INTRODUCTION

1
 CHAPTER I

INTRODUCTION

Old age refers to age nearing or surpassing the life expectancy of human life cycle .Terms
and condition for old people include, old people senior citizen and elders (in many cultures
including the culture of aboriginal people).Old people often have limited regenerative ability
and are more susceptible to disease, syndrome and sickness than younger adult. The medical
study of aging process is called Gerontology and the study of diseases that afflict the
elderly.They face other social issues around retirement, loneliness and ageism (Srilakshmi,
2014).

Old people are more vulnerable to health and risks, especially female, rural and ethnic for
older people. Children and others, as well as continued work remain the core source of income
for older people .Poverty amongst older people (particularly over 70 years) is higher than
average in Vietnam, as in poverty amongst women, ethnic minorities and the rural
population(Worth,2000).

As people age, there is a decrease in skeletal tissue mass. The result is decrease in store of
protein, so protein intake of 1 gram per kilogram, the normal adult requirement is safe during old
age, so total calorie intake is 11 to 12 %. Intake of Vitamin D improves bone density and may
prevent fractures. The antioxidants to vitamins such as vitamin E, carotenoids, and vitamin C.
Vitamin A, B6, B12 and folate should be taken through diet, B12 and folate should be taken
through diet(Waxnan,2004).

Calcium needs during old age increase and osteoporosis is the common care for women
over 50, 800 mg/day is recommended. Sufficient fluid of 1.5 litres should be taken every day.
Water can also be consumed in the form of buttermilk, fruit juice, porridge and soups. Fibre rich
foods should be gradually increased in the diet to avoid bowel discomfort fibre of tender
vegetable, fruit should be taken (Pat thane,2000).

2
 About three fourth of adults aged 60 and other are overweight/obesity. Obesity is related
to type 2Diabetes. Cardio vascular disease, breast and colon cancer, gall bladder diseases and
high blood pressure. More than 40 % of adult 60 have metabolic syndrome( Johnson,2001).

Almost 44 million adults aged 50 and older suffer from low bone mass effect. One third
adult’s experience a fall and suffer injuries(T.Rosenthal,2000).

There is an increased risk of cancer during this age. Most types are cervical cancer,
endometrial cancer and prostate cancer. It affects more than one third of men and women in the
age of 45 to 54 group. It also includes coronary heart disease. Heart failure, hypo tension, stroke
and congeal heart disease (Mike,2003).

About 119 million people aged 40 and older are affected by this. Probably most of their
people keep their own teeth. Implants and bleaching can make the teeth to look younger. Only 25
% of people over age 60 wear dentures today(Harry,2005).

Beginning at age 51, requirements change once again and relate to the nutritional issues
and health challenges that older people face. After age 60, blood pressure rises and the immune
system may have more difficulty battling invaders and infections. The skin becomes more
wrinkled and the hair turns grey or white or fallen out, resulting in hair thinning. Older adults
may gradually lose an inch or two in height. Also, short term memory might not be as keen as it
was(Hume,2012)

Nutritional intervention should focus primarily on a healthy diet. It increases the

frequency of meals and adding healthy high-calorie foods (nuts, potato, whole grain, pasta and
avocados) to the diet. Liquid supplements between meals may help to improve calorie
intake(Lenker,2007).

Many older people suffer from vision problems and a loss of vision. Age-related
molecular degeneration is the leading cause of blindness in Americans over age 60. American
medical association, is the guide to prevention and wellness (Harwood,2007).

The study evaluated an exciting education and support programme specifically designed
for early stage Alzheimer’s disease (AD). No significant changes from baseline were observed
im AD knowledge, coping self-efface or phycology adjustment to illness(Kinsley,2016).

3
 Old age refers to ages nearing the life expectancy of human beings and thus the end of
human life cycle. Terms and conditions foe old people includes, old people often have limited
regenerative abilities. The chronological age denoted as “old age” varies culturally and
historically .An impaired glucose tolerance in the elderly can lead to hypoglycaemia. Whole
grain cereals and pulses should be included in the diet(Garden,2004).

Perception of old-age from a middle age perspective many books by middle age writers
depict the perception of old people. One writer notices the change in his parents: they move
slowly, they have lost their strength, repeat stories often, minds wander and they are frightened.
Another writer sees her aged parents and is bewildered: they refuse to know her advice, they are
obsessed with the past, they avoid risk, and they live at a “logical phase”. Other writers treat the
perception middle age people regarding their own old-age. In their denial aging (Wallis,2009).

Old age from perspective old age is a pleasant time: children are grown, retirement from
work, time to pursue internet. Many people are also willing to get involved in community and
activities organisations to promote their well-being. In contrast perspective of old age by writers
80+ years old tend to be negative(Anderson,2014).

Based on the above facts the present study was conducted with the following objectives.

 To assess the Socio economic status of the selected old age people.
 To assess the nutritional status of the selected old age people.

4
REVIEW OF LITERATURE
5
 CHAPTER II

REVIEW OF LITERATURE

The review of literature of the present study entitled"Assessment Of Nutritional Status

Of Institutionalised Elderly (60-75 years)of Coimbatore District ”is presented under
following headings:

2.1 Introduction to Old Age

2.2 Nutritional Requirements During Old Age

2.3 Nutritional Related Problems of Old Age

2.4 Nutritional Assessment

6
2.1 INTRODUCTION TO OLD AGE

Successful ageing is defined not by longevity alone but also by sufficient well being in
multiple domains – socially,physically and mentally.The three components for successful ageing
are avoiding disease, engagement with life and maintaining high physical and cognitive
function.Old age is best defined as the age retirement that is 60 year and above improvement in
health care technology has resulted in increase life expectancy (Srilakshmi,2014).

