• TABLE OF CONTENTS
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 Title Page
 Table of Contents
 Acknowledgement
 Introduction
 Review of the literature
 Methods
 Results
 Discussion
 Summary and conclusions
 Literature cited














Group Title: Bulletin - University of Florida. Agricultural Experiment Station ; no. 562
Title: Dietary and hematologic studies of the aged
CITATION THUMBNAILS PAGE IMAGE ZOOMABLE
Full Citation
STANDARD VIEW MARC VIEW
Permanent Link: http://ufdc.ufl.edu/UF00027332/00001
 Material Information
Title: Dietary and hematologic studies of the aged
Series Title: Bulletin Agricultural Experiment Station, University of Florida
Physical Description: 16 p. : ;
Language: English
Creator: Abbott, O. D ( Ouida Davis ), b. 1892
Publisher: Agricultural Experiment Station
Place of Publication: Gainesville Fla
Publication Date: 1955
 Subjects
Subject: Nutrition   ( mesh )
Genre: non-fiction   ( marcgt )
 Notes
Statement of Responsibility: by O. D. Abbott and others
General Note: Cover title.
 Record Information
Bibliographic ID: UF00027332
Volume ID: VID00001
Source Institution: University of Florida
Rights Management: All rights reserved by the source institution and holding location.
Resource Identifier: aleph - 000926759
oclc - 14683770
notis - AEN7459

Table of Contents
    Title Page
        Page 1
    Table of Contents
        Page 2
    Acknowledgement
        Page 2
    Introduction
        Page 3
    Review of the literature
        Page 3
        Page 4
    Methods
        Page 5
        Page 6
    Results
        Page 7
        Page 8
        Page 9
        Page 10
        Page 11
    Discussion
        Page 12
        Page 13
        Page 14
    Summary and conclusions
        Page 15
    Literature cited
        Page 16
Full Text


Bulletin 562


May 1955


UNIVERSITY OF FLORIDA
AGRICULTURAL EXPERIMENT STATIONS
WILLARD M. FIFIELD, Director
GAINESVILLE, FLORIDA











Dietary and Hematologic Studies

of the Aged


By O. D. ABBOTT, RUTH O. TOWNSEND and R. B. FRENCH
In cooperation with
OTIS MARSHALL and ETHYL NEELANDS








TECHNICAL BULLETIN








Single copies free to Florida residents upon request to
AGRICULTURAL EXPERIMENT STATION
GAINESVILLE, FLORIDA
















CONTENTS


INTRODUCTION ................. ...-


REVIEW OF LITERATURE ..............


M ETHODS ..................................


Selection of Subjects ..........


Diagnosis and Treatment ....


Hematology .......... ---.. ..


Dietary Records ........... .. ..


RESULTS .... .. ..- ..-- -..


Diets .....-... .. --


Hemoglobin ........... ---..


Erythrocytes ............ ...- .


Leucocytes .. ....... ......


Differential Leucocyte Counts


Hematinic Treatment ...........


DISCUSSION ...............--- -


SUMMARY AND CONCLUSIONS ........


LITERATURE CITED ................- -


PAGE


.-----.........................................


..................... ----...... ..........------ 3





......................... ......... .... 5

............... ........................ 5


..--..................................... 5
-.... ....--- ..-- .-.-...-- ......- ... 5


.. -.......-.-.-.--- ...- ... -..-.. .- 5


------- -..- .- ... ...-..-.-.- .... .. 7
....--- .---------------------------. -------- 7




.......... .--.-..- ... ..-- -- ..- ...- 7


...... ... ..-- -...- ....-- .- ....--- 7
----- ----- ------- ------- -.-.-- 7



-.-.-- -.. ..-. ..... .--. ... ...... 10


............... ...- .. -- ........ 1 0

-------- ----- --- .- ------ -- .-------- 10


-...- .- ......---- --- -... -.-. .. .......- 12


-. ....- .. ..-- -- ... .....- .... ....--..... 15


.. .-.- .-.-....- ....--..-- .....-....... 16


ACKNOWLEDGMENTS


The authors wish to express their thanks and appreciation to the

residents and superintendent of the Memorial Home Community at Penney

Farms for their whole-hearted cooperation during this study; to the J. B.

