DOI QR코드

DOI QR Code

Difference in food and nutrient intakes in Korean elderly people according to chewing difficulty: using data from the Korea National Health and Nutrition Examination Survey 2013 (6th)

  • Kwon, Song Hee ;
  • Park, Hae Ryun ;
  • Lee, Young Mi ;
  • Kwon, Soo Youn ;
  • Kim, Ok Sun ;
  • Kim, Hee Young ;
  • Lim, Young Suk
  • Received : 2016.11.03
  • Accepted : 2017.01.04
  • Published : 2017.04.01

Abstract

BACKGROUND/OBJECTIVES: Chewing difficulty is a factor contributing to a poor nutritional status in the elderly. The aim of this study was to examine disparities in food and nutrition intakes among Korean elderly people with and without chewing difficulty. SUBJECTS/METHODS: This study utilized data from the sixth Korea National Health and Nutrition Examination Survey conducted in 2013. The study subjects included males and females over 65 years of age who were not required to adhere to a special diet due to disease or sickness. They were divided into groups according to their chewing ability. Those who found chewing "very difficult" or "difficult", were combined to form the chewing difficulty group. Similarly, those who found chewing "moderately difficult", "easy", and "very easy" were combined to form the normal chewing group. RESULTS: Of the 999 subjects, 47.7% had chewing difficulties and the prevalence of chewing difficulty was higher in females than in males (P = 0.03) and higher in those 75 years of age and over than in younger individuals (P < 0.001). The chewing difficulty group had a significantly lower intake of fruits and vegetables (P < 0.05) and lower vitamin C and potassium intake than those in the normal group. Comparison of the percentages of Dietary Reference Intakes for Koreans (KDRIs) in the two groups indicated that the intake of most nutrients (energy, vitamin C, thiamin, riboflavin, niacin, calcium, phosphorus, sodium, potassium, and iron) were significantly lower in the chewing difficulty group than in the normal group. In particular, calcium intake was inadequate (51% of KDRIs) in the chewing difficulty group. CONCLUSIONS: The results indicate that chewing difficulty is closely related to food and nutrient intake in the elderly and can result in vitamin and mineral intake deficiencies. It is evident that the care of elderly subjects with chewing difficulty is essential for maintaining a healthy lifestyle.

