Protein-energy malnutrition in low income elderly Nairobi women

Nutritional data for two groups of low income elderly women ((X) over bar = 64, range 57-74 years) in Nairobi, Kenya were compared. Group I (n = 113), slum dwellers, had an income of less than or equal to$20 Cd per month; Group II (n = 88), poor urban area inhabitants, had an income of less than or equal to$170 Cd per month. Dietary intakes were assessed quantitatively by four 24-h dietary recalls; anthropometric and biochemical data were obtained. Twenty-one women (16% of Group I; 3% of Group II) were classified as having protein-energy malnutrition (PEM) based on abnormal anthropometric measurements or low serum albumin concentration. The malnutrition was marasmic-like; the anthropometric measurements (body weight, triceps skinfold thickness (TSF), mid-arm muscle circumference (MAMC)) of the PEM Group were lower (P less than or equal to 0.05) than those of Groups I and II. The PEM Group was older ((X) over bar = 68 years), had lost more teeth, and had more subnormal values than Groups I and II for: serum albumin, hemoglobin, hematocrit, MCHC, MCH, serum transferrin and serum iron. Inferior diets were a contributing factor. Mean energy and protein intakes of the PEM Group were low: 1471 kcal day(-1) (26 kcal kg(-1)) and 42 g day(-1) (0.79 g kg(-1)), respectively. The main protein sources were vegetables (48%) and cereals (36%); only 6 g protein was of high quality. Group TI mean protein and energy intakes were greater (P less than or equal to 0.05, P less than or equal to 0.01) than those of the PEM Group and mean dairy product intake was higher (P less than or equal to 0.001). The PEM Group and Group I had low mean energy intakes and an unsatisfactory dietary pattern; they consumed less meat (P less than or equal to 0.01) and less fat (P less than or equal to 0.001) than Group II. For the PEM Group dietary intakes of energy, fat and sugar were significantly correlated with TSF and MAMC; for the PEM Group monthly income was significantly correlated with weight, BMI, TSF and MAMC. Data suggest that elderly women living in Nairobi slums are at high risk of malnutrition; one of the factors contributing to the problem is inadequate food intake.