Dietary supplement use in a randomly selected group of elderly Australians. Results from a large nutrition and health survey

The Use of Dietary Supplements and Their Association with COVID-19-Related Anxiety among Non-Institutionalized Elderly in Northern Greece

The elderly constitute a vulnerable group for increased anxiety and poor diet during the COVID-19 pandemic. There is limited research on the levels of COVID-19-related anxiety and dietary habits including dietary supplementation practices among the elderly and very elderly in Greece. A cross-sectional survey was conducted in 364 non-institutionalized elderly (65-74 y) and very elderly (≥75 y) living in northern Greece, with the aim to investigate the use of dietary supplements and their association with other factors, particularly the COVID-19-related anxiety. Levels of anxiety were assessed with the use of the Coronavirus Anxiety Scale (CAS-5). The percentage of dietary supplement users was 62.6%. The most popular dietary supplements used were vitamin D followed by vitamin C and multivitamin and mineral supplements. Multivariate analysis showed that the very elderly and overweight individuals were less likely to consume vitamin D supplements. Approximately a third of the participants (33.8%) exhibited signs of COVID-19-related anxiety but only 8% showed dysfunctional levels of anxiety. Regression analysis indicated that women, former smokers, and people exhibiting any sign of COVID-19 anxiety were approximately two times more likely to consume dietary supplements of any kind (Gender: OR 2.34, 95% CI 1.30-4.19; Smoking: OR 2.15, 95% CI: 1.08-4.26; COVID-19 anxiety: OR 2.16, 95 % CI: 1.20-3.91). Our results provide useful insights into the current practices of dietary supplement use in this population group and could be used by dietetic and medical associations as well as public authorities in the formulation of targeted, safe, and effective interventions for the protection of public health.

Demographic Characteristics of Supplement Users in an Elderly Population

This study investigated the association of demographic characteristics with supplement use in 257 elderly participants of the Georgia Centenarian Study in their 60s (n = 89), 80s (n = 92), and 100s (n = 76). Of these elders, 44% used a specific vitamin or mineral supplement. Multivitamins/minerals (28%), vitamin C (13%), and vitamin E (7%) were the most common vitamins reported; whereas calcium (8%) and potassium (5%) were the most common minerals reported. Centenarians were as likely as those in their 60s and 80s to use a supplement. Females were more likely than males to report consuming any supplement and multivitamins/minerals; Whites were more likely than Blacks to report consuming any supplement, vitamin E, and vitamin C. Health care providers must be aware that even the oldest old are frequent users of supplements, but being male and of minority status may be a barrier to the use of nutritional supplements.

Healthy eating norms and food consumption

BACKGROUND/OBJECTIVES

Beliefs about what people think they ought to eat to be healthy ('healthy eating norms (HENs)') may be important influences on food consumption. The purpose of this study was to examine the predictive roles of normative expectations and demographics, personal values, substance use behaviours and body weight on reported food consumption among middle-aged Australians.

SUBJECTS/METHODS

A questionnaire was administered by mail to a random sample of people aged 40 years and above, drawn from the Electoral Rolls in Victoria, Australia. Part of the questionnaire contained questions about the respondents' beliefs about what should they eat to be healthy, what actually they ate, their personal values, smoking and alcohol use, as well as self-reported heights and weights and demographic characteristics.

RESULTS

Respondents' reported food consumption did not match their HENs. Demographics, smoking, body mass index (BMI) and personal values, and HENs were associated with reported consumption but the relationships differed among men and women. Generally, high energy-dense, nutrition-poor (EDNP) food consumption was negatively associated with age. Fruit and vegetable HEN and consumption was positively linked to universalist values but negatively related to smoking status among men. In contrast in women, fruit and vegetable HENs were positively related to income and education while EDNP HEN was negatively associated with age and income but positively linked to body weight and power values.

CONCLUSIONS

Reported food consumption was associated with HEN, personal values, demographics, smoking and BMI through different pathways among men and women. The implications for nutrition promotion are discussed.

The relationship between education and food consumption in the 1995 Australian National Nutrition Survey

Objective:

To assess the relationship between education and the intake of a variety of individual foods, as well as groups of foods, for Australian men and women in different age groups.

