背景：隨著台灣老年人口數的增加，老年人在其健康與長壽的飲食營養上所扮演的角色已引起諸多注意。在老化的過程中，生理上的、社會的變遷、慢性疾病的發展、藥物的使用及活動量的減少等等皆是導致老年人處於營養不良的危險因子。鐵的攝取與其營養狀況亦受到年齡、性別、收入和飲食型態的影響；故一般認為老年人普遍有鐵攝取不足及鐵缺乏的情形。為了評估老人之間其鐵質狀況與營養素攝取之間的相關性，因此本研究的目的在：1.調查台中地區老年人營養攝取的情況。2.分析此類族群的血液生化值及鐵營養狀況。3.比較健康與罹患慢性疾病老人之間其鐵質狀況與營養素攝取之間的差異。
方法：共有96名老人參與本研究。受測者分為4組 (28位健康男性、12位患慢性疾病男性、29位健康女性、27位患慢性疾病女性)。受測者需完成基本資料及醫療病史問卷的填寫，另外需完成24小時的飲食回憶記錄及食物頻率問卷調查。血液生化值的測量則包括血紅素(hemoglobin)、血比容(hematiocrit)、平均血球容積(mean cell volume)、血漿鐵質(plasma iron)及鐵蛋白(ferritin)、總鐵結合能力(total iron binding capacity)及轉運鐵蛋白飽合度(transferrin saturation)。體內鐵的貯存(iron stores)是根據血紅素、鐵蛋白及轉運鐵蛋白飽合度計算而得。
結果：發現所有組別中，其平均每日鐵攝取量均高於目前台灣的RDNA (10 mg)。鐵的攝取量與各種鐵質狀況的生化指標在各組中均無顯示其相關性。在兩性中健康與慢性病組別之間鐵質營養狀況並沒有顯著的差異；然而體內鐵的貯存與血漿鐵蛋白之間呈現顯著的正相關 (P<0.05)。兩位健康及一位患慢性病男性，兩位健康及三位患慢性病女性有缺鐵性貧血，因為血漿中的鐵蛋白濃度<12μg/L，且有一種或以上的其他異常鐵質狀況的生化指標。
結論：雖然健康和慢性病的老人都有足夠的鐵質攝取甚且高於RDNA，但是鐵質缺乏仍舊存於老年人口中，可能原因是鐵的生物利用率似乎因其他原因而受到限制。另外，在評估老年人的鐵值狀況，血漿鐵蛋白是很好的評估指標。
Background: Since the turn of the century, the age of the population in Taiwan has steadily increased. The role of dietary nutrition to maintain good health and long life has caught more attention. Aging is a multifaceted event that encompasses molecular, cellular, physiological, and psychological changes. Individual nutritional needs may thereby change in response to progressive loss of efficiency within organ systems. The iron intake and status are influenced by age、sex、income and the pattern of diet. Thus, elderly people are more likely than young adults to be at high risk of iron deficiency. The purposes of this study were: 1). To examine nutrient intakes of elderly people. 2). To assess the hematological parameters and iron status of elderly people. 3). To compare nutrient intakes and iron status of the elderly with chronic diseases to that of the healthy elderly.
Method: Ninety-six elderly (40males, 56 females) participated in this study, subjects were divided into four groups (28 healthy males, 12 males with chronic diseases, 29 healthy females, and 27 females with chronic diseases). Each subject completed a 24-h diet recall and food frequency questionnaire. Hemoglobin、 hematocrit、mean cell volume、plasma iron and ferritin、total iron binding capacity and transferrin saturation were measured. Body iron stores were calculated.
Results: The mean iron intake was higher than the current Taiwan Recommended Daily Nutrient Allowance of 10 mg in all groups. However, iron intake did not correlate with any iron status indicators in any study groups. There were no significant differences in iron status indicators between healthy and chronically-diseased groups. Body iron stores were correlated positively with plasma ferritin (p< 0.05). Two healthy males, one chronically-diseased male; two healthy females and three chronically-diseased females had iron deficiency anemia; they had anemic ferritin levels (< 12μg/L) and one or more other abnormal iron status indicators.
Conclusion: Although the elderly subjects had sufficient iron intake even higher than the RDNA, the bioavailability of iron might be limited to maintain body iron stores. A combination of plasma ferritin and other iron indices is recommended to determine the iron status in elderly subjects
