Submitted to: Public Health Nutrition
Publication Type: Peer reviewed journal
Publication Acceptance Date: 8/7/2010
Publication Date: 5/1/2011
Citation: Sempertegui, F., Estrella, B., Tucker, K., Hamer, D., Narvaez, X., Sempertegui, M., Griffiths, J.K., Noel, S., Dallal, G., Selhub, J., Meydani, S. 2011. Metabolic syndrome in elderly living in marginal peri-urban communities in Quito, Ecuador. Public Health Nutrition. 14(5):758-767. Interpretive Summary: The number of elderly is estimated to double world wide in the next 50 years. Many older people will be living in developing countries, which are at present less prepared to deal with the challenges of an aging population. The proportion of the population in Latin America above the age of 60 y is expected to double during the next few decades. Our study focused on Metabolic syndrome (MetS) which has a high rate of illness and death among elderly around the world. Little is known about MetS in Latin America, particularly in Ecuador. We examined the prevalence of MetS and its risk factors in a low income urban area of Quito, Ecuador. MetS and its causes are not fully known but research so far suggests that it is a complex interaction between genetic, metabolic and environmental factors. Nutrition is a prominent environmental influence and can be observed by obesity, dietary glycemic index, fruit and vegetable intake, type and total of fat intake, dairy products in the diet, and micronutrients. Various chemical aspects of this syndrome were evaluated in the blood using a cross section of 352 elderly Ecuadorians. MetS was prevalent at 45 percent—a higher percentage was among women at 53 percent than in men at 29 percent. Blood levels showed various deficiencies of vitamins and minerals. MetS combined with nutritional deficiencies indicate elderly Ecuadorians suffer from increasing double burden of disease associated with unstable quality of nutrition in less-developed countries. More research is needed to determine cause of MetS in elderly but generally, the data suggest that the elderly would benefit from preventive measures in their diet. Foods that contribute to normalizing fat levels in the blood, reducing high blood pressure and weight gain, and improving nutrition would give them best chance of optimal physical health while aging. Such research can be applied to any culture as our worldwide aging population is expanding and living longer.
Technical Abstract: The proportion of the population in Latin America above the age of 60 is expected to double during the next few decades. Metabolic syndrome (MetS) is associated with high morbidity and mortality worldwide. However, little is known about MetS in Latin America in general, and in Ecuador in particular. This study examined the prevalence of MetS in a low income urban area and evaluated the association between blood micronutrient, homocysteine (tHcy) and C-reactive protein (CRP) concentrations with MetS. We performed a cross-sectional study of 352 elderly (greater or equal to 65 years) Ecuadorians living in a peri-urban slum community in Quito, Ecuador. MetS was determined using the International Diabetes Federation (IDF) definition. Plasma micronutrient, CRP and tHcy concentrations were assessed. MetS was prevalent (45 percent)—more so among women (53 percent) than men (29 percent). In addition, many of those without MetS exhibited one or more of its components. Plasma micronutrient deficiencies were prevalent: greater than 70 percent for vitamin C, greater than 45 percent for zinc, and greater than 20 percent for vitamin B12 and folate. Vitamin C and E concentrations were inversely, and CRP positively associated with MetS. The co-existence of MetS with micronutrient deficiencies indicates that elderly Ecuadorians suffer from the increasingly common double burden of diseases associated with food insecurity and nutrition transition in less-developed countries. More research is needed to determine causal factors, but the results presented suggest that these elderly would benefit from interventions to normalize blood lipids, reduce hypertension and weight gain, and to improve micronutrient status.