Relationship between Chewing Ability and Nutritional Status in Japanese Older Adults: A Cross-Sectional Study.

Keiko Motokawa,Kazushige Ihara,Maki Shirobe,Hisashi Kawai,Ayako Edahiro,Yuki Ohara,Yutaka Watanabe,Yoshinori Fujiwara,Yurie Mikami,Masanori Iwasaki,Shuichi Obuchi,Hirohiko Hirano,Takeshi Kera

doi:10.3390/ijerph18031216

Abstract

Objectives: This study aimed to determine the relationship between objective chewing ability and the nutritional status of Japanese community-dwelling elders. Design: A cross-sectional study. Participants: A total of 509 community-dwelling elders living in the Tokyo metropolitan area participated in a comprehensive survey conducted in October 2013. Measurements: The basic characteristics were sex, age, and body mass index. Undernutrition was examined through serum albumin levels. Chewing ability was examined through color-changeable xylitol gum by evaluating the color changes in chewing gum. Nutritional intake was examined using the semi-quantitative food frequency questionnaire. Results: In the poor chewing ability group, all nutrient intake levels were significantly low, except for carbohydrates, and intake levels for all food groups were significantly low, except for cereals, confectionery, sugars, seasonings, and spices. Additionally, after adjusting for covariates for sex, age, Tokyo Metropolitan Institute of Gerontology-Index of Competence (TMIG-IC) score, Mini-Mental State Examination (MMSE) score, body mass index (BMI), stroke, number of functional teeth, energy intake, and protein intake, chewing ability was found to be significantly associated with undernutrition. Conclusion: We concluded that chewing ability was closely associated with nutrient and different food groups’ intake, as well as undernutrition, among Japanese community-dwelling elders. Thus, to ensure comprehensive nutritional management, nutritionists and dentists should collaborate when treating the same patients.

Highlights

Our results showed that chewing ability was related to nutrient and food group intake among community-dwelling older adults in urban areas of Japan
Good chewing ability among older adults may help them maintain a high dietary variety; in turn, this can lead to the maintenance of nutritional status
In the current study, chewing ability was associated with nutrient and food group intake and undernutrition, even when adjusting for the number of functional teeth, including dentures

Summary

Introduction

Japan is experiencing unprecedented population aging, transforming the country into a super-aged society. By 2015, the proportion of the population over 65 years old had reached 26.0% [1]. Developed countries with an aging population, such as. Urgently need to take measures to provide appropriate care that meets the needs of older adults, who incur increased illness incidences owing to their advanced age. A report from Health Japan 21 reports that about 18% of community-dwelling older adults are undernourished (as per body mass index (BMI)). This ratio is expected to increase in the future [2].

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Discussion

Conclusion