Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 7, 2019; 25(45): 6681-6692
Published online Dec 7, 2019. doi: 10.3748/wjg.v25.i45.6681
Gastrointestinal discomforts and dietary intake in Chinese urban elders: A cross-sectional study in eight cities of China
Ai Zhao, Mei-Chen Wang, Ignatius Man-Yau Szeto, Li-Ping Meng, Yan Wang, Ting Li, Yu-Mei Zhang
Ai Zhao, Mei-Chen Wang, Yu-Mei Zhang, School of Public Health, Peking University, Beijing 100191, China
Ignatius Man-Yau Szeto, Li-Ping Meng, Yan Wang, Ting Li, Yili Innovation Center, Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot 010110, Inner Mongolia Autonomous Region, China
Ignatius Man-Yau Szeto, Li-Ping Meng, Yan Wang, Ting Li, Inner Mongolia Dairy Technology Research Institute Co., Ltd., Hohhot 010110, Inner Mongolia Autonomous Region, China
Author contributions: Szeto IMY and Zhang YM contributed to study conception and design; Zhao A contributed to data acquisition, data analysis and interpretation, and writing of the article; Wang MC, Meng LP, Wang Y, and Li T contributed to editing, reviewing, and final approval of the article.
Supported by the Inner Mongolia Yili Industrial Group Co. Ltd. (Inner Mongolia Dairy Technology Research Institute Co. Ltd.).
Institutional review board statement: This study was approved by the Medical Ethics Research Board of Peking University.
Informed consent statement: Written consent was obtained from the participants before the study began.
Conflict-of-interest statement: There is no conflict of interest.
Data sharing statement: Data is available from the corresponding author at zhangyumei@bjmu.edu.cn.
STROBE statement: The guidelines of the STROBE Statement have been adopted in preparing the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yu-Mei Zhang, PhD, Professor, School of Public Health, Peking University, 38 Xueyuan Road, Beijing 100191, China. zhangyumei@bjmu.edu.cn
Telephone: +86-10-8280157563 Fax: +86-10-82801518
Received: June 6, 2019
Peer-review started: June 10, 2019
First decision: July 21, 2019
Revised: October 24, 2019
Accepted: November 13, 2019
Article in press: November 13, 2019
Published online: December 7, 2019
Research background

China’s aging population is the largest in the world. Gastrointestinal (GI) discomforts are common in the elderly population. GI discomforts may affect the dietary behaviors and contribute to the malnutrition in elders. Likewise, the inappropriate dietary behaviors may cause GI discomforts.

Research motivation

This study was motived by the unknown status of GI discomforts in Chinese elders and its associations with elders’ nutrition. Understanding the effects of GI discomforts on elders’ dietary intake is vital to developing dietary solutions that prevent malnutrition.

Research objectives

The objectives of this study were to assess the prevalence of GI discomforts in Chinese elders and to explore the potential associations between GI discomforts and dietary intake. Based on the potential associations found in this study, future longitudinal studies should further clarify the causality and develop the appropriate dietary recommendation to Chinese elders.

Research methods

With a cross-sectional design, a multi-stages sampling strategy was used in this study to recruit 688 eligible elders from eight cities of China. The gastrointestinal symptom rating scale was used to identify GI discomforts. Dietary pattern, food intake frequencies, average intake amount of 14 food groups, and nutrient intake were evaluated based on the semi-quantitative food intake frequency questionnaire and one time of 24-h dietary recall.

Research results

This study revealed an extremely high incidence of GI discomforts (83%) in elders and dyspepsia was the most commonly reported. The socio-demographic factors were found associated with a higher rate of GI discomforts, including female gender, lower education level, and lower family income. Also, being diagnosed with GI-related disease and chronic disease were related with GI discomforts. We first reported the associations of GI discomforts with dietary patterns and food and nutrient intake in Chinese elders. A significantly lower intake of bean products and a marginally lower dairy product intake were found in elders with GI discomforts. It indicated that the food choice was more or less affected by the GI discomforts. However, the causality could not be determined.

Research conclusions

GI discomforts are common in Chinese urban elders. Female gender, lower education level, and lower family income are associated more sever GI discomforts. Having a chronic disease and having a GI-related disease are associated with GI discomforts. GI discomforts contribute to the choice of food. Participants with GI discomforts have a significantly lower bean intake and marginally lower dairy product intake, which bring potential risk of insufficient protein intake and consequently lead to the reducing of muscle. The results of this study will be helpful for providing a comprehensive dietary strategy for Chinese elders with GI discomforts to ensure healthy aging.

Research perspectives

National-wide studies, including subjects from both rural and urban areas, should be conducted to determine the GI health status in Chinese elders. Longitudinal studies are needed to clarify the causality between dietary intake and GI discomfort.