Development and analysis of acceptance of a nutrition education package among a rural elderly population: an action research study.

BACKGROUND: It is well known that older adults are often vulnerable to malnutrition. This action research was conducted to develop a nutrition education package for promoting healthy ageing and reducing risk of chronic diseases among older adults in a rural area of Malaysia. METHODS: This study was designed and conducted in three stages, including needs assessment, development of the package and analysis of acceptance among 33 older adults aged 60 years and over in rural communities, and 14 health staff members at rural health clinics. Subjects completed a questionnaire including sociodemographic factors and acceptance evaluation of the nutrition education package with respect to content, graphics and design. Data were analysed descriptively using numbers and percentages. RESULTS: A nutrition education package comprising a booklet, flipchart and placemats was developed. A total of 42.4% of the older adults expressed that the sentences in the flipchart needed to be simplified and medical terms explained. Terminology (60%), illustrations (20%) and nutrition recommendations (20%) were the aspects that prevented elderly subjects from fully understanding the booklet. Information on the placemats was easily understood by subjects. CONCLUSIONS: A well accepted nutrition education package for promoting healthy ageing and reducing risk of chronic diseases was developed that incorporated modifications based on feedback from older adult subjects and health clinic staff in a rural area. It is a tool that can effectively be used for health education in this population.

Absorption of calcium from milk and tempeh consumed by postmenopausal Malay women using the dual stable isotope technique.

Assessment of calcium bioavailability from non-dairy foods containing moderate amounts of calcium is especially important in populations that have habitually low dairy consumption. Absorption of calcium from milk and tempeh (a traditional fermented soy product) was compared in a sample of Malay subjects. A randomized, crossover design was utilized to assess calcium absorption in 20 postmenopausal women from either a glass of milk (114 g) or from a meal of tempeh (206 g); each containing 130 mg calcium. At each study of Phase 1 (mid-July) and Phase 2 (mid-August), intravenous (42)Ca and oral (44)Ca were administered and calcium absorption was measured in 24-h urine collections post-dosing; with a 1-month washout period between phases. Absorption of calcium from tempeh did not differ significantly from milk (36.9 +/- 10.6% vs. 34.3 +/- 8.6%, respectively). Due to differences in the calcium content of tempeh, four servings of this product would be needed to get the same amount of absorbed calcium as that obtained from a 4-ounce glass of milk. Tempeh may provide readily available calcium for this population of women at risk for low bone mass.

A multidimensional assessment of nutritional and health status of rural elderly Malays.

A multidimensional assessment of nutritional and health status comprised of subjective global assessment (SGA), anthropometry function, biochemistry, dietary intake, social and health aspects was carried out on 820 older people (52.8% men and 47.2% women) from four rural areas of Peninsular Malaysia. A proportion of the subjects had been classified as either overweight (25.7%) or chronic energy deficient (20.3%). Although 49% of subjects had normal body weight, 68.4% have been classified as having mild to moderate malnutrition according to the SGA. Only 1.1% and 2.3% had low serum albumin and ferritin, respectively. Almost 80% of subjects, especially men, were at high risk of cardiovascular diseases on the basis of the assessment of total cholesterol and LDL-cholesterol. The majority of the subjects (87.2%) were fully independent in performing daily tasks, with men having a significantly higher score compared to women (p<0.001). However, men were less likely to be able to perform a flexibility test (50.7%) than were women (27.0%) (p<0.05). The mean energy intake for men (1412 +/- 461 kcal/d) and women (1201 +/- 392 kcal/d) were below the Recommended Nutrient Intake (RNI) for Malaysia, although this is a difficult assertion to make in an age-group which generally experiences declining energy expenditure. Moreover, 52.5% of men and 47.5% of women might have underreported their food intake. Dietary micronutrients most likely to be deficient were thiamin, riboflavin and calcium. It is concluded that a substantial proportion of rural elderly Malays had problems related to both undernutrition and overnutrition. An appropriate nutrition intervention program is needed to improve the nutritional status of rural elderly Malays.