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Kwak, Yon, Lee, Oh, and Park: Investigation on Influencing Environmental Factors on Health Status of Korean Septuagenarians Dwelling in Longevity Region in Jeonla Province
Research Article

Korean Journal of Community Nutrition 2014; 19(2): 142-162.

Published online: 30 April 2014

DOI: https://doi.org/10.5720/kjcn.2014.19.2.142

Investigation on Influencing Environmental Factors on Health Status of Korean Septuagenarians Dwelling in Longevity Region in Jeonla Province

Chung Shil Kwak1, Miyong Yon2, Mee Sook Lee3, Se In Oh4, Sang Chul Park1

1Institute on Aging, Seoul National University, Seoul, Korea.

2Nutrition Policy Team, Department of Health Industry & Policy, Korea Heallth Industry Development Institute, Chungwon, Korea.

3Department of Food and Nutrition, Hannam University, Daejeon, Korea.

4Department of Food and Nutrition, Seoil University, Seoul, Korea.

Corresponding author: Chung Shil Kwak. Institute on Aging, Seoul National University, 199-1 Dongsoong-dong, Jongno-gu, Seoul 110-810, Korea. Tel: (02) 740-8506, Fax: (02) 742-0626, kwakcs@snu.ac.kr

Received 27 December 2013       Revised 14 March 2014       Accepted 14 March 2014

Copyright © 2014 The Korean Society of Community Nutrition

(open-access):

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

To evaluate the critical environmental factors on healthy-aging of Korean people, we investigated the significant factors influencing health status of septuagenarians living in rural area of Jeonla province, known to be one of the representative longevity regions in Korea.

Methods

We divided subjects into healthy group (36M/25F) or poor-health group (26M/73F) based on self-reported health status, body mass index, a number of prescription, and blood test data. General characteristics, physical measurements, lifestyle, dietary behavior and nutrient intake, physical health and mental health data were statistically compared between the two groups.

Results

Average age was not different between healthy group and poor-health group in men and women, respectively. In men, significantly favorable factors to health were observed to be higher education, regular exercise, higher grip strength and walking function, body mass index (≥ 18.5 kg/m2), moderate frequency of drinking and eating-out, non-smoking, normal red blood cell (RBC) count, higher serum dehydroepiandrosterone-sulfate (DHEAS) level, good digestive function and appetite, normal hearing function, regular meals, adequate vegetable and fruit intake, diverse food intake, adequate energy and nutrients (protein, vitamin B1, B6, C and E, folate, niacin, P, Zn and K) intake, higher mini-nutrient status assessment (MNA) score and low level of depression. On the other hand, in women, those were literacy, living arrangement, moderate frequency of drinking, healthy teeth, higher grip strength and walking function, bone mineral density, normal RBC and white blood cell (WBC) count, higher DHEAS concentration, higher MNA score, normal cognition and memory function, having snack and adequate fruit intake.

Conclusions

These results could be useful to plan effective strategies to increase health-life expectancy of Korean old people living in rural areas.

Keywords: older adults, rural area, healthy-aging, health-life expectancy

Figures and Tables

Fig. 1
Flow chart of selection process of healthy or poor-health persons.
kjcn-19-142-g001
Table 1
Distribution of the initial volunteers in health status parameters
kjcn-19-142-i001

1) Mean ± SD, 2) n (%), 3) Body mass index, 4) Hemoglobin a1c, 5) Not significant, 6) Glutamic pyruvic transaminase, 7) Glutamic oxaloacetic transaminase

***: p < 0.001

Table 2
General characteristics of the subjects
kjcn-19-142-i002

1) Mean ± SD, 2) Not significant, 3) n (%)

*: p < 0.05

Table 3
Blood test and self-reported disease prevalence
kjcn-19-142-i003

1) n (%), 2) Low hemoglobin (< 13 g/dL for men, < 12 g/dL for women) or low hematocrit (< 38% for men, < 36% for women), 3) Mean ± SD, 4) Not significant, 5) GOT > 40 IU/L or GPT > 40 IU/L, 6) Red blood cell < 4.2 × 106/mL for men, < 3.6 × 106/mL for women, 7) White blood cell < 3.8 × 103/mL for men, < 3.15 × 103/mL for women, 8) Insulin-like growth factor, 9) High sensitive C-reactive protein, 10) Dehydroepiandrosterone sulphate

Table 4
Life style and aging-associated basic functions
kjcn-19-142-i004

1) n (%), 2) Not significant

*: p < 0.05, **: p < 0.01, ***: p < 0.001

Table 5
Physical measurement, muscle strength and bone mineral density
kjcn-19-142-i005