Ageing is a universal process that began with the origin of life. Accumulation of the
diverse deleterious changes produced by ageing throughout the cells and tissues progressively
impairs function and eventually cause death.Ageing changes can be attributed to
development,genetic defects,the environment,disease and an inbron process.According to the
United Nations, the number of people worldwide aged 60 years or older will increase from 1 in
10 currently to 1 in 5 by 2050(Sharma,et.al.,2011).

2.2 NUTRITIONAL REQUIREMENTS DURING OLD AGE

2.2.1 ENERGY

After the age of 35 the basal metabolic rate decreases due to reduce muscle mass and
other metabolically active tissue mass.Lean body mass declines approximately 2 to 3 percent less
than that in youth adults.The average body fat percentage in males increase from 15 percent
when young to 25 percent (Srilakshmi,2014).

The average body fat percentage in males increase from about 15 percent when young to
the age of 60 years.The Change in body fat is attributed to less intense physical activity and to
alteration in testosterone and growth hormone production that effects anabolism and lean tissue
growth.The calorie intake should be adjusted to maintain the body weight
constant(Patwardhanand Paramesh,2011).

2.2.2 CARBOHYDRATE

Impaired glucose tolerance lead to hypoglycemia ,hyperglycemia and type ll diabetes

mellitus.Insulin sensitivity can be enhanced by balanced energy intake ,weight management and

7
regular physical activity.Whole grains cereals and pulses sholud be maintained in diet.It is
necessary that at least 50 percent of calories are derived from carbohydrate (Srilakshmi,2014).

2.2.3 PROTEIN

As people age there is a decrease in skeletal tissue mass.The dietary protein intake is
more important to meet essential needs.A protein intake of 1.0 g per kg ,the noraml adult
requirement is safe during old age.To meet this protein rich foods like milk,curd can be
included.Due to decreased appetite and poor digestion,old people are likely to consume less
protein.Deficiency of protein leads to oedema,anaemia,lower resistance to infection.The total
caloric intake 11-12 percent should be from protein(Srilakshmi,2014).

2.2.4 LIPIDS

Elders who take sufficient omega -3 fatty acid have better visual acuity.It may help in
hair loss,impairment of vision,improper digestion and gas,poor kidney function,tissue
inflammation,osteo -arthritis,painful joints and muscle and mental depression(Mitra,2011).

2.2.5 MINERALS

Calcium needs during old age increase.Women over 50years of age who are not receiving
estrogen require more Calcium as there is increased losses resulting in demineralisation of bone
and osteoporosis.Women over fifty years,800mg is recommended for calcium is available only
from a limited number of foods,To compensate age -related bones loss and to improve calcium
balance,To decrease thr prevalence of fractures and dental decay.Milk is an important source of
calcium.Iron deficiency seen in elderly due to inadequate iron intake.Blood loss due to chronic
disease.Mild anaemia affects the health of old age people due to less efficient circulation of
blood.Iron intake should be adequate to prevent anaemia.Iron requirement of adult man is
30mg.If there is anaemia,supplemental iron can be given.consumption of liver once or twice a
week,green leaf vegetables,whole grains,dry fruits and iron fortified salt.some features of old age
such as delayed wound healing ,decrease taste sensitivity and anorexia are also findings
associated with zinc deficiency(Srilakshmi,2014).

8
  IRON

The transportation of oxygen in the entire body is done by iron. It also powers their
immune system to fight against foreign entities.Iron is essential mineral that has several
important roles in the body,including helping to make red blood cells which carry oxygen around
the body(Anderson,2014).

 CALCIUM

Calcium is an important mineral as it help to bulid strong bones and teeth,regultes muscle
contraction,including heartbeat and helps blood to clot normally.milk,cheese and yoghurt are all
good source of calcium,as well as green leaf vegetables,nuts and fish like sardines.Eating 3-4
portions of dairy products a day should provide all the calcium is needed(Avasth,2013).

2.2.6 VITAMINS

Elderly people are risk for vitamin D deficiency due to decreased exposure to sunlight or
decreases in renal mass.Supplementation of calcium and vitamin D improve bone density and
prevent fracture.vitamin C may be protective against cataract at an intake level 150-250mg per
day.changes in immune system can be overcome by taking 200mg of vitamin E.Alcoholism is a
risk factor for the folate deficiency,it results in anaemia,elevated serum homocysteine levels a
risk factor for cardio disease. Consumption of folate rich foods should be
encouraged(Srilakshmi,2014).

 FOLIC ACID

The RDA is 300mcg/day in those over 65 years. A deficiency in folate intake can lead to
the development of megaloblastic anaemia and macrocytosis. Dietary sources of folate include
vegetables, liver and kidney. Folate is destroyed by prolonged cooking, as well as poor food
choice, ie. 'tea and toast' diet. It is important to remember that serum levels of B12 decline with
age. Many cases of low serum B12 are associated with malabsorption due to gastric atrophy.
Excess supplementation of folic acid in the presence of vitamin B12 deficiency can mask the
neurological symptoms of B12 deficiency (Srilakshmi,2014).

