Priority Research Centre for Gender, Health and Ageing, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia; Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.
Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.
Clin Nutr. 2017 Apr;36(2):444-451. doi: 10.1016/j.clnu.2015.12.015. Epub 2015 Dec 25.
BACKGROUND & AIMS: Epidemiological data of dietary patterns and anaemia among older Chinese remains extremely scarce. We examined the association between dietary patterns and anaemia in older Chinese, and to assess whether biomarkers of serum magnesium, C-reactive protein (CRP) and serum ferritin can mediate these associations.
We analysed the 2009 China Health and Nutrition Survey data (2401 individuals aged ≥60 years for whom both dietary and biomarker data are available). Dietary data was obtained using 24 h-recall over three consecutive days. Fasting blood samples and anthropometry measurement were also collected. Factor analysis was used to identify dietary patterns. Factor scores representing dietary patterns were used in Poisson regression models to explore the association between each dietary pattern and anaemia.
Of the 2401 participants, 18.9% had anaemia, 1.9% had anaemia related to inflammation (AI), and 1.3% had iron-deficiency anaemia (IDA). A traditional dietary pattern (high intake of rice, pork and vegetables) was positively associated with anaemia; a modern dietary pattern (high intake of fruit and fast food) was inversely associated with anaemia. Progressively lower magnesium and BMI levels were associated with increasing traditional dietary quartiles; while a progressively higher magnesium and BMI levels were associated with increasing modern dietary quartiles (p < 0.001). There were no significant differences (p > 0.05) in CRP and serum ferritin across quartiles for either dietary pattern. In the fully adjusted model, the prevalence ratio (PR) of anaemia, comparing the fourth quartile to the first quartile, was 1.75 (95% CI: 1.33; 2.29) for a traditional dietary pattern, and 0.89 (95% CI: 0.68; 1.16) for a modern dietary pattern. The association between dietary patterns and anaemia is mediated by serum magnesium.
Traditional dietary pattern is associated with a higher prevalence of anaemia among older Chinese. Future studies need to examine whether correcting micronutrient deficiency (e.g. magnesium) by promoting overall healthy diet, rather than iron supplementation, is a suitable strategy for anaemia prevention in older Chinese people.
中国老年人的饮食模式和贫血的流行病学数据极其匮乏。我们研究了中国老年人的饮食模式与贫血之间的关系，并评估了血清镁、C 反应蛋白（CRP）和血清铁蛋白的生物标志物是否可以调节这些关联。
我们分析了 2009 年中国健康与营养调查数据（2401 名年龄≥60 岁且饮食和生物标志物数据均可用的个体）。饮食数据通过连续三天的 24 小时回忆获得。还采集了空腹血样和人体测量数据。使用因子分析来识别饮食模式。因子得分代表饮食模式，用于泊松回归模型，以探索每种饮食模式与贫血之间的关系。
在 2401 名参与者中，18.9%患有贫血，1.9%患有与炎症相关的贫血（AI），1.3%患有缺铁性贫血（IDA）。传统饮食模式（高摄入米饭、猪肉和蔬菜）与贫血呈正相关；现代饮食模式（高摄入水果和快餐）与贫血呈负相关。血清镁和 BMI 水平逐渐降低与传统饮食四分位数的增加有关；而血清镁和 BMI 水平逐渐升高与现代饮食四分位数的增加有关（p<0.001）。两种饮食模式的 CRP 和血清铁蛋白在四分位数之间没有显著差异（p>0.05）。在完全调整的模型中，与第一四分位数相比，传统饮食模式的贫血患病率比（PR）为 1.75（95%CI：1.33；2.29），现代饮食模式的 PR 为 0.89（95%CI：0.68；1.16）。饮食模式与贫血之间的关联是由血清镁介导的。
传统饮食模式与中国老年人贫血的患病率较高有关。未来的研究需要检验通过促进整体健康饮食（例如补充镁）来纠正微量营养素缺乏（如镁）是否是预防中国老年人贫血的合适策略。
