Search

This study aimed to identify food environment factors in the local community that could affect the levels of nutritional status and frailty in 372 older adults (at least 65 years old) experiencing food insecurity and enrolled in the integrated Community Health Promotion Program (CHPP) in two districts of Seoul. The local food environment was assessed using perceived food store accessibility questionnaires. In order to quantify nutrient intake, the 24-h recall method was applied. Malnutrition was measured using the Mini Nutritional Assessment tool, while frailty was assessed using the Frailty Measurement Questionnaire developed for the CHPP. Malnourished or frail elderly adults commonly had a lower intake of cereals and potatoes, meats, and vegetables than those who were not, and their resulting intake levels of energy, protein, iron, and vitamin groups were also significantly lower (all p -values < 0.05). Among the local community food store environment factors, the sufficiency of food stores (odds ratio (OR) = 1.988, 95% confidence interval (CI] = 1.211-3.262), freshness of foods (OR = 1.767, 95% CI = 1.075-2.886), and variety in foods (OR = 1.961, 95% CI = 1.197-3.212) were significant factors affecting the risk of malnutrition. For frailty, the freshness of foods (OR = 1.997, 95% CI = 1.053-3.788), variety in foods (OR = 2.440, 95% CI = 1.277-4.661), and small purchase of foods (OR = 2.645, 95% CI = 1.362-5.139) were significant environmental factors. In conclusion, we found that the perceived food store environment in the local community can influence the occurrence of malnutrition and frailty in vulnerable, urban older adults.

Background: We aimed to estimate whether elevated levels of complement C3a and C5a in amniotic fluid (AF) are independently associated with increased risks of intra-amniotic infection and/or inflammation (IAI) and spontaneous preterm delivery (SPTD) in women with cervical insufficiency or a short cervix (≤ 25 mm)., Methods: We conducted a retrospective cohort study of 96 consecutive women with cervical insufficiency (n = 62) or a short cervix (n = 34) at 17 to 27 weeks, and who underwent an amniocentesis. AF was cultured and analyzed for C3a and C5a by enzyme-linked immunosorbent assay kits. The primary outcome measures were IAI (defined as a positive AF culture and/or an elevated AF interleukin-6 level [≥ 7.6 ng/mL]) and SPTD at < 32 weeks., Results: In multivariable analysis, AF level of C3a was the only variable significantly associated with IAI, whereas C5a level in AF and serum C-reactive protein level were not associated with IAI. Using SPTD at < 32 weeks as the outcome variable in logistic regression, elevated AF levels of C3a were associated with increased risk of SPTD at < 32 weeks after adjusting for other baseline confounders, whereas elevated AF levels of C5a were not., Conclusion: In women with cervical insufficiency or a short cervix, elevated AF level of C3a, but not C5a, is independently associated with increased risks of IAI and SPTD at < 32 weeks. These findings suggest that subclinical IAI or SPTD in the context of cervical insufficiency is related to activation of complement system in AF., Competing Interests: Disclosure: The authors have no potential conflict of interest to disclose.