9
  VITAMIN C

The RDA is 60mg/day. As well as helping to increase iron absorption, vitamin C aids in
wound healing (including pressure sores) and helps to fight infections. Up to 50% of vitamin C
can be lost in cooking and during storage of food. A glass of freshly squeezed orange juice which
contains 40-60mg/ 100ml of vitamin C taken daily will achieve the recommended intake.
Alternatively drinks which are rich in vitamin C such as grapefruit juice, fruit drinks with added
vitamin C or blackcurrant drinks with added vitamin C such as Ribena can be used. Older people
who are not taking these drinks rich in vitamin C, should eat either one orange, half a grapefruit,
two satsumas/mandarins or one kiwi fruit at least three to four times weekly to achieve the
recommended intake of vitamin C (Priya,2013).

 VITAMIN D
This is often referred to as the sunshine vitamin and the Irish RDA is 7.5g/day. Exposure
to sunlight is therefore important to promote vitamin D production in the skin; 15-20 minutes
spent out of doors daily during the spring and summer months safeguards against vitamin D
deficiency. As the home bound or inactive older person has reduced exposure to sunlight, dietary
intake of vitamin D is important. Margarines and milk can be fortified with vitamin D and should
be included in the diet of the elderly person.Liver, eggs and oily fish should also be included
regularly (once a week each)supplementation with vitamin D to compensate for lack of sunshine
may be required if a person is confined indoors for a prolonged period. As vitamin D is a fat
soluble vitamin excess intake can be toxic. A supplement containing 10mcg daily is adequate to
supplement the diet(Bharatraj and Rajaram,2011).

2.2.7 DIETARY FIBRE

It is important for an older person to maintain an adequate intake of dietary fibre,

especially the bulk forming cereal fibre. It is of importance in the prevention of constipation and
lack of dietary fibre may be a contributory factor to the development of large bowel cancer.Fibre
intake should be increased gradually as a sudden change from a low to high fibre diet can cause
diarrhoea, cramps, flatulence and/or constipation. To increase fibre intake in the diet 100%
10
wholemeal can be used instead of white bread. Using wholegrain or high fibre cereal daily can
also significantly increase the fibre intake. Examples of such cereals include All Bran,
Branflakes, Weetabix and Shredded Wheat. Porridge, which is popular with older people, does
not contain much cereal fibre (except when made from pinhead oatmeal), therefore a
dessertspoon of All Bran will ensure an adequate (Srilakshmi,2014).

2.2.8 WATER

It is essential for older people.kidney can function adequately when there is sufficient
fulid(1.5 l) to eliminate waste.Dehydration can result in mental confusion,headache and
instability.Elderly should be advised some fluid ar regular intervals even if there is noy
thirsty.Water can be consumed in the form of juices,porridge(Srilakshmi,2014).

2.3 NUTRITION RELATED PROBLEMS OF OLD AGE

The elderly are at risk of poor nutrition due to economic pressure, poor dentition, aging
tissues and inadequate diet, which may be compounded with the incidence of chronic
disease(Srilakshmi,2014).

Osteoporosis is characterized by decreasing bone mass and density. As a result the bones
become porous, light and fragile becoming more vulnerable to fractures. The incidence of
osteoporosis is more common in women after menopause.Oestrogen therapy in post menopausal
women has been shown to slow the rate of bone loss although it does not stimulate low bone
formation.vitamin D supplements in older individuals in stable health is associate with 20percent
reduction in risk of falls.prevention of osteoporosis can be achieved by adopting life cycle that
involves exercise and avoiding the avoidable risk factor.milk and sardines are good source of
vitamin D(Srilakshmi,2014).

Many of the elderly are Obese They fail to make adjustments in their energy intake
corresponding to decreased energy needs(Srilakshmi,2014).

Anaemia characterized by feeling of fatigue, anxiety, lack of energy is common. Iron

inadequacy is caused by low dietary intake, decreased absorption or lack of haem iron, vitamin C
or blood loss.Pernicious anaemia due to vitamin B12 deficiency is common among elderly
women. The diet for elderly should include foods rich in haem iron and vitamin B12.Iron

11
supplements together with a diet providing iron source of high bioavailability and vitamin C to
enhance absorption.In the diet they include animal foods like liver,egg,yolk(Potter,2011).

The causes ofmalnutrition during old age are economic constraints, physical inactive,
cumulative effect of chronic disease and medication, social isolation, lack of knowledge in
preparing meals adequate to meet their needs.The avere daily intake of majority nutrients such as
calcium,iron,vitaminA,thiamine,riboflavin,vitamin C(Srilakshmi,2014).

Aging disturbs the natural rythmic contraction of colon due to loss of

bone,stress,medications,lack of exercise, low fibre diet, insufficient fluid intake.These result in
constipation(Goyal andGupta,2012).

The incidence of Non Insulin Dependent Diabetes Mellitus (NIDDM) is increased due to
impaired glucose tolerance and decreased sensitivity of cells to insulin( Srilakshmi,2014).

