| Objective:To analyze the dietary nutritional status and the prevalence status under different glucose metabolism states among the Chinese elderly aged 65 years and above.To explore the dietary factors and other influence factors of DM and compare the dietary nutritional status of the diagnosed and undiagnosed diabetes patients among the Chinese elderly aged 65 and above.Methods:The subjects of this study were the elderly aged 65 years and above who were in China Adult Chronic Disease and Nutrition Surveillance(CACDNS)in 2015.CACDNS carried out multi-stage cluster random sampling method and collected basic information,lifestyle,diet and health status of the elderly through family and personal inquiry surveys,physical measurements,dietary surveys and laboratory tests.The dietary survey adopted three-day consecutive 24-hour dietary recalls and weighing methods.The dietary nutrients intake was calculated based on Chinese Food Composition Tables,and the levels of fasting blood glucose and HbAlc were used as the diagnostic indexes of diabetes.SAS 9.4 software was used for data cleaning and analyze,and complex sampling weighted processing was carried out to calculate the mean value and rate.The weight of the base sample was calculated according to the sampling design.The 2010 Chinese population census data were used as the standard population,and the post-stratification weight was calculated according to urban and rural areas,age and gender.The final weight was the product of the base sample weight and the post-stratification weight.Proc surveymeans and proc surveyreg were used to calculate the mean value and test the difference,respectively.Proc surveyfreq and proc surveylogistic were used to calculate the rate and test the difference.Multiple linear regression was used to analyze the differences in dietary nutrients and food intake between undiagnosed and diagnosed diabetics,and logistic regression was used to analyze the relationship between socioeconomic level,dietary nutrition and lifestyle and DM.Odd ratios(odd ratios,ORs)and 95%confidence interval(CI)were used to express the results.Bilateral P<0.05 was considered statistically significant.Results:1.The status of dietary nutrients and food intake among the Chinese elderly aged 65 and above1.1 Dietary energy and nutrients intakesThe energy intake of the Chinese elderly aged 65 and above was 1595.5 kcal/d,and the intake of carbohydrate,protein and fat was 208.7 g/d,47.9 g/d and 63.6 g/d,respectively.The energy contribution from carbohydrate,protein and fat was 52.7%,12.1%and 35.4%,respectively.The proportion of dietary intake of vitamin A,thiamine,riboflavin and folate below the EAR were more than 90%,and the proportion of dietary vitamin C intake below the EAR was as high as 70.4%.The proportion of the dietary calcium,magnesium,zinc and selenium intake below the EAR were 97.9%,74.8%,56.2%and 85.7%,respectively;the proportion of dietary potassium intake below the AI was 90.3%,and the proportion of dietary sodium intake exceeding PI-NCD was 91.1%.1.2 Food intakesThe dietary intake of cereals,potatoes,vegetables and fruits,dairy and its products,livestock and poultry meat were 250.6 g/d,37.3 g/d,237.1 g/d,29.3 g/d,25.5 g/d and 63.4 g/d,respectively.The dietary intake of cooking oil and salt were 35.3 g/d and 8.9 g/d,respectively.The proportion of the intake of fruits,nuts,milk and its products were more than 90%,the proportion of the intake of vegetables,beans and aquatic products was more than 80%,the proportion of the intake of tubers and eggs was more than 70%,and the proportion of the intake of livestock and poultry meat was less than the recommended amount.More than 60 percent of the elderly consumed more than the recommended amounts of grain,cooking salt and cooking oil.2.Nutritional status of the elderly aged 65 and over in ChinaIn China,the average body mass index of the elderly aged 65 and above was 23.9 kg/m2,the waist circumference was 83.4cm,the prevalence of underweight was 4.7%,the prevalence of overweight was 33.3%,and the prevalence of obesity was 12.4%.Compared with the elderly aged 60 and above from 2010 to 2013,the prevalence of underweight among the participants in this study decreased,while the body mass index,waist circumference,the prevalence of overweight and obesity all increased.3.Abnormal glucose metabolism in the Chinese elderly aged 