1) Mean ± SD, 2) Not significant, 3) Body mass index, 4) n (%), 5) Normal range of body fat (%): 19 ≤ and < 25 for men, 26 ≤ and < 30 for women, 6) Waist-hip circumstance ratio, 7) Normal range of WHR (%): < 95 for men, < 85 for women, 8) Bone mineral density

*: p < 0.05, **: p < 0.01, ***: p < 0.001

Table 6
Dietary behavior
kjcn-19-142-i006

1) Mean ± SD, 2) Not significant, 3) n (%)

*: p < 0.05, **: p < 0.01, ***: p < 0.001

Table 7
Average daily food intake, meal balance and diversity
kjcn-19-142-i007

1) Mean ± SD, 2) Not significant, 3) Dietary variety score, 4) Korean dietary diversity score: number of taken food group in a day from 6 food groups such as grain & potatoes, meat, eggs & fish, legumes, milk & its product, vegetables and fruits, 5) Meal balance

*: p < 0.05, **: p < 0.01, ***: p < 0.001

Table 8
Average daily nutrient intakes
kjcn-19-142-i008

1) Mean ± SD, 2) Not significant, 3) Saturated fatty acid, 4) Monounsaturated fatty acid, 5) Polyunsaturated fatty acid

*: p < 0.05, **: p < 0.01, ***: p < 0.001

Table 9
Proportions of daily energy and nutrient intakes to Korean dietary recommendation, mean adequacy ratio (MAR) and index of nutrient quality (INQ) of diet
kjcn-19-142-i009

1) Estimated energy requirement, 2) Mean ± SD, 3) Not significant, 4) Percent of subjects taking energy below 75% EER, 5) Estimated average requirement, 6) Percent of subjects taking nutrient below EAR, 7) Adequate intake, 8) Mean adequacy ratio of 13 nutrients established EAR, 9) n (%), 10) Number of nutrient taken below EAR, 11) Number of nutrient of which INQ < 1

*: p < 0.05, **: p < 0.01, ***: p < 0.001

Table 10
Mini-nutrient status assessment, depression and cognitive function
kjcn-19-142-i010

1) Mini-nutrient status assessment, 2) Mean ± SD, 3) Not significant, 4) n (%), 5) Korean mini-mental status examination, 6) Geriatric depression scale

*: p < 0.05, **: p < 0.01, ***: p < 0.001

Notes

This work was supported by Ministry of Health and Welfare and Soonchang County in 2009 through Institute on Aging at Seoul National University