The incidence of hypertension and other cardiovascular diseases like atherosclerosis,

acute myocardial infarction, angina pectoris, and congestive heart failure is high due to changes
in cardio vascular function. These may impose dietary restrictions, change in texture of diet and
use of diuretics and hypotensives. These inturn may affect the dietary intake and health of the
individual(Srilakshmi,2014).

Neurological dysfunction is observed among elderly.The problems of disorientation and

a slowing a neurological funtioning,both seen in elderly.Deficiency of vitamin B6 and thiamine
associated with central nervous system problem(Potter,2011).

Deficiency number of nutrients have been linked to decreased immune function notably
vitaminA,vitaminC,zinc,vitaminB6,iron,copper,selenium.Low intake of selenium,omega_3 fatty
acid and higher than recommended intake of vitamin A may influence overall immune function
in elderly person(Barua et.al.,2011).

2.4 NUTRITIONAL ASSESSMENT

Nutritional assesment is the interpretation of anthropometric, biochemical

(laboratory),clinical and dietary data to assesment whether a person or grops of people are well
nourished or malnourished(over nourished or under-nourished)(Greyand Aubrey,2014).

12
2.4.1ANTHROPOMETRIC MEASUREMENTS

Anthropometric measurements are used to assess the size,shape and composition of the
human body.The anthropometric measurements include

a. Weight
b. Height
c. Body Mass Index(BMI)
d. Ideal Body Mass (IBW)
 WEIGHT

Weight should be measured in all participants, except pregnant women, wheelchair bound
individuals, or persons who have difficulty standing steady.Weight is a basic anthropometric
measurement that is easily measured with a weighing balance.Individuals removed shoes and
heavy cloths prior to weighing(Gillapsy,2015).

 HEIGHT

Human height varies greatly between individuals and across populations for a variety of
complex biological, genetic, and environmental factors, among others.Height can be determined
with a simple measuring stick(Gillapsy,2015).

 BODY MASS INDEX(BMI)

The body mass index(BMI) or quetelet index is a value derivef from the mass(weight)
and height of an individual .The BMI is defined as the body mass divided by the square of the
body heigh,and is universally expressed in ujits kg/m 2 resisting from mass in kilograms and
height in metres (Dighe et.al.,2013).

BMI= weight in kg/height in m2

13
  IDEAL BODY WEIGHT(IBW)
A weight that is believed to be maximally healthful for a person,based chiefly on
height but modified by factors such as gender,age,build and degree of muscular
development (Messi et.al.,2013).

IBW = height in (cm) _ 100

2.4.2 CLINICAL ASSESSMENT

Clinical examination assess levels of health of individuals or population groups in

relation to the food they consume.It is simplest and practical method.When two or more clinical
signs characteristic of a deficiency disease are present simultaneously,their diagnostic
significance is greatly enhanced(Srilakshmi,2014).

2.4.3 DIETARY ASSESSMENT

A dietary assessment is a comprehensive evaluation of a person's food intake.It is one of

four parts of a nutrition.assessment done in a clincal setting(Richard and Craig,2013).

 FOOD FREQUENCY QUESTIONNAIRE(FFQ)

It is a limited checklist of foods and beverages with a fequency response section for
subjects to report how often each item was consumed over a specified period of time.Semi-
quantitative FFQ's collect portion size information as standardized portions or as a choice of
portion sizes(Delbono and Wang,2013).

 24-HOUR RECALL

The 24-hour diet recall interview is a quantitative research method used in nutritional
assessment, which asks individuals to recall foods and beverages they consumed in the twenty
four hours prior to the interview .It may be self administration or administrated by a trained
professional(Willet,2014).

14
 METHODOLOGY
15
 CHAPTER III

METHODOLOGY

The methodology study of the present study entitled “Assessment of Nutritional Status
ofInstitutionalised Elderly’’(60 -75 years) of Coimbatore District” is present under following
headindgs:

3.1 Selection of Topic

3.2 Selection of Area

3.3 Selection of Subjects

3.4 Conduct of Survey

3.4.1 Socio economic Background

3.4.2 Nutritional Assessment

 Anthropometric Assessment

 Clinical Assessment

 Dietary Assessment

3.5 Statistical Analysis

The methodology of the present study is given in form of flow chart in Figure 1

16
 Selection of Topic

Selection of Area

Selection of Subjects

Selection of Tool

Conduct of Survey

Socio economic Back ground

Clinical assessment

Nutritional status analysis Anthropometric measurement

Anthropometric assessment

Dietary assessment

Statistical Analysis

Figure 1

METHODOLOGY

17
3.1 SELETION OF TOPIC. :

Old age is best defined as age of retirement chat is 60 years and above. Ageing is not a
disease but a biological process. It is a normal process begins at conception and ends only with
the death Old age refers to ages nearing or surpassing the life Expectancy of human beings and is
thus the end of the human life cycle (Kinsley.2016).

Old age people often have limited regenerative abilities and more susceptible to disease.
The distinguishing mark of old age normally occurs in all five senses at different times and
different rates persons (Gardan,2004).

The present study was undertaken to study nutritional status of old age people .

3.2 SELETION OF AREA. :

The area chosen conduct of study was St.Thomas home Coimbatore. Based on the easy
accessibility and the co-operation of the authorities of the old age home the area was chosen to
conduct the study.

3.3 SELECTION OF SUBJECTS :

The subjects (N=50) were selected by simple random sampling .In this method of
sampling the samples are selected randomly from the chosen population.