65 and aboveThe prevalence of diabetes,prediabetes and awareness of diabetes were 15.3%,15.0%and 57.0%in the Chinese elderly aged 65 and above.Compared to 2010-2013,the prevalence and awareness of diabetes increased.4.Influencing factors of diabetes in the elderly aged 65 and above4.1 Dietary nutrientsMultivariate analysis showed that after adjustment for socioeconomic level,lifestyle and other nutrient intake,carbohydrate Q3(200.5～264.9 g/d)and vitamin E Q4(≥39.5 mg/d)were negatively associated with diabetes risk with OR values of 0.76(95%CI:0.58～0.99)and 0.72(95%CI:0.58～0.91).4.2 FoodThe multivariate analysis showed that vegetables(216.7～316.7 g/d)were negatively associated with diabetes(OR=0.82,95%CI:0.68～0.99)after adjusting for socioeconomic status,lifestyle,and other food intake.4.3 Other factorsThe results of multivariate analysis showed that high family income,total static behavior Q2(2.0～4.0 h/d),family history,overweight,obesity,central obesity,hypertension and dyslipidemia were positively correlated with the incidence of diabetes after adjusting for other factors such as socioeconomic level,lifestyle and total dietary energy,with OR values of 1.23(95%CI:1.01～1.51),1.23(95%CI:1.02～1.49),1.90(95%CI:1.48～2.44),1.30(95%CI:1.11～1.54),1.88(95%CI:1.50～2.35),1.51(95%CI:1.28～1.79),1.46(95%CI:1.25～1.69)and 1.65(95%CI:1.45～1.89),respectively.Women,daytime outdoor activity time(≥4.8 h/d)and low body weight were negatively correlated with the incidence of diabetes,with OR values of 0.83(95%CI:0.70～0.99),0.75(95%CI:0.61～0.91)and 0.50(95%CI:0.32～0.78),respectively.5.Dietary differences between undiagnosed and diagnosed diabetics5.1 Dietary nutrientsThere were significant difference in the dietary intake of calcium,iron and selenium between the diagnosed and undiagnosed diabetics in male elderly(P<0.05).There were statistically significant differences in potassium intake between diagnosed and undiagnosed diabetics in female elderly(P<0.05).5.2 FoodThere were significant difference in dietary intake of potatos,vegetables,animal innards,plant oils and animal oils between diagnosed and undiagnosed diabetics in the female elderly(P<0.05).There were significant difference in the intake of vegetables and animal oil between the diagnosed and undiagnosed diabetics in the female elderly(P<0.05).Conclusion:1.This study analyzes the dietary data of Chinese people aged 65 and above in a national survey,and found that the dietary structure of Chinese people aged 65 and above is unreasonable,and both insufficient and excessive intake exist.Insufficient intake of vitamins A,B vitamins and minerals such as calcium and potassium,and excessive intake of fat and sodium.Most older adults consumed the recommended amounts of cereals,cooking salts and cooking oils,while other foods did not.2.This study analyzes the medical examination data of the Chinese aged 65 and above in a national survey,and found that the overweight and obesity rate of the Chinese aged 65 and above was still on the rise.Female elderly,urban elderly and young elderly need to be focused on crowd;3.This study analyzes the fasting blood glucose and HbAlc data of Chinese people aged 65 and over in the national survey,and found that the prevalence and awareness of diabetes in China were on the rise,and the problems of rural areas and the elderly were more prominent;4.This study analyzed the socioeconomic factors,dietary data,medical physical examination data and laboratory test data of Chinese elderly people aged 65 and above in a national survey to explore the relationship between socioeconomic level,diet and lifestyle and diabetes in the elderly.It was found that female,carbohydrate(200.5～264.9 g/d),vitamin E(≥39.5 mg/d),vegetables(216.7～316.7 g/d),daytime outdoor activity time(≥4.8 h/d)and low body weight were negatively correlated with diabetes in the elderly.High family income,total static behavior(2.0～4.0 h/d),overweight,obesity,central obesity,family history,hypertension,dyslipidemia were positively correlated with diabetes mellitus in the elderly;5.This study compared the diets of newly diagnosed and diagnosed elderly diabetic patients in a national survey and found that compared with newly diagnosed diabetic patients,the diet of diabetic patients has undergone some changes,but there are still many problems. |
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