References

1. Ahmadi SM, Mohammadi MR, Mostafavi SA, Keshavarzi S, Kooshesh SM, Joulaei H, Sarikhani Y, Peimani P, Heydari ST, Lankarani KB. Dependence of the geriatric depression on nutritional status and anthropometric indices in elderly population. Iran J Psychiatry. 2013; 8(2):92–96.
2. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes care. 2010; 33:S62–S69.
3. Bang SM, Lee JO, Kim YJ, Lee KW, Lim S, Kim JH, Park YJ, Chin HJ, Kim KW, Jang HC, Lee JS. Anemia and activities of daily living in the Korean urban elderly population: Results from the Korean longitudinal study on health and aging (KLoSHA). Ann Hematol. 2013; 92:59–65.
4. Berliner N. Anemia in the elderly. Trans Am Clin Climatol Assoc. 2013; 124:230–237.
5. Bollwein J, Volkert D, Diekmann R, Kaiser MJ, Uter W, Vidal K, Sieber CC, Bauer JM. Nutritional status according to the mini nutritional assessment(MNA) and frailty in community dwelling older persons: a close relationship. J Nutr Health Aging. 2013; 17(4):351–356.
6. Bourne PA. Self-rated health of the educated and uneducated classes in Jamaica. N Am J Med Sci. 2010; 2(1):27–35.
7. Campion EW, deLabry LO, Glynn RJ. The effect of age on serum albumin in healthy males: report from the Normotive Aging Study. J Gerontol. 1988; 43(1):M18–M20.
8. Choe JS, Kwon SO, Paik HY. Nutritional status and related factors of the elderly in longevity areas. III. Relation among self-rated health, health-related behaviors, and nutrient intake in rural elderly. Korean J Nutr. 2006; 39(3):286–298.
9. Chun H, Khang YH, Kim IH, Cho SI. Explaining gender differences in ill-health in South Korea: the roles of socio-structural, phycosocial, and behavioral factors. Soc Sci Med. 2008; 67(6):988–1001.
10. Cooper JK, Gardner C. Effect of aging on serum albumin. J Am Geriatr Soc. 1989; 37(11):1039–1042.
11. Dean M, Raats MM, Grunert KG, Lumbers M. Factors influencing eating a varied diet in old age. Public Health Nutr. 2009; 12(12):2421–2427.
12. Guthrie HA, Scheer JC. Validity of a dietary score for assessing nutrient adequacy. J Am Diet Assoc. 1981; 78:240–245.
13. Hamer M, Lavoie KL, Bacon SL. Taking up physical activity in later life and healthy ageing: the English longitudinal study of aging. Br J Sports Med. 2013; 48(3):239–243.
14. Hansen RG, Wyse BW. Expression of nutrient allowances per 1,000 kcal. J Am Diet Assoc. 1980; 76(3):223–227.
15. Hardy R, Cooper R, Aihie Sayer A, Ben-Shlomo Y, Cooper C, Deary IJ, Demakakos P, Gallacher J, Martin RM, McNeill G, Starr JM, Steptoe A, Syddall H, Kuh D. HALCyon study team. Body mass index, muscle strength and physical performance in older adults from eight cohort studies: The HALCyon programme. PLoS One. 2013; 8(2):e56483.
16. Haveman-Nies A, Groot LPGM, Cruz JAA, Osler M, van Staveren WA. Dietary quality and lifestyle factors in relation to 10-year mortality in older Europeans. The SENECA study. Am J Epidemiol. 2002; 156:962–968.
17. Herrmann M, Widmann T, Colaianni G, Colucci S, Zallone A, Herrmann W. Increased osteoclast activity in the presence of increased homocysteine concentration. Clin Chem. 2005; 51(12):2348–2353.
18. Hooshmand B, Solomon A, Kreholt I, Rusanen M, Hnninen T, Leivisk J, Winblad B, Laatikainen T, Soininen H, Kivipelto M. Associations between serum homocysteine, holotranscobalamin, folate and cognition in the elderly: a longitudinal study. J Intern Med. 2012; 271:204–212.
19. Houston DK, Johnson MA, Nozza RJ, Gunter EW, Shea KJ, Cutler GM. Age-related hearing loss, vitamin B12 and folate in elderly women. Am J Clin Nutr. 1999; 69:564–571.
20. Idler EL, Kasl SV. Self-rating of health: do they also predict change in functional ability? J Gerontol B Psychol Sci Soc Sci. 1995; 50(6):s344–s353.
21. Iizaka S, Tadaka E, Sanada H. Comprehensive assessment of nutritional status and associated factors in the healthy, community-dwelling elderly. Geriatr Gerontol Int. 2008; 8:24–31.
22. Kang Y, Kim MY, Eliza L. The relationship of perceived health status, activities of daily living and nutrition status in the community-dwelling Korean elderly. J Korean Acad Nurs. 2008; 38(1):122–130.
23. Kasayama S, Morita S, Otsuki M, Asanuma N, Saito H, Mukai M, Koga M. Independent association between insulin-like growth factor-1 and dehydroepiandrosterone sulphate in women in middle adulthood. Clin Endocrinol (Oxf). 2007; 66:797–802.
24. Kato K, Zweig R, Schchter C, Verghese J, Barzilai N, Atzmon G. Personality, self-rated health and cognition in centenarians : Do personality and self-rated health relate to cognitive function in advanced age? Aging (Albany NY). 2013; 5(3):183–191.
25. Kilpatrick ES, Bloomgarden Z, Zimmet P. Is hemoglobin A1c a step forward for diagnosis diabetes? BMJ. 2009; 339:b4432.
26. Kitamura K, Nakamura K, Kobayashi R, Oshiki R, Saito T, Oyama M, Takahashi S, Nishiwaki T, Iwasaki M, Yoshihara A. Physical activity and 5-year changes in physical performance tests and bone mineral density in postmenopausal women: The Yokogoshi study. Maturitas. 2011; 70:80–84.