Design:

Cross-sectional national survey of free-living men and women.

Subjects:

A sample of 2501 men and 2739 women aged 18 years and over who completed the National Nutrition Survey (NNS) 1995.

Methods:

Information about the frequency of consumption of 88 food items was obtained using a food-frequency questionnaire in a nation-wide nutrition survey. Irregular and regular consumers of foods were identified according to whether they consumed individual foods less than or more than once per month. The relationship between single foods and an index of education (no post-school qualifications, vocational, university) was analysed via contingency table chi-square statistics for men and women. Food group variety scores were derived by assigning individual foods to conventional food group taxonomies, and then summing the dichotomised intake scores for individual foods within each food group. Two-way analyses of variance (education by age groups) were performed on food variety scores for men and women, separately.

Results:

While university-educated men and women consumed many individual foods more regularly than less-educated people, they were less likely to be regular consumers of several meat products. The relationship between education and food consumption was less apparent when individual food scores were aggregated into food group scores. University-educated men and women exhibited higher scores on total food group variety than the other educational groups.

Conclusions:

Higher education is associated with the regular consumption of a wider variety of foods. Aggregation of individual food consumption indices into food variety scores may mask the apparent effects of educational background on food consumption.

Intake of vitamin and mineral supplements in an elderly german population

AIM

To assess the prevalence of vitamin and mineral supplement use in a free-living elderly population and the contribution of these supplements to usual dietary intake.

METHODS

Analyses are based on data obtained from 388 subjects (>or=60 years) participating in the longitudinal study on nutrition and health status in an ageing population in Giessen (GISELA), Germany, in 2002. Nutrient intake from food was assessed by means of a 3-day estimated dietary record. Supplement use was recorded over a period of 3 days using a self-administered questionnaire.

RESULTS

Nearly half of the study population consumed at least 1 supplement within these 3 days. The use of supplements was more prevalent among women than among men (51.5 vs. 33.9%). On average women consumed 2.03+/-1.30 products and men 1.65+/-1.07 products. Magnesium, vitamin C and vitamin E were supplemented most often by men, while women supplemented magnesium, vitamin E and calcium most often. Most of the supplemented nutrients did not distinctly increase the average intake of the respective nutrients from the diet in this population. However, supplement use markedly decreased the proportions of elderly subjects with an intake below the current reference values for certain nutrients, particularly for vitamin E.

CONCLUSION

Results indicate that the intake of supplements is a common behavior in the population under investigation and therefore has to be considered when nutrient intake is evaluated.

Do users of dietary supplements differ from nonusers in their food consumption?

The objective of the study was to analyse macronutrient and food intakes of regular users (310 men, 495 women) and nonusers (1136 men, 1269 women) of vitamin and mineral supplements, aged 18-79 years. These, were participants of the German Nutrition Survey, which was part of the German National Health Interview and Examination Survey 1998. Information on dietary behaviour including supplementation habits was assessed using a validated computerised dietary history method (DISHES 98). There were no major differences in macronutrient intakes between regular users and nonusers. After adjustment for age, energy intake, smoking, sport activity, socio-economic status and East/West German residence, regular supplement use was associated with a higher consumption of drinking water. Among men, a higher consumption of vegetable fat, poultry and fruit/vegetable juice, and among women, a higher consumption of fish, milk products, fruits and tea was also associated with regular supplement use. An inverse association was observed between regular supplement use and the consumption of coffee among women. Significant differences in food consumption between regular users and nonusers were observed, indicating a tendency for a healthier food choice among regular users.

Nutritional and non-nutritional factors for 'healthy' longevity

The far-reaching effects of the ageing of populations is being increasingly appreciated. Lengthening longevity, associated with decreasing family size, evokes rising charges, socioeconomically, and on health services. Information on these and other parameters is presented for developed and developing populations. Examples are given, with lessons to be learned, of long-living segments of populations, past and present. The roles of diet, physical activity, and smoking and alcohol consumption also of attitudes, are discussed. It is concluded that if the middle-aged and elderly could be persuaded to follow long-term practices associated with good public health, then morbidity could be compressed, and disability-free years extended. However, this goal could only be achieved with a high level of motivation.