3.4 SELECTION OF TOOL :

An interview schedule was prepare to collect data information .The tool was used to
collect the socio economic and nutritional status of the selected subject.

3.5 CONDUCT OF SUREVY:

The interview schedule was prepared based on socio economic details and nutritional
assessment .An interview schedule consist of number of questioned printed or typed in a definite
order form or asset of forms it is used for acute communication and for ascertaining accurate
response (Wallis,2009 ).

18
 The interview schedule used in the present study is given in Appendix I

Plate I shows the conduct of Survey

PLATE I

CONDUCT OF SURVEY

3.5.1.SOCIO ECONOMIC BACK GROUND :

The questions concern socio economic status of the house hold include details
on,religion the members of family and education of the parents. In addition information about
the types of family and types of the food choice, income,expenditure are also collected(Timiras
2009).

3.5.2 NUTRITIONAL STATUS:

 Anthropometry

Anthropometric is simple,non- invasive,quick and reliable form of obtaining information

about a person's Nutritional status.

19
a) Height:

Height is frequently used along with weight to determine body mass index and nutritional
status in epidemiologic research on older adults (Gillapsy,2015).

The height of an old age people was measured by using a stadiometer.human height
varies greatly according to the individual and population.Height should be measured in an
upright position for the elderly who are agile.

PLATE II shows measurement of height

PLATE II

MEASUREMENT OF HEIGHT

20
b)Weight:

Body weight is the most widely used simplest reproducible Anthropometric

measurement.

The weight of the selected person were recorded by using weighing machine without
foot wear and with light clothing. During weighing the person were asked to stand straight
without holding any things (Silverman,2010).

PLATE III shows measurement of weight

PLATE III

MESUREMENT OF WEIGHT

21
c) Body mass index(BMI)

Body mass index has been used widely to estimate total body fatness.It is an
inexpensive and easy method. BMI can be estimated by using the formula (Kesselving,2007).

BMI= Weight in (kg)/Height in (M²)

d) Ideal body weight (IBW)

Ideal body weight is a weight that is believed to be maximally healthful for a person,
based chiefly on height but modified by factors such as gender, age, build, and degree of
muscular development (Sorton,2004).

IBW = Height (cm)-100

 CLINICAL ASSESSMENT

Clinical assessment is an important feature of all nutrition survey.It is the simplest

method for determining Nutritional status of a group of individual.It is a parameter used to detect
the Nutritional deficiencies.Here the hair,skin,face,eyes,lips,tongue and neurological changes
were checked by the investigator to find whether there is any deficiency or not (Richard,2013).

 DIETARY ASSESSMENT:

Diet is a major life style-related risk factor of a wide range of chronic diseases. Change in
dietary habits have been found to reduce cancer incidence by one third. Dietary information has
been useful in cardio vascular disease risk prediction and consuming a nutrient-dense diet was
associated with a low risk of all cause mortality contrary to other life style risk factors
(eg:smoking) in accurate dietary assessment may be a serious obstacle of understanding the
impact of dietary factors on disease(Richard,2013).

Subjective dietary assessment methods that assess an individual's intake include the 24
hour recall (24HR), Dietary record(DR),Dietary history,and FFQ (Aderson,2007).

In the present study FFQ and 24 hour recall was used to assess the nutritional status.

22
3.5 STATISTICAL ANALYSIS:

The data collected were consolidated,tabulated and analysed using mean.

23
RESULT AND DISCUSSION

24
 CHAPTER IV

RESULT AND DISCUSSION

The result and discussion of the present study “Assessment of Nutritional status
ofInstitutionalised Elderly (60-75years) of Coimbatore District” is discussed under following
headings:

4.1. SOCIO-ECONOMIC DETAILS

4.1.1. Age Wise Distribution of the Selected Subjects.

4.1.2. Gender Wise Distribution of the Selected Subjects

4.1.3. Religion Wise Distribution of the Selected Subjects.

4.2. ANTHROPOMETRIC MEASUREMENTS

4.2.1. Details Regarding Height of the Selected Subjects.

4.2.2. Details Regarding Weight of the Selected Subjects.

4.2.3. Details Regarding Body Mass Index (BMI) of the Selected Subjects.

4.2.4. Details Regarding Ideal Body Weight of the Selected Subjects.

4.3. CLINICAL EXAMINATION

4.4. DIETARY ASSESSMENT

4.4.1. Details Regarding Food Habits of the Selected Subjects.

4.4.2. Details Regarding Food Consumption Pattern of the Selected Subjects.

4.4.3. Details Regarding Nutrient Intake of the Selected Subjects.

25
4.1 SOCIO-ECONOMIC DETAILS

Socio economi1c details is about nutritional status. The questions concerning socio
economic status of the house hold, religion, members of the family and level of the income also
influences food availability and the diet. (Richard,2013).

Thus the subject’s socio economic details including age and religion were assessed.

4.1.1 AGE-WISE DISTRIBUTION OF THE SELECTED SUBJECTS

The details regarding age wise distribution of selected subjects is given in Table I and
Figure 2.

