1. Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. 2. Division of Human Nutrition and Health, Wageningen University and Research. P.O. Box 176700 AA Wageningen, The Netherlands.
Acta Med Indones. 2022 Apr;54(2):255-265.
Milk consumption in the Indonesian elderly population is among the lowest in the world, and two-thirds of the population are lactose intolerant. This might have an impact on energy and nutrient intakes. However, data on the prevalence of nutrient intake inadequacies in dairy users versus non-dairy users, as well as population characteristics, are lacking. Therefore we obtained data comparing nutritional inadequacies and characteristics of Indonesian older adults consuming or refraining from dairy products.
A cross-sectional study was conducted in 2021 as a part of the INA LACTASE study, involving 194 community-dwelling older adults in the outpatient geriatric clinic at Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. We collected data on demographic and clinical characteristics as part of a routinely performed comprehensive geriatric assessment. A structured questionnaire was developed to categorize participants as dairy-or non-dairy users based on habitual dairy intake. Food records were collected to assess nutrient intakes. The prevalence of inadequacies of energy, macronutrients, and a selection of micronutrients (calcium, vitamin D, and vitamin B12) was calculated by comparing the reported mean intakes to the recommended dietary intakes of the Indonesian population (Indonesian RDA). Prevalence ratios were calculated to measure the association between dairy product consumption and the prevalence of nutrient inadequacies.
We recruited 194 eligible participants. This study found that dairy users had a higher proportion of women, a higher monthly income, but a lower proportion of hypertension, diabetes mellitus, and dyslipidaemia in older adults consuming dairy products. We observed wide variability in energy and nutrient intakes, as well as a high prevalence of inadequacies for all dietary intake parameters, particularly micronutrients. Dairy users had a lower prevalence of micronutrient inadequacies than non-dairy users. The prevalence of vitamin D inadequacies in dairy users versus non-dairy users was 91.6% vs. 99.3% in men and 71.9% vs. 98.0% in women, respectively. Inadequate vitamin B12 intake was found in 60.6% of dairy users vs. 89.4% of non-dairy users in men and 65.5% vs.. 68.4% of women, respectively. The most pronounced difference was found in the prevalence of calcium intake inadequacies in dairy users vs. non-dairy users, which was 64.8% vs. 99.5% in men and 89.9% vs. 99.8% in women. We found statistically significant differences in the prevalence of calcium, vitamin D, and vitamin B inadequacies between dairy and non-dairy users.
This study identified that dairy users had a higher monthly income and had a lower proportion of hypertension, diabetes mellitus, and dyslipidemia. In addition, we discovered a high prevalence of nutrient intakes inadequacies in Indonesian older adults, particularly among non-dairy users. Micronutrient inadequacies are major sources of concern, with statistically significant difference in calcium, vitamin D, and vitamin B12 prevalence of inadequacies.
印度尼西亚老年人的牛奶摄入量是世界上最低的，有三分之二的人口不耐乳糖。这可能会对能量和营养素的摄入产生影响。然而，关于乳制品使用者和非乳制品使用者的营养素摄入不足的流行率以及人口特征的数据却很缺乏。因此，我们获取了比较食用和不食用乳制品的印度尼西亚老年人营养不足情况和特征的数据。
2021 年，作为 INA LACTASE 研究的一部分，我们在印度尼西亚雅加达 Cipto Mangunkusumo 医院的老年门诊诊所进行了一项横断面研究，共纳入 194 名社区居住的老年人。我们收集了人口统计学和临床特征数据，作为常规进行的全面老年评估的一部分。我们开发了一个结构化问卷，根据习惯性的乳制品摄入量将参与者分为乳制品使用者或非乳制品使用者。我们收集了食物记录来评估营养素的摄入量。通过将报告的平均摄入量与印度尼西亚人群的推荐膳食摄入量（RDA）进行比较，计算了能量、宏量营养素和一些微量营养素（钙、维生素 D 和维生素 B12）不足的发生率。计算了患病率比值来衡量乳制品消费与营养素不足患病率之间的关系。
我们招募了 194 名符合条件的参与者。本研究发现，乳制品使用者中女性比例较高，月收入较高，但患高血压、糖尿病和血脂异常的比例较低。我们观察到能量和营养素的摄入量存在很大差异，所有饮食摄入参数的不足率都很高，尤其是微量营养素。与非乳制品使用者相比，乳制品使用者的微量营养素不足率较低。男性中，维生素 D 不足的患病率分别为乳制品使用者 91.6%，非乳制品使用者 99.3%；女性中分别为乳制品使用者 71.9%，非乳制品使用者 98.0%。维生素 B12 摄入不足分别见于男性乳制品使用者 60.6%，非乳制品使用者 89.4%；女性乳制品使用者 65.5%，非乳制品使用者 68.4%。最明显的差异是乳制品使用者与非乳制品使用者的钙摄入不足率，男性分别为 64.8%和 99.5%，女性分别为 89.9%和 99.8%。我们发现乳制品使用者与非乳制品使用者之间的钙、维生素 D 和维生素 B 不足的患病率存在统计学显著差异。
本研究发现，乳制品使用者的月收入较高，患高血压、糖尿病和血脂异常的比例较低。此外，我们发现印度尼西亚老年人的营养素摄入不足率很高，尤其是非乳制品使用者。微量营养素不足是主要关注点，钙、维生素 D 和维生素 B12 的不足率存在统计学显著差异。
