Inadequate food intake in elderly: drug-nutrient interaction

Keywords: malnutrition, aging, polypharmacy, deficiency diseases

Abstract

Aims: to evaluate the inadequacy of food consumption and the estimated nutrient depletion caused by the use of drugs in the elderly.

Methods: a cross-sectional population study, attended by 427 elderly. Food consumption was obtained from the 24-hour Food Recall Survey and the Research Dietetic History. The use of drugs was assessed by a pharmacotherapeutic questionnaire.

Results: 85.8% of elderly use medications, the most prevalent inhibitors angiotensin converting enzyme inhibitor (29.2%), acetylsalicylic acid (28.7%), hydrochlorothiazide (24.4%), hydroxymethyl-glutaryl coenzyme A reductase enzyme inhibitor (17.0%), calcium carbonate (12.6%) and proton pump inhibitors (8.2%). Acetylsalicylic acid, hydrochlorothiazide and proton pump inhibitors are the drugs that possibly deplete the greatest number of nutrients. Users of hydroxymethyl-glutaryl coenzyme A reductase enzyme inhibitor, 97% could had inadequate for vitamin E; of potassium-sparing diuretics, 90.0% of inadequacy for magnesium; digoxin, 83.3% of inadequate for magnesium and 58.3% for calcium and potassium.

Conclusions: the drugs most commonly used by elderly are responsible for the depletion of numerous micronutrients, often associated with a high prevalence of inadequate consumption, which may cause possible nutritional deficiencies.

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Author Biographies

Carina Duarte Venturini, Hospital de Aeronáutica de Canoas (HACO), Canoas, RS.
Nutricionista. Doutora em Gerontologia Biomédica. Hospital de Aeronáutica de Canoas.
Paula Engroff, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS.
Farmacêutica. Doutora em Gerontologia Biomédica. Pontifícia Universidade Católica Do Rio Grande do Sul.
Vanessa Sgnaolin, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS.
Farmacêutica. Doutora em Gerontologia Biomédica. Pontifícia Universidade Católica Do Rio Grande do Sul.
Raquel Milani El Kik, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS.
Nutricionista. Doutora em Gerontologia Biomédica. Pontifícia Universidade Católica do Rio Grande do Su
Fernanda Bueno Morrone, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS.
Farmacêutica. Doutorado em Ciências Biológicas Bioquímica. Pontifícia Universidade Católica do Rio Grande do Sul.
Irenio Gomes, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS.
Médico. Doutor em Gerontologia Biomédica. Pontifícia Universidade Católica do Rio Grande do Sul.

References

Jyrkkä J, Mursu J, Enlund H, et al. Polypharmacy and nutritional status in elderly people. Curr Opin Clin Nutr Metab Care. 2012;15(1):1-6. https://doi.org/10.1097/mco.0b013e32834d155a

Jyrkkä J, Enlund H, Lavikainen P, et al. Association of polypharmacy with nutritional status, functional ability and cognitive capacity over a three-year period in an elderly population. Pharmacoepidemiol Drug Saf. 2011;20(5):514-22. https://doi.org/10.1002/pds.2116

Morley, John E. Decreased food intake with aging. J Gerontol A Biol Sci Med Sci. 2001;56(2):81-8.

Bales CW, Buhr G. Is obesity bad for older persons? A systematic review of the pros and cons of weight reduction in later life. J Am Med Dir Assoc. 2008;9(5):302-12. https://doi.org/10.1016/j.jamda.2008.01.006

Cansado P, Ravasco P, Camilo M. A longitudinal study of hospital undernutrition in the elderly: comparison of four validated methods. J Nutr Health Aging. 2009;13(2):159-64. https://doi.org/10.1007/s12603-009-0024-y

Kim MJ, Marchand P, Henegar C, et al. Fate and complex pathogenic effects of dioxins and polychlorinated biphenyls in obese subjects before and after drastic weight loss. Environ Health Perspect. 2011;119(3):377-83. https://doi.org/10.1289/ehp.1002848

World Health Organization - WHO. Trends in life expectancy [Internet]. Genebra: WHO; 2012 [Capturado em 2012 Ago 01]. Disponível em: http://www.who.int/whr/1998/media_centre/press_release/en/index3.html.

Glick M. The health of the nation: why you should care. J Am Dent Assoc. 2007;138(2):144-6.

Morley JE. Undernutrition in older adults. Fam Pract. 2012;29:i89-i93.

Instituto Brasileiro de Geografia e Estatística - IBGE. Resultados preliminares do censo 2010 [Internet]. Brasília: IBGE; 2010 [Capturado em 2012 jun 10]. Disponível em: http://www.ibge.gov.br. https://doi.org/10.5752/p.2175-5841.2012v10n28p1122

Vagnini F, Fox B. The side effects bible: the dietary solution to unwanted side effectos of common medications. New York: Broadway Books; 2005.

Gomez R, Venturini C. Interação entre alimentos e medicamentos. Porto Alegre: Suliani Letra e Vida Editora; 2009.

Institute of Medicine of The National Academies. Dietary reference intakes: the essential guide to nutrient requirements, 2006. [Capturado em 2012 apr 22]. Disponível em: http://www.nap.edu/openbook.php?record_id=11537&page=R3.