Table I

AGE-WISE DISTRIBUTION OF THE SELECTED SUBJECTS

N=50

S.NO AGE(Years) NUMBER PERCENTAGE (%)

1 60-65 18 36
2 66-70 21 42
3 71-75 11 22

26
 22.00%

36.00%
60-65 years
66-70 years
71-75 years

42.00%

Figure- 2

Age Wise Distribution of Selected Subjects

Table I and Figure 2 shows that 42 percent belong to the age group between 66-70
years,36 percent belongs to the age group between 60-65 years and 22 percent belong to the age
group between 71-75 years of age.

4.1.2.GENDER WISE DISTRIBUTION OF THE SELECTED SUBJECTS

The details regarding gender wise distribution of the selected subjects is given in Table II
Figure 3.

S.NO GENDER NO OF PERCENTAGE(%)

SAMPLES
1 Female 50 100
2 Male - -

27
 Fema l e
Mal e

100.00%

Figure 3

Gender Wise Distribution of the Selected Subjects

The above Table II and Figure 3, 100 percent of the selected subjects are females.

4.1.3. RELIGION WISE DISTRIBUTION OF SELECTED SUBJECTS.

The details regarding religion wise distribution of selected subjects is given in Table III
and Figure 4.

Table III

RELIGION WISE DETAILS OF THE SELECTED SUBJECTS

N=50

S.NO RELIGION NUMBER PERCENTAGE (%)

1 HINDU 31 62
2 CHRISTIAN 19 38
3 MUSLIM - -

28
 38.00%
Hi ndu
Chri stia n
62.00%

Figure 4

Religion wise Details of the selected subjects

The above Table III and Figure 4 conclude that the 62 percent of the people belong to
Hindu community and 38 percent of the people belongs to Christian community.

4.2 ANTHROPOMETRIC MEASUREMENT

29
 Anthropometric measurement is body measurement and provide information about body
muscle mass and fat reserves. Human body reflects changes in morphological variation due to
inappropriate food intake or malnutrition. Information on this aspect is therefore important and
has practical application. A variety of anthropometric measurement can be made either covering
the whole body or parts of the body .Anthropometric measurement can be taken cross sectional
or longitudinal studies (Srilakshmi 2010).

4.2.1 DETAILS REGARDING HEIGHT OF THE SELECTED SUBJECTS

The details regarding height of the selected subjects is given in Table IV and Figure 5.

Table IV

HEIGHT OF THE SELECTED SUBJECTS

N=50

S.NO HEIGHT (cms) NUMBER PERCENTAGE (%)

1 130-140 11 22
2 141-150 24 48
3 151-160 15 30

22.00%
30.00%

130-140cm
141-150cm
151-160cm

48.00%

30
 Figure 5

Height of the Selected Subjects

Above Table IV and Figure 5 shows that the 48 percent of the selected subjects were
between 141-150cm of height 30 percent of the selected subjects were between 151-160cm of
height and 22 percent of the selected subjects were between 130-140cm of height.

4.2.2 DETAILS REGARDING WEIGHT OF THE SELECTED SUBJECTS

The details regarding weight of the selected subjects is given in Table IV and Figure 6.

Table V

WEIGHT OF THE SELECTED SUBJECTS

N=50

S.NO WEIGHT (kg) NUMBER PERCENTAGE (%)

1 40-50 15 30
2 51-60 20 40
3 61-70 15 30

31
 30.00% 30.00%

40-50
51-60
61-70

40.00%

Figure 6

Weight of the Selected Subjects

Above Table V and Figure 6 shows that 40 percent of subjects weigh 51-60 kg, 30
percent of subjects weigh 61-70kg and 30 percent of subjects weigh 40-50kg.

4.2.3 DETAILS REGARDING BODY MASS INDEX OF THE SELECTED SUBJECTS

32
 The details regarding body mass index of the selected subjects is given in Table
VIandFigure 7.

Table VI

BODY MASS INDEX OF THE SELECTED SUBJECTS

N=50

S.NO BMI NUMBER PERCENTAGE (%)

1 Underweight( <18.5) - -
2 Normal (18.5-25) 30 60
3 Obese (>26) 20 40

40.00%
Normal
Obes e
60.00%

Figure 7

Body Mass Index of the Selected Subjects

33
 Above Table VI and Figure 7 shows that 60 percent of subjects have normal BMI and 40
percent of subjects were obese.

4.2.4 DETAILS REGARDING IDEAL BODY WEIGHT OF THE SELECTED SUBJECTS

The details regarding ideal body weight of the selected subjects is given in Table VII and
Figure 8.

Table VII

IDEAL BODY WEIGHT OF THE SELECTED SUBJECTS

N=50

S.NO IBW NUMBER PERCENTAGE (%)

1 Less than IBW 11 22

2 IBW 36 72
3 More than IBW 3 6

34
 6.00%
22.00%

Less tha n IBW

IBW
More than IBW

72.00%

Figure 8

Ideal Body Weight of the Selected Subjects

Above Table VII and Figure 8 shows 72 percent of subjects have normal IBW,22 percent
of subjects have less than IBW and 6 percent of subjects have more than IBW.

35
4.3 CLINICAL EXAMINATION

Clinical examination is an essential feature of nutritional survey it is also the simplest and
most practical method of ascertaining the nutritional of a group of individuals
( Silverman,2012).

Clinical examination involves detecting the physical changes. Here, the hair, nail, skin,
eye, mouth, neck were checked by the investigator to find whether there is any deficiency in old
age people.

The details regarding clinical examination of the selected subjects is given in Table VIII.

