In-Depth Assessment of the Nutritional Status of Korean American Elderly

Although studies of immigrants have generally indicated significant dietary changes that mirror a Western diet upon immigration, previous data are limited to the dietary patterns and intakes of younger and middle-aged adults. Using a relatively large sample of Korean American elderly (KAE) immigrants, this article offers an in-depth assessment of the nutritional status of KAE, one of the most rapidly increasing minority populations in the United States. In this study, 202 KAE in a metropolitan city on the East Coast participated in a comprehensive nutritional survey using 24-hour dietary recall. Despite their spending about 16 years in the United States, the KAE consumed more than 2 regular meals in a day that were considered part of a Korean food pattern. When compared with the National Health and Nutrition Examination Survey III, the average consumption of nutrients reported was generally lower than in Americans, with the exception of carbohydrates, vegetable protein, and sodium intake. Inadequate intake of calcium, dietary fiber, and folate were notable when examined in comparison to the Dietary Reference Intakes. These findings can help health care providers and researchers design appropriate nutritional education programs to facilitate the adoption of healthier dietary practices in this immigrant population. In particular, future interventions should consider ways to lower sodium intake and increase fruit and vegetable consumption among KAE, while encouraging them to maintain their healthy dietary pattern.

Introduction

Numerous studies have reported on the significant impact of dietary intake on health, independence, and quality of life in the elderly population.1, 2, 3 For example, it is well known that several critical nutrients such as calcium, protein, magnesium, zinc, and vitamin C significantly influence the development and maintenance of bone mass and the prevention and treatment of osteoporosis.⁴ Animal fats are associated with an increased risk of coronary heart disease,⁵ whereas intake of total vegetables, legumes, and fruit is significantly inversely associated with cardiovascular disease and cancer mortality.6, 7, 8, 9

Although some counter-examples exist,10, 11 researchers have documented general changes in dietary patterns that mirror a Western diet after migration among immigrants from Eastern countries (i.e., increased consumption of animal protein, animal fats, and refined sugar).12, 13, 14, 15, 16, 17 Indeed, the research regarding the dietary intake of Korean Americans, one of the fastest growing immigrant populations in the United States,¹⁸ has generally indicated an increase in the consumption of beef, dairy products, soda, bread, cereal, ham, and sweets as well as a decrease in the intake of fish and rice and other grains in the population.13, 14, 19, 20, 21, 22, 23 However, previous studies have been limited to the dietary practices of adolescents or younger and middle-aged adults. Only a few published studies examined the topic in older groups of Korean immigrants with small sample sizes (<100) with no in-depth assessment of their nutritional status.24, 25

As the proportion of elderly immigrants increases exponentially in the United States,²⁶ understanding and addressing their health needs have emerged as important public health policy tasks. More detailed information on the nutritional intake and dietary patterns of Korean American elderly (KAE) would be helpful in assisting health care providers with adequate dietary assessment and nutritional education, counseling, and support in this rapidly increasing immigrant population. In light of these considerations, we conducted a comprehensive assessment of dietary pattern and nutritional status in a relatively large sample of KAE. Specifically, the objectives of this study were to 1) describe KAE's dietary pattern and nutritional status on the basis of 24-hour dietary recall, 2) compare their nutrient intake values with those from the most recent national nutrition survey (i.e., the National Health and Nutrition Examination Survey [NHANES] III), and 3) determine the adequacy of their nutrient intake using the Dietary Reference Intakes.²⁷