.…”

“…Malnutrition among older people has been reported in developed countries (Lipschitz, 1992;Stuckey et al, 1984;DHSS, 1979;DHSS, 1972) and to a limited extent, in developing countries (Marlow et al, 1996;Ethangatta et al, 1996;Thoner, 1993;Yassin & Terry, 1991;Ndaba & O'Keefe, 1985). In Africa, studies on the well being of older people are now emerging (Allain et al, 1997;Aspray et al, 1996;Angura & Anyuru, 1994;Coombes et al, 1994;Nmadu, 1994;Matuja et al, 1994;McLigeyo, 1993;Wilson et al, 1991;Olubuyide et al, 1991;Apt, 1990;Pappoe et al, 1990;Hampson, 1985;Waterston, 1982;Drury, 1972) but most lack crucial nutrition data.…”

“…In Africa, studies on the well being of older people are now emerging (Allain et al, 1997;Aspray et al, 1996;Angura & Anyuru, 1994;Coombes et al, 1994;Nmadu, 1994;Matuja et al, 1994;McLigeyo, 1993;Wilson et al, 1991;Olubuyide et al, 1991;Apt, 1990;Pappoe et al, 1990;Hampson, 1985;Waterston, 1982;Drury, 1972) but most lack crucial nutrition data. More recently, the nutritional status of older people has been assessed in Africa (Ethangatta et al, 1996;Thoner, 1993;Aspray et al, 1994), but the studies did not consider alternatives to measurement of height.…”

Nutrition, health, and aging in sub-Saharan Africa

“…Protein was derived mainly from plants; animal protein and dairy intake were very low 10,13,38 . Among elderly women living in underserved areas of Nairobi, Kenya, a mean of only 6 g/d was reported for animal protein 17,45 . About a quarter (27%) of the elderly in Zimbabwe ate a protein‐containing meal less than once a week, and 17.6% of black South Africans had intakes that were less than 66% of Dietary Reference Intakes (DRI), the lower reference value for adequate intake 17,29,46 …”

Dietary Egg Yolk Supplementation Improves Low-Protein-Diet-Induced Fatty Liver in Rats

“…PEM was also observed in people who could not eat sufficient dairy products because of low income (or other reasons) (8). Animal experiments have shown that several foods and food components such as antioxidants improve or protect against hepatic steatosis induced by several triggers, alcohol (9), carbon tetrachloride (10) and streptozotocin diabetes (11).…”