Ross AC, Manson JE, Abrams SA, et al. The 2011 dietary reference intakes for calcium and vitamin D: what dietetics practitioners need to know. J Am Diet Assoc, 2011;111(4):524-7.

Venturini CD, Engroff P, Sgnaolin V, et al. Consumo de nutrientes em idosos residentes em Porto Alegre (RS), Brasil: um estudo de base populacional. Ciênc saúde coletiva. 2015; 20(12):3701-11. https://doi.org/10.1590/1413-812320152012.01432015

Fabian E, Bogner M, Kickinger A, et al. Intake of medication and vitamin status in the elderly. Ann Nutr Metab. 2011;58(2):118-25. https://doi.org/10.1159/000327351

Herrmann WJ, Lorenzl S, Obeid R. Review of the role of hyperhomocysteinemia and B-vitamin deficiency in neurological and psychiatric disorders--current evidence and preliminary recommendations. Fortschr Neurol Psychiatr. 2007;75(9):515-27.

Barbagallo M, Belvedere M, Dominguez LJ. Magnesium homeostasis and aging. Magnes Res. 2009;22(4):235-46.

Martins C, Moreira SM, Pierosan SR. Interações droga-nutriente. Curitiba: Nutroclínica; 2003.

Andreazza RS, Silveira De Castro M, et al. Causes of drug-related problems in the emergency room of a hospital in southern Brazil. Gac Sanit. 2011;25(6):501- 6. https://doi.org/10.1016/j.gaceta.2011.05.016

Ventura MT, Laddaga R, Cavallera P, et al. Adverse drug reactions as the cause of emergency department admission: focus on the elderly. Immunopharmacol Immunotoxicol. 2010;32(3):426-9.

https://doi.org/10.3109/08923970903468847

Ren J, Pulakat L, Whaley-Connell A, et al. Mitochondrial biogenesis in the metabolic syndrome and cardiovascular disease. J Mol Med (Berl). 2010;88(10):993-1001. . https://doi.org/10.1007/s00109-010-0663-9

Lee JH, Jarreau T, Prasad A, et al. Nutritional assessment in heart failure patients. Congest Heart Fail. 2011;17(4):199-203. https://doi.org/10.1111/j.1751-7133.2011.00239.x

Deichmann R, Lavie C, Andrews S. Coenzyme q10 and statin-induced mitochondrial dysfunction. Ochsner J. 2010;10(1):16-21.

Nakbi A, Koubaa N, Ben Hamda K, et al. Association between oxidative stress parameters and inflammation markers according to the gravity of the acute coronary syndrome. Tunis Med. 2011;89(7):621-6.

Palomäki A, Malminiemi K, Malminiemi O, et al. Effects of lovastatin therapy on susceptibility of LDL to oxidation during alpha-tocopherol supplementation. Arterioscler Thromb Vasc Biol. 1999;19(6):1541-8.

https://doi.org/10.1161/01.atv.19.6.1541

Masubuchi Y, Nakayama J, Sadakata Y. Protective effects of exogenous glutathione and related thiol compounds against drug-induced liver injury. Biol Pharm Bull. 2011;34(3):366-70. https://doi.org/10.1248/bpb.34.366

Clavel JP, Emerit J, Thuillier A. Lipid peroxidation and free radicals. Role in cellular biology and pathology. Pathol Biol (Paris). 1985;33(1):61-9.

Schulz HU, Schürer M, Krupp S, et al. Effects of acetylsalicylic acid on ascorbic acid concentrations in plasma, gastric mucosa, gastric juice and urine -- a double-blind study in healthy subjects. Int J Clin Pharmacol Ther. 2004;42(9):481-487. https://doi.org/10.5414/cpp42481

Sugimoto M, Nishino M, Kodaira C, et al. Esophageal mucosal injury with low-dose aspirin and its prevention by rabeprazole. J Clin Pharmacol. 2010;50(3):320-30. https://doi.org/10.1016/s0016-5085(09)62058-8

Greenwald DA. Aging, the gastrointestinal tract, and risk of acid-related disease. Am J Med. 2004;117:8S-13S.

Kapadia C. Cobalamin (Vitamin B12) deficiency: is it a problem for our aging population and is the problem compounded by drugs that inhibit gastric acid secretion? J Clin Gastroenterol. 2000;30(1):4-6. https://doi.org/10.1097/00004836-200001000-00003

Coe FL, Parks JH, Bushinsky DA, et al. Chlorthalidone promotes mineral retention in patients with idiopathic hypercalciuria. Kidney Int. 1988;33(6):1140- 6. https://doi.org/10.1038/ki.1988.122

Published
2020-03-30
How to Cite
Duarte Venturini, C., Engroff, P., Sgnaolin, V., Milani El Kik, R., Bueno Morrone, F., & Gomes, I. (2020). Inadequate food intake in elderly: drug-nutrient interaction. PAJAR - Pan American Journal of Aging Research, 8(1), e34072. https://doi.org/10.15448/2357-9641.2020.1.34072
Section
Original Article