Table VIII

CLINICAL EXAMINTION OF SELECTED SUBJECTS

N=50

S.NO ORGAN SYMPTOMS PRESEN PERCEN ABSENT PERCEN

T T T
1 HAIR Easily 3 15 17 85
pluckability
Dry 11 55 9 40
Brittle 7 35 13 65
2 NAIL Transverse 3 15 17 85
lines
Spooning 9 45 11 55
Dry 16 80 4 20
3 SKIN Pale colour 17 85 3 15
Pigmentation 8 40 12 60
4 Eyes Night 2 10 18 90
blindness
Xerosis 11 55 9 45
Conjunctival 3 15 17 85
inflammation
5 MOUTH Glossitis - - 20 100
Bleeding 2 10 18 90

36
 gums
Angular 6 30 14 70
stomatitis
Cracking of 12 60 8 40
the corner of
the mouth
Loss of the 18 90% 2 10%
tooth enamel
6 NECK Goitre 2 10% 18 90%
Parotid 4 20% 16 80%
enlargement

Above Table shows the details regarding clinical examination of the selected subjects.

In the case of hair, 15 percent of the people had easy pluckable hair. Dry and
brittle hair was present in 55 percent and 35 percent respectively.

In case of the nails, 15 percent of the subjects had transverse lines, 45 percent of
the subjects has spooning of nails. About 80 percent subjects had dry nails.

In skin, pale colour was observed among 85 percent and pigmentation 40 percent
was observed in selected subjects. Night blindness was observed among 10 percent of subjects,
Xerosis was present among 55 percent of subjects and 15 percent of subjects had conjunctival
inflammation in eyes.

In mouth, bleeding gums was present in 10 percent .Angular stomatitis and

cracking of the corner of the mouth was found among 30 percent and 60 percent of subject
respectively. About 90 percent of the subjects had loss of tooth enamel.

In the case of neck, 10 percent of subjects had goiter and parotid enlargement
found with 20 percent of subjects.

4.4 DIETARY ASSSESSMENT

37
 A diet survey provides information about dietary pattern of specific food consumed and
estimated nutrient intakes.It indicate relative dietary inadequate, which is helpful in planning
health education activities and changes needed in the agriculture and food production industries
(Richard, 2013).

4.4.1 DETAILS REGARDING FOOD HABITS OF SELECTED SUBJECTS

The details regarding food habits of selected subjects is given in Table IX and Figure 9.

Table IX

FOOD HABITS OF SELECTED SUBJECTS

N=50

S.NO FOOD HABITS NO.OF SAMPLES PERCENTAGE (%)

1 Vegetarian 16 32
2 Non-vegetarian 34 68

38
 32.00%

Vegeta ri an
Non-Vegeta ri a n

68.00%

Figure 9

Food Habits of the Selected Samples

Above Table IX and Figure9 shows that around 50 samples, 68 percent were non-vegetarian and
32 percent were vegetarians.

39
4.4.2 DETAILS REGARDING FOOD CONSUMPTION PATTERN OF THE SELECTED
SUBJECTS

The details regarding food consuming pattern of the selected subjects is given in Table X.

Table X

FOOD CONSUMPTION PATTERN OF THE SELECTED SUBJECTS

N=20

S.NO FOOD DAILY WEEKLY MONTHLY OCCASSIONALLY

GROU NO.OF % NO.OF % NO.OF % NO.OF %
P SAMPLE SAMPLE SAMPLE SAMPLE
S S S S
1 Cereals 20 100 - - - - - -
2 Pulses 20 100 - - - - - -
3 Millets 4 20 10 50 6 30 - -
4 Roots 9 45 11 55 - - - -
and
tubers
5 Green 4 20 16 80 - - - -
leafy
vegetabl
e
6 Other 12 60 8 40 - - - -
vegetabl
e
7 Milk 16 80 4 20 - - - -
and
Milk
product
8 Meat - - 10 50 6 30 4 20
9 Chicken 2 10 11 55 5 25 2 10
10 Fish 14 70 16 30 - - - -
11 Egg 6 30 14 70 - - - -
12 Sugar 15 75 5 25 - - - -

40
13 Sweets 16 80 4 20 - - - -
14 Junk - - - - 4 20 16 80
foods

The above Table X indicate that all the selected subjects consume cereals and pulses
daily. Majority 50 percent of the selected subjects consumed millets on weekly basis. About 55
percent of selected subjects consumed roots and tubers on weekly basis.Most (80 percent) of the
selected subjects consumed green leafy vegetables on weekly basis.And about 60 percent of the
selected subjects consumed other vegetables on daily basis.Majority (80 percent) of the selected
samples consumed milk and milk products on daily basis. About 50 percent of the selected
subjects consumed meat on weekly basis.Most (55 percent) of the selected subjects consumed
chicken on weekly basis.About 30 percent of the selected subjects consumed fish on weekly
basis.Majority 70 percent of the selected subjects consumed egg on weekly basis.Most (75
percent) of the selected subjects consumed sugar on daily basis. Majority (80 percent) of the
selected subjects consumed sweets on daily basis.About 80 percent of the selected subjects
consumed junk foods on occasionally.

4.4.3 DETAILS REGARDING NUTRIENT INTAKE OF THE SELECTED SUBJECTS

The details regarding nutrient intake of the selected subjects is given in Table XI and
Figure 10.

