Nutritional status of Chinese-, Korean-, and Japanese-American elderly.

The increased proportion and number of elderly persons in the United States have caused growing concern about the role of nutrition in health and longevity. Several national nutrition surveys have included the elderly, for example, the Ten State Nutrition Survey and (1) the first and second National Health and Nutrition Examination Surveys (NHANES I and II) (2,3). These studies addressed the nutritional status of whites and blacks aged 65 to 74 years but not of Asian elderly (4).

Arthritis, heart disease, hypertension, and diabetes are the four most common chronic conditions in the elderly (5). Nutrition plays an integral role in the etiology and management of at least three of these diseases. Mortality data for two major Asian subgroups (Chinese and Japanese) have indicated that death rates because of heart disease and diabetes are lower for Asian-Americans than for white Americans (6). Available data on the prevalence of hypertension show relatively lower rates for Asians as a whole compared with whites, although rates vary widely in different Asian subpopulations. Because the diet of the Asian elderly is generally thought to reflect cultural background and is different from the diets of other elderly populations, investigation of different Asian ethnic groups would help to clarify the role of nutrition in diseases of the aged.

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Large national and regional studies have been conducted to evaluate the nutritional status of white, Hispanic, and black elderly (1-3,7), but there have been only isolated evaluations of the nutritional status of the Asian elderly (8-11). Netland and Brownstein (8,9) evaluated 170 Asian elderly in the San Francisco Bay area of California by means of 24-hour dietary recalls, social data, and anthropometric measurements. Kim et al (10) reported the 24-hour calcium intake of 40 Korean elderly. More recently, Chau et al (11) examined the dietary habits, health beliefs, and food practices of 45 elderly Chinese women in the San Francisco Bay area. These studies suggest that the nutrition problems of the Asian elderly may be unique to their culture and may differ from the nutritional status of elderly American whites, blacks, and Hispanics. Therefore, we concluded that a study with a large sample of different Asian ethnic groups would elucidate different dietary patterns that potentially affect nutritional status.

The purpose of our article is to report our findings on the nutritional status of Chinese-, Korean-, and Japanese-American elderly according to anthropometric measurements and dietary intake.

METHODS

Subjects

The sample consisted of 169 Chinese, 90 Korean, and 50 Japanese elderly who lived in five predominantly Asian senior-citizen congregate housing units in Chicago, Ill. Criteria for sample selection were being Chinese, Korean, or Japanese; being 60 years of age or older; living independently in the community; and having eaten usual meals the day before the interview. Because data collection relied heavily on subjects' short-term recall ability, it was necessary to assess cognitive function before obtaining the 24-hour dietary recall. We used the Mini Mental State Examination (12), which has been translated and found to be valid in China (13), to ascertain cognitive status. Those who scored 17 or less of a possible 30 points were not included in the study because of possible memory problems that could interfere with their ability to recall 24-hour dietary intake.

Ages of the entire sample ranged from 60 to 95 years. Mean ages of the Chinese, Korean, and Japanese elderly were 74.6, 72.1, and 79.1 years, respectively. Approximately one third of the sample were men and two thirds were women. About 50% (88 of 169) of the Chinese and 40% (36 of 90) of the Korean subjects, but less than 10% (4 of 50) of the Japanese, were married. Most Japanese subjects were widowed. More than 25% of the Chinese and Korean subjects had no formal education. In contrast, all the Japanese elderly had some formal education. The Chinese and Koreans were predominantly foreign born; only 40% of the Japanese group were foreign born.

The demographic characteristics of the Chinese and Korean elderly in our study were similar to those reported in the 1980 US census for Chinese and Koreans aged 65 years or older (14). In contrast, the distributions of the Japanese elderly by gender, marital status, and educational level were different from those of the 1980 census (14). The Japanese subjects in our study had higher levels of formal education than …