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Protein nutritional status and function are associated with type 2 diabetes in Hispanic elders^1,2,3,4

¹ From the US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston.

Background: Hispanic elders have a high prevalence of diabetes and poor glycemic control, leading to inadequate nutritional status, muscle wasting, and impaired function.

Objective: We examined the association of type 2 diabetes with nutritional status measured by serum albumin concentrations and midupper arm muscle area (MAM) and with function measured by difficulty with at least one activity of daily living.

Design: Health history and disability were assessed by self report in 556 Hispanics with a mean (± SD) age of 69 ± 7 y and 158 non-Hispanic whites (NHW; aged 71 ± 7 y) from the Massachusetts Hispanic Elders Survey. Energy intake (in MJ/d) and protein intake (in g/d) were estimated with use of a food-frequency questionnaire. Body mass index (BMI; in kg/m²) and C-reactive protein concentrations (in mg/L) were also measured. Multiple logistic regression models by ethnic group were used.

Results: There were no significant differences between Hispanics and NHWs in the proportion of those with low albumin concentrations or low MAM. Hispanic diabetic women had the lowest proportion of low MAM. The risk of low serum albumin concentration was twice as high in Hispanics taking insulin as in their NHW counterparts. Among Hispanics, low albumin concentration and low BMI were associated with low MAM; female sex, low albumin concentration, high BMI, and insulin use were significantly associated with risk of functional impairment.

Conclusion: Type 2 diabetes is associated with poor nutritional status, muscle loss, and functional impairment among Hispanic elders.

Key Words: Serum albumin • diabetes • Hispanics • nutritional status • disability • midupper arm muscle area • non-Hispanic whites • Massachusetts Hispanic Elders Survey

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