27. Korea National Statistics Office. 2013 Statistics on aged population. 2013. cited December 10, 2013. Available from http://kostat.go.kr.
28. Korean Geriatric Society. Tools for the assessment of cognitive function for elderly. Korean-MMSE. 2009. cited January 4, 2009. Available from http://www.geriatrics.or.kr.
29. Korean Nutrition Society. Dietary reference intakes for Koreans. Seoul: Kookjin publishing;2010.
30. Korean Society for the Study of Obesity. Diagnosis and therapy of obesity: Asia-Pacific area guideline. Seoul: 2000.
31. Krebs-Smith SM, Wright HS, Guthrie HA, Krebs-Smith J. The effects of variety in food choices on dietary quality. J Am Diet Assoc. 1987; 87(7):897–903.
32. Kuo HK, Sorond FA, Chen JH, Hashmi A, Milberg WP, Lipsitz LA. The role of homocysteine in multisystem age-related problems: a systematic review. J Gerontol A Biol Sci Med Sci. 2005; 60:1190–1201.
33. Kwon J, Suzuki T, Kumagai S, Shinkai S, Yukawa H. Risk factors for dietary variety decline among Japanese elderly in a rural community: a 8-year follow-up study from TMIG-LISA. Eur J Clin Nutr. 2006; 60(3):305–311.
34. Kwon J, Suzuki T, Yoshida H, Kim H, Yoshida Y, Iwasa M, Furuna T. Association between change in bone mineral density and decline in usual walking speed in elderly community-dwelling Japanese women during 2 years of follow-up. J Am Geriatr Soc. 2007; 55(2):240–244.
35. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Lancet Physical Activity Series Working Group. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012; 380:219–229.
36. Lee KS, Cheong HW, Kim EA, Kim KR, Oh BH, Hong CH. Nutritional risk and cognitive impairment in the elderly. Arch Gerontol Geriatr. 2009; 48:95–99.
37. Lee YH, Choi KS, Kang IO. Determinants of self-rated health among the Korean elderly living in the community. J Korea Gerontol Soc. 1998; 18(2):110–124.
38. Lengyel CO, Tate PB, Obirek BLatz AK. The relationships between food group consumption, self-rated health, and life satisfaction of community-dwelling canadian older men: the manitoba follow-up study. J Nutr Elder. 2009; 28(2):158–173.
39. Meng S, Ciment S, Jan M, Tran T, Pham H, Cueto R, Yang XF, Wang H. Homocysteine induces inflammatory transcriptional signaling in monocytes. Front Biosci (Landmark Ed). 2013; 18:685–695.
40. Meng X, D'Arcy C. Successful aging in Canada:Prevalence and predictors from a population-based sample of older adults. Gerontology. 2014; 60:65–72.
41. Montlahuc C, Soumare A, Dufouil C, Berr C, Dartigues JF, Poncet M, Tzourio C, Alperovotch A. A self-rated health and risk of incident dementia: A community-based elderly cohort, the 3C study. Neurology. 2011; 77:1457–1464.
42. Park SC. Korean centenarians. Seoul: Seoul National University Publishing;2002.
43. Ravaglia G, Forti P, Maioli F, Martelli M, Servadei L, Brunetti N, Porcellini E, Licastro F. Homocysteine and folate as risk factors for dementia and Alzheimer disease. Am J Clin Nutr. 2005; 82:636–643.
44. Rowe JW, Kahn RL. Successful aging. Gerontologist. 1997; 37:433–440.
45. Sakamoto W, Isomura H, Fujie K, Deyama Y, Kato A, Nishihira J, Izumi H. Homocysteine attenuates the expression of osteocalcin but enhances osteopontin in MC3T3-E1 preosteoblastic cells. Biochim Biophys Acta. 2005; 1740:12–16.
46. Sieber CC. Nutritional screening tools - How dose the MNA compare? Proceeding of the session held in Chicago May 2-3, 2006 (15 Years of Mini Nutritional Assessment). J Nutr Health Aging. 2006; 10(6):488–492.
47. Sheikh JI, Yesavage JA. Geriatric depression scale(GDS), recent evidence and development of a shorter version. Clin Gerontology. 1986; 5:165–172.
48. Sorenson AW, Wyse BW, Wittwer AJ, Hansen RG. An index of nutritional quality for a balanced diet. New help for an old problem. J Am Diet Assoc. 1976; 68(3):236–242.
49. Stevens PJ, Syddall HE, Patal HP, Martin HJ, Cooper C, Aihie Sayer A. Is grip strength a good marker of physical performance among community-dwelling older people? J Nutr Health Aging. 2012; 16(9):769–774.
50. Tsai AC, Kai MY. Mini nutritional assessment and short-form mini nutritional assessment can predict the future risk of falling in older adults-Results of a national cohort study. Clin Nutr. 2013; doi: 10.1016/j.clnu.2013.10.010. [Epub ahead of print].
51. Vuorisalmi M, Lintonen T, Jylha M. Comparative vs global self-rated health: associations with age and functional ability. Aging Clin Exp Res. 2006; 18(3):211–217.
52. Weisen SF, Frishman WH, Aronson MK, Wassertheil-Smoller S. Self-rated health assessment and development of both cardiovascular and dementing illness in an ambulatory elderly population: A report from the Bronx Longitudinal aging study. Heart Dis. 1999; 1(4):201–205.
53. Yatabe MS, Taguchi F, Ishida I, Sato A, Kameda T, Ueno S, Takano K, Watanabe T, Sanada H, Yatabe J. Mini nutritional assessment as a useful method of predicting the development of pressure ulcers in elderly patients. J Am Geriatr Soc. 2013; 61(10):1698–1704.
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