Barbara Bowman

Folate nutrition in the elderly.

The consensus of this panel is that average dietary intake of folate in the free-living elderly population is probably adequate in most. Certainly more good data are needed; in addition, safe and reasonable dietary goals for folate intake are required. However, patients who have diseases requiring hospitalization or conditions for which institutionalization are required are obviously at greater risk. In addition, there is some evidence that the elderly poor in the US may be at greater risk of deficiency. Similarly, the evidence for folate deficiency based on blood assay data would seem to focus on the lower socioeconomic (largely Black and Hispanic) populations in addition to the hospitalized and institutionalized elderly. An additional factor in the genesis of folate deficiency among the aged is the factor of alcohol use which probably represents the single most important risk factor in folate deficiency among the elderly as well as among the nonelderly population. Although certain drugs such as anticonvulsants and sulfasalazine, may interfere with folate absorption or utilization, the number of elderly patients who are taking these drugs is relatively small and therefore this factor is not considered to be a major contributor to the problem of folate deficiency in the elderly. The question of folate malabsorption in the elderly has been examined. It is our conclusion that disease in the elderly population including gastric surgery and intestinal malabsorption, etc can certainly interfere with folate absorption but these problems are not widespread among the elderly population. There is only limited evidence that the physiological process of aging influences the intestinal absorption of folate.(ABSTRACT TRUNCATED AT 250 WORDS)

Intestinal Physiology and Parasitic Diseases

This paper reviews the major steps in alimentation, digestion, and absorption, which must be intact as a basis for normal nutrition, and discusses evidence relating parasitic infection in humans to effects on intestinal physiology. Parasites, with their ability to induce systemic toxicity and fever, to release active and toxic substances into the intestinal lumen, to compete for certain nutrients, to cause both functional and structural changes in the intestinal mucosa, and to stimulate hypermotility, which lessens the time available for digestion and absorption, can influence the alimentary process a almost every one of its steps. However, parasitic infection is likely to exert its most important impact at the very first step of the alimentary process, by adversely affecting the intake of food through any of a variety of mechanisms.

Top sources of dietary sodium from birth to age 24 mo, United States, 2003–2010

BACKGROUND Sodium intake is high in US children. Data are limited on the dietary sources of sodium, especially from birth to age 24 mo. OBJECTIVE We identified top sources of dietary sodium in US children from birth to age 24 mo. DESIGN Data from the NHANES 2003-2010 were used to examine food sources of sodium (population proportions and mean intakes) in 778 participants aged 0-5.9 mo, 914 participants aged 6-11.9 mo, and 1219 participants aged 12-23.9 mo by sociodemographic characteristics. RESULTS Overall, mean dietary sodium intake was low in 0-5.9-mo-old children, and the top contributors were formula (71.7%), human milk (22.9%), and commercial baby foods (2.2%). In infants aged 6-11.9 mo, the top 5 contributors were formula (26.7%), commercial baby foods (8.8%), soups (6.1%), pasta mixed dishes (4.0%), and human milk (3.9%). In children aged 12-23.9 mo, the top contributors were milk (12.2%), soups (5.4%), cheese (5.2%), pasta mixed dishes (5.1%), and frankfurters and sausages (4.6%). Despite significant variation in top food categories across racial/ethnic groups, commercial baby foods were a top food contributor in children aged 6-11.9 mo, and frankfurters and sausages were a top food contributor in children aged 12-23.9 mo. The top 5 food categories that contributed to sodium intake also differed by sex. Most of the sodium consumed (83-90%) came from store foods (e.g., from the supermarket). In children aged 12-23.9 mo, 9% of sodium consumed came from restaurant foods, and 4% of sodium came from childcare center foods. CONCLUSIONS The vast majority of sodium consumed comes from foods other than infant formula or human milk after the age of 6 mo. Although the majority of sodium intake was from store foods, after age 12 mo, restaurant foods contribute significantly to intake. Reducing the sodium content in these settings would reduce sodium intake in the youngest consumers.