Keywords

Aged;elderly;nutrient;food;malnutrition

References

  1. United Nations. World population prospects: the 2015 revision [Internet]. New York (NY): United Nations; 2015 [cited 2016 June 12]. Available from: https://esa.un.org/unpd/wpp/Publications/Files/Key_Findings_WPP_2015.pdf.
  2. Korean Statistical Information Service. Statistics population Korea: future population projection [Internet]. Statistics Korea; 2016 [cited 2016 August 8]. Available from: http://kosis.kr/ups/ups_01List.jsp.
  3. Reedy J, Krebs-Smith SM, Miller PE, Liese AD, Kahle LL, Park Y, Subar AF. Higher diet quality is associated with decreased risk of all-cause, cardiovascular disease, and cancer mortality among older adults. J Nutr 2014;144:881-9. https://doi.org/10.3945/jn.113.189407
  4. Maitre I, Van Wymelbeke V, Amand M, Vigneau E, Issanchou S, Sulmont-Rosse C Food pickiness in the elderly: relationship with dependency and malnutrition. Food Qual Prefer 2014;32:145-151. https://doi.org/10.1016/j.foodqual.2013.04.003
  5. Zulkowski K. Nutrition and aging: a transdisciplinary approach. Ostomy Wound Manage 2006;52:53-7.
  6. Padilha DM, Hilgert JB, Hugo FN, Bos AJ, Ferrucci L. Number of teeth and mortality risk in the Baltimore Longitudinal Study of Aging. J Gerontol A Biol Sci Med Sci 2008;63:739-44. https://doi.org/10.1093/gerona/63.7.739
  7. Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ 2005;83:661-9.
  8. Marshall TA, Warren JJ, Hand JS, Xie XJ, Stumbo PJ. Oral health, nutrient intake and dietary quality in the very old. J Am Dent Assoc 2002;133:1369-79. https://doi.org/10.14219/jada.archive.2002.0052
  9. Bailey RL, Ledikwe JH, Smiciklas-Wright H, Mitchell DC, Jensen GL. Persistent oral health problems associated with comorbidity and impaired diet quality in older adults. J Am Diet Assoc 2004;104:1273-6. https://doi.org/10.1016/j.jada.2004.05.210
  10. Ohmure H, Takada H, Nagayama K, Sakiyama T, Tsubouchi H, Miyawaki S. Mastication suppresses initial gastric emptying by modulating gastric activity. J Dent Res 2012;91:293-8. https://doi.org/10.1177/0022034511433847
  11. Miura H, Kariyasu M, Yamasaki K, Arai Y. Evaluation of chewing and swallowing disorders among frail community-dwelling elderly individuals. J Oral Rehabil 2007;34:422-7. https://doi.org/10.1111/j.1365-2842.2007.01741.x
  12. Savoca MR, Arcury TA, Leng X, Chen H, Bell RA, Anderson AM, Kohrman T, Gilbert GH, Quandt SA. Association between dietary quality of rural older adults and sekf-reported food avoidance and food modification due to oral health problems. J Am Geriatr Soc 2010;58:1225-32. https://doi.org/10.1111/j.1532-5415.2010.02909.x
  13. Papas AS, Palmer CA, Rounds MC, Russell RM. The effects of denture status on nutrition. Spec Care Dentist 1998;18:17-25. https://doi.org/10.1111/j.1754-4505.1998.tb01354.x
  14. Lee MS, Huang YC, Wahlqvist ML. Chewing ability in conjunction with food intake and energy status in later life affects survival in Taiwanese with the metabolic syndrome. J Am Geriatr Soc 2010;58:1072-80. https://doi.org/10.1111/j.1532-5415.2010.02870.x
  15. Marcenes W, Steele JG, Sheiham A, Walls AW. The relationship between dental status, food selection, nutrient intake, nutritional status, and body mass index in older people. Cad Saude Publica 2003;19:809-16. https://doi.org/10.1590/S0102-311X2003000300013
  16. Kimura Y, Ogawa H, Yoshihara A, Yamaga T, Takiguchi T, Wada T, Sakamoto R, Ishimoto Y, Fukutomi E, Chen W, Fujisawa M, Okumiya K, Otsuka K, Miyazaki H, Matsubayashi K. Evaluation of chewing ability and its relationship with activities of daily living, depression, cognitive status and food intake in the community-dwelling elderly. Geriatr Gerontol Int 2013;13:718-25. https://doi.org/10.1111/ggi.12006
  17. Hildebrandt GH, Dominguez BL, Schork MA, Loesche WJ. Functional units, chewing, swallowing, and food avoidance among the elderly. J Prosthet Dent 1997;77:588-95. https://doi.org/10.1016/S0022-3913(97)70100-8
  18. Brownie S. Why are elderly individuals at risk of nutritional deficiency? Int J Nurs Pract 2006;12:110-8. https://doi.org/10.1111/j.1440-172X.2006.00557.x
  19. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2013: Korea National Health and Nutrition Examination Survey (KNHANES VI-1). Cheongju: Korea Centers for Disease Control and Prevention; 2014.
  20. Dion N, Cotart JL, Rabilloud M. Correction of nutrition test errors for more accurate quantification of the link between dental health and malnutrition. Nutrition 2007;23:301-07. https://doi.org/10.1016/j.nut.2007.01.009
  21. Schimmel M, Katsoulis J, Genton L, Muller F. Masticatory function and nutrition in old age. Swiss Dent J 2015;125:449-54.
  22. Han D. Chewing difficulty and multiple chronic conditions in Korean elders: KNHANES IV. J Korean Dent Assoc 2013;51:511-7.
  23. Hwang SH, Han SS, Yoo WK. The effects of chewing difficulty on the prevalence of osteoarthritis in adults aged 50 years and older. J Dent Hyg Sci 2015;15:145-52. https://doi.org/10.17135/jdhs.2015.15.2.145
