Indicators of nutritional risk in a rural elderly Hispanic and non-Hispanic white population: San Luis Valley Health and Aging Study.

OBJECTIVE: To describe the prevalence of nutritional risk factors among elderly residents in a rural Hispanic and non-Hispanic white population. DESIGN: A geographically based survey of community-dwelling elderly adults. SUBJECTS/SETTING: From July 1993 to July 1995, all Hispanic persons older than 65 years and an age-stratified, random sample of 69% of non-Hispanic white persons, from 2 Colorado counties, were invited to participate in a study of functional impairment and disability (81% responded). After exclusion of 184 respondents who required a surrogate respondent and 8 with missing diet data, the study consisted of 1,006 subjects. Interviews included questions similar to the Nutrition screening Initiative checklist, a 21-item food frequency questionnaire, and anthropometric measures. STATISTICAL ANALYSES PERFORMED: Gender- and ethnicity-specific, age-adjusted prevalence for each risk factor was estimated by use of logistic regression. RESULTS: Hispanic participants were more likely than non-Hispanic whites to report inadequate intake of vegetables, problems with teeth or dentures that limited the kinds and amounts of food eaten, difficulty preparing meals, and lack of money needed to buy food. Hispanic women reported nutritional risk factors more often than Hispanic men, although anthropometric markers indicated that Hispanic men may be at higher risk of nutritional deficiency. APPLICATIONS/CONCLUSIONS: Hispanic men and women had a higher prevalence of nutritional risk factors than non-Hispanic whites. Intervention programs targeting rural, elderly Hispanics should aim to ensure that basic nutrition needs (access to food, help preparing meals, and adequate dental care) are being met. Community programs to increase activity levels and consumption of nutrient-dense foods are recommended.

Ethnic differences in micronutrient intake in a rural biethnic population.

Differences in micronutrient intake have been observed between populations of differing socioeconomic status (SES) and ethnicity. This study reports micronutrient intake among Hispanic and non-Hispanic white (NHW) persons in the rural San Luis Valley of southern Colorado. Current diet was assessed for a geographically based sample of 552 Hispanic and 754 NHW adults 30-74 years of age in two counties of rural southern Colorado (1984-1988). Diet was assessed by 24-hour recall. NHWs reported higher mean calorie intakes than Hispanics of both genders. NHWs had greater intakes of calcium, magnesium, potassium, phosphorus, riboflavin, niacin, zinc, vitamin A, and vitamin C than Hispanics, after accounting for ethnic differences in gender, age, and calorie intake. Differences in intake by gender were observed within and between ethnic groups. After adjusting for gender, age, ethnicity, and calories, we observed no statistically significant trends by SES measures. We conclude that diets of Hispanic adults would benefit from the addition of fresh fruits, vegetables, and high-calcium foods.

Association of education level with atherogenic diets in a rural biethnic population.

Better definition of dietary intakes among subpopulations will facilitate the implementation of relevant public health interventions. This study describes total calorie and macronutrient intake by level of education as reported by Hispanic and non-Hispanic white persons in the rural San Luis Valley of southern Colorado. Current diet was assessed for a geographically based sample of 552 Hispanic and 754 non-Hispanic white (NHW) adults 30-74 years of age in two counties of rural southern Colorado 1984-1988). Diet was assessed by 24-hour recall. Hispanic men and women reported lower total calorie intakes at all ages than NHWs; however, the macronutrient composition was similar between groups (38.5% and 46.0% of calories from fat and carbohydrate, respectively). Ethnic differences in body size and reported physical activity did not account for ethnic differences in reported calorie intake. In both ethnic groups, subjects with more education reported higher calorie intake and less atherogenic diets (lower total fat, saturated fat, cholesterol, and Keys Index; higher polyunsaturated fat, P/S ratio, and total carbohydrate). In Hispanics and NHWs, lower education groups may require targeted interventions to decrease total fat, saturated fat, and cholesterol. Further study is needed to understand the ethnic difference in reported calorie intake.

Excess incidence of known non-insulin-dependent diabetes mellitus (NIDDM) in Hispanics compared with non-Hispanic whites in the San Luis Valley, Colorado.

Non-insulin-dependent diabetes mellitus is between two and five times more prevalent among Hispanic Americans than among non-Hispanic whites (NHW). Incidence data for Hispanic populations will help to determine whether this excess prevalence is due to increased incidence, survivorship, or other factors. Incident cases were identified through concurrent surveillance of all local medical practices from 1983 to 1988 in two southern Colorado counties in which the population was 46% Hispanic. All identified subjects were invited for an oral glucose tolerance test. Among the subjects who attended clinic, 83% were confirmed as having diabetes, using WHO criteria. The standardized average annual incidence rates per 1000 for confirmed non-insulin-dependent diabetes, accounting for nonresponse, were 3.7 and 1.6 for Hispanic and NHW males, and 4.5 and 1.2 for Hispanic and NHW females, respectively. The age and nonresponse adjusted rate ratio comparing Hispanics to NHWs was 3.1 (95% CI: 2.3-4.2), indicating a significant excess risk of diabetes incidence for the Hispanic population in southern Colorado. Peak age-specific incidence among Hispanics occurred in persons 50 to 59 years old, a decade earlier than among NHWs. These results are consistent with data from the Mexican-American population in Texas and suggest that the previously observed excess in diabetes prevalence is due to higher incidence rates. The earlier age-specific peak in incidence has also been observed in Mexican-American and American Indian populations, suggesting that risk factors may operate at earlier ages.