Table XI

NUTRIENT INTAKE OF THE SELECTED SUBJECTS

N=20

S.NO NUTRIENT RDA* MEAN VALUE PERCENTAGE

EXCESS/
DEFICIT
1 Energy 1900 1454.5 -23.4
2 Protein 55 52.7 -4

41
3 Visible Fat 20 36.14 +80.7
5 Calcium 600 440.7 -26.5
6 Fibre 30 7.235 -75.8

*Source:ICMR,RDA-2010

-75.8 Fi bre

-26.5Cal ci um

Vi s i bl e Fat 80.7

Protei n-4

-23.4Energy

-100 -80 -60 -40 -20 0 20 40 60 80 100

Exces s /Defici t

Figure 10

Nutrient Intake of the Selected Subjects

From the above Table XI and Figure 10 it is observed that there is a deficit intake of
Energy

(-23.4), Protein (-4), Calcium(-26.5), Fibre (-75.8) and excess intake of Visible Fat (80.7).

42
43
 SUMMARY AND CONCLUSION

CHAPTER V

SUMMARY AND CONCLUSION

Old age refers to ages nearing or surpassing the life expectancy of human being and is
thus the end of the human life cycle. Terms and euphemisms for old people include, old people
often have limited regenerative abilities and are more susceptible to disease, syndromes and
sickness than younger adults. The organic process of ageing is called senescence, the medical
study of the aging process is called gerontology, and the study of diseases that afflict the elderly
is called geriatrics. The elderly also face other social issues around retirement, loneliness and
ageism, the chronological age denoted as “old age” varies culturally and historically.

In this project a study on “Nutritional Assessment of Institutionalised Elderly (60-75

years) of Coimbatore District” was carried out. About 50 samples were selected by random
sampling method. An Interview schedule was used to elicit information pertaining to socio
economic status and nutritional status of the selected subjectsThe results of the present study is
summarized as follows:

 The age group showed that, 42 percent belongs to the age group between 66-70
years,36 percent belongs to the age group between 60-65 years and 22 percent
belong to the age group between 71-75 years of age.
 The gender wise distribution showed that,100 percent of the selected subjects are
females.

44
 The religion wise details showed that, 62 percent of the people belong to Hindu
community and 38 percent of the people belongs to Christian community
 The height of the selected subjects showed that , 48 percent of the selected
subjects were between 141-150cm of height 30 percent of the selected subjects
were between 151-160cm of height and 22 percent of the selected subjects were
between 130-140cm of height
 The weight of the selected subject showed that, 40 percent of subjects weigh 51-
60 kg, 30 percent of subjects weigh 61-70kg and 30 percent of subjects weigh 40-
50kg.
 The BMI of the selected subjects showed that ,60 percent of subjects have normal
BMI and 40 percent of subjects were obese.
 The IBW of the selected subjects showed that, 72 percent of subjects have normal
IBW,22 percent of subjects have less than IBW and 6 percent of subjects have
more than IBW.

 Clinical examination showed that, in the case of hair, 15 percent of the people had
easy pluckable hair. Dry and brittle hair was present in 55 percent and 35 percent
respectively. In case of the nails, 15 percent of the subjects had transverse lines,
45 percent of the subjects has spooning of nails. About 80 percent subjects had
dry nails. In skin, pale colour was observed among 85 percent and pigmentation
40 percent was observed in selected subjects. Night blindness was observed
among 10 percent of subjects, Xerosis was present among 55 percent of subjects
and 15 percent of subjects had conjunctival inflammation in eyes.In mouth,
bleeding gums was present in 10 percent .Angular stomatitis and cracking of the
corner of the mouth was found among 30 percent and 60 percent of subject
respectively. About 90 percent of the subjects had loss of tooth. In the case of
neck, 10 percent of subjects had goiter and parotid enlargement found with 20
percent of subjects.
 In the case of dietary pattern of selected subject, 68 percent were vegetarian and
32 percent were non-vegetarians.
 All the selected subjects consumed cereals and pulses daily. Majority (50 percent)
of the selected subjects consumed millets on weekly basis. About 55 percent of
selected subjects consumed roots and tubers on weekly basis. Most (80 percent)
of the selected subjects consumed green leafy vegetables on weekly basis. And

45
 about 60 percent of the selected subjects consumed other vegetables on daily
basis. Majority (80 percent) of the selected samples consumed milk and milk
products on daily basis. About 50 percent of the selected subjects consumed meat
on weekly basis. Most (55 percent) of the selected subjects consumed chicken on
weekly basis. About 30 percent of the selected subjects consumed fish on weekly
basis. Majority 70 percent of the selected subjects consumed egg on weekly basis.
Most (75 percent) of the selected subjects consumed sugar on daily basis.
Majority (80 percent) of the selected subjects consumed sweets on daily basis.
About 80 percent of the selected subjects consumed junk foods on occasionally.
 Nutrient intake of the selected subjects showed that there is a deficit intake of
Energy(-23.4), Protein (-4), Calcium(-26.5), Fibre (-75.8) and excess intake of
Visible Fat (80.7).

CONCLUSION

From the result of the survey it can be concluded that majority of the selected subjects
were within normal BMI. Nutrient intake showed that except for fat, all the other nutrients were
consumed in deficit amounts.

46