  24. Bae YH, Lee HK. The relationship between chewing ability and health status in the urban elderly who resides in the house. Yeungnam Univ J Med 2004;21:51-9. https://doi.org/10.12701/yujm.2004.21.1.51
  25. Rural Development Administration, National Institute Agricultural Sciences (KR). Standard Food Composition Table. 8th rev. ed. Paju: Kyomunsa; 2012. p.519.
  26. Friedlander AH. The physiology, medical management and oral implications of menopause. J Am Dent Assoc 2002;133:73-81. https://doi.org/10.14219/jada.archive.2002.0025
  27. Tezal M, Wactawski-Wende J, Grossi SG, Dmochowski J, Genco RJ. Periodontal disease and the incidence of tooth loss in postmenopausal women. J Periodontol 2005;76:1123-8. https://doi.org/10.1902/jop.2005.76.7.1123
  28. Marques MR, da Silva MA, Barros SP. Periodontal disease and osteoporosis association and mechanisms: a review of the literature. Braz J Oral Sci 2003;2:137-40.
  29. Lee HK, Lee YK. The relationship between chewing ability and health status in the long-lived elderly of Kyungpook area. Yeungnam Univ J Med 1999;16:200-7. https://doi.org/10.12701/yujm.1999.16.2.200
  30. Kossioni A, Bellou O. Eating habits in older people in Greece: the role of age, dental status and chewing difficulties. Arch Gerontol Geriatr 2011;52:197-201. https://doi.org/10.1016/j.archger.2010.03.017
  31. Borrell LN, Crawford ND. Social disparities in periodontitis among United States adults 1999-2004. Community Dent Oral Epidemiol 2008;36:383-91. https://doi.org/10.1111/j.1600-0528.2007.00406.x
  32. Kagawa R, Ikebe K, Inomata C, Okada T, Takeshita H, Kurushima Y, Kibi M, Maeda Y. Effect of dental status and masticatory ability on decreased frequency of fruit and vegetable intake in elderly Japanese subjects. Int J Prosthodont 2012;25:368-75.
  33. Mann T, Heuberger R, Wong H. The association between chewing and swallowing difficulties and nutritional status in older adults. Aust Dent J 2013;58:200-6. https://doi.org/10.1111/adj.12064
  34. Cousson PY, Bessadet M, Nicolas E, Veyrune JL, Lesourd B, Lassauzay C. Nutritional status, dietary intake and oral quality of life in elderly complete denture wearers. Gerodontology 2012;29:e685-92. https://doi.org/10.1111/j.1741-2358.2011.00545.x
  35. Hung HC, Colditz G, Joshipura KJ. The association between tooth loss and the self-reported intake of selected CVD-related nutrients and foods among US women. Community Dent Oral Epidemiol 2005;33:167-73. https://doi.org/10.1111/j.1600-0528.2005.00200.x
  36. Brown IJ, Tzoulaki I, Candeias V, Elliott P. Salt intakes around the world: implications for public health. Int J Epidemiol 2009;38:791-813. https://doi.org/10.1093/ije/dyp139
  37. Tserendejid Z, Hwang J, Lee J, Park H. The consumption of more vegetables and less meat is associated with higher levels of acculturation among Mongolians in South Korea. Nutr Res 2013;33:1019-25. https://doi.org/10.1016/j.nutres.2013.09.001
  38. Wu SJ, Chang YH, Wei IL, Kao MD, Lin YC, Pan WH. Intake levels and major food sources of energy and nutrients in the Taiwanese elderly. Asia Pac J Clin Nutr 2005;14:211-20.
  39. Adegboye AR, Christensen LB, Holm-Pedersen P, Avlund K, Boucher BJ, Heitmann BL. Intakes of calcium, vitamin D, and dairy servings and dental plaque in older Danish adults. Nutr J 2013;12:61. https://doi.org/10.1186/1475-2891-12-61
  40. Kim MJ. Blue ocean of food market ' Care Foods for Older People 'Food Market' [Internet]. Seoul: Korea Trade-Investment Promotion Agency; 2016 [cited 2016 August 29]. Available from: http://news.kotra.or.kr/user/globalBbs/kotranews/4/globalBbsDataView.do?setIdx=243&dataIdx=35559.
  41. Choi SH. Senior food industry [Internet]. Seoul: Mirae Asset Retirement Institute; 2016 [cited 2016 June 28]. Available from: http://retirement.miraeasset.com/contents/EF4A5CA892A0C02CE043D36FDA0BC02C;20142014.
  42. Office for Shokuiku Promotion-(JP). What We Know From SHOKUIKU, the Japanese Spirit -Food and Nutrition Education in Japan. Tokyo: Office for shokuiku Promotion; 2010.
  43. Higashiguchi T. Novel diet for patients with impaired mastication evaluated by consumption rate, nutrition intake, and questionnaire. Nutrition 2013;29:858-64. https://doi.org/10.1016/j.nut.2012.12.016

Cited by

  1. Socio-demographic factors and diet-related characteristics of community-dwelling elderly individuals with dysphagia risk in South Korea vol.12, pp.5, 2018, https://doi.org/10.4162/nrp.2018.12.5.406
  2. Functional determinants of dietary intake in community-dwelling older adults: a DEDIPAC (DEterminants of DIet and Physical ACtivity) systematic literature review vol.21, pp.10, 2018, https://doi.org/10.1017/S1368980017004244
  3. Factors affecting objective and subjective masticatory ability assessment of Korean elderly people vol.42, pp.4, 2018, https://doi.org/10.11149/jkaoh.2018.42.4.216

Acknowledgement

Supported by : Ministry of Health and Welfare