Roerig Company; the Upjohn Company; and to Dr. Melvin E. Page for

biologicals and pharmaceuticals used in these investigations.
















CONTENTS


INTRODUCTION ................. ...-


REVIEW OF LITERATURE ..............


M ETHODS ..................................


Selection of Subjects ..........


Diagnosis and Treatment ....


Hematology .......... ---.. ..


Dietary Records ........... .. ..


RESULTS .... .. ..- ..-- -..


Diets .....-... .. --


Hemoglobin ........... ---..


Erythrocytes ............ ...- .


Leucocytes .. ....... ......


Differential Leucocyte Counts


Hematinic Treatment ...........


DISCUSSION ...............--- -


SUMMARY AND CONCLUSIONS ........


LITERATURE CITED ................- -


PAGE


.-----.........................................


..................... ----...... ..........------ 3





......................... ......... .... 5

............... ........................ 5


..--..................................... 5
-.... ....--- ..-- .-.-...-- ......- ... 5


.. -.......-.-.-.--- ...- ... -..-.. .- 5


------- -..- .- ... ...-..-.-.- .... .. 7
....--- .---------------------------. -------- 7




.......... .--.-..- ... ..-- -- ..- ...- 7


...... ... ..-- -...- ....-- .- ....--- 7
----- ----- ------- ------- -.-.-- 7



-.-.-- -.. ..-. ..... .--. ... ...... 10


............... ...- .. -- ........ 1 0

-------- ----- --- .- ------ -- .-------- 10


-...- .- ......---- --- -... -.-. .. .......- 12


-. ....- .. ..-- -- ... .....- .... ....--..... 15


.. .-.- .-.-....- ....--..-- .....-....... 16


ACKNOWLEDGMENTS


The authors wish to express their thanks and appreciation to the

residents and superintendent of the Memorial Home Community at Penney

Farms for their whole-hearted cooperation during this study; to the J. B.

Roerig Company; the Upjohn Company; and to Dr. Melvin E. Page for

biologicals and pharmaceuticals used in these investigations.









Dietary and Hematologic Studies

of the Aged

By O. D. ABBOTT, RUTH TOWNSEND 1 and R. B. FRENCH
In cooperation with
OTIS MARSHALL 2 and ETHYL NEELANDS 3

Many studies of physical and mental conditions of the aged
are based on men and women who are indigent, illiterate, mal-
nourished and chronically ill. It is evident that these people
have been exposed to adverse environments, the effects of which
so cloud the picture that the results of aging per se are obscure.
Clinical hematologic standards are often based upon men
and women 20 to 30 years of age. At present few reports give
data on just how far these standards are applicable to the aged
and what variations from these standards are the results of un-
complicated aging. This suggests that clinical standards must
be established for the aged so that variations therefrom may be
evaluated.
After visiting several homes for the aged it was decided that
the residents of the Memorial Home Community at Penney
Farms, Florida, because of their apparent good health, offered
an opportunity not only for the determination of a hematologic
normal, but also for a study of the dietary regimen. Un-
doubtedly this dietary program has been a contributing factor
to the longevity of these men and women. In the fall of 1952
a project was designed to study the cellular components of the
blood of the residents of this home in relation to dietary prac-
tices.
REVIEW OF THE LITERATURE
Data on physiological and biochemical changes in blood asso-
ciated with aging are not only meager but sometimes contra-
dictory, as shown by the following review. Miller (9), in his
study of hematologic standards of the aged, says, "In the older
groups senile retrogressive changes, arteriosclerosis, pulmonary
emphysema and hypertension are present to a greater or lesser
degree. These degenerative changes are an integral part of the
Professional assistant, Agr. Expt. Sta.
Resident Physician, Penney Farms, Florida.
3 Director of Nursing Service, Penney Farms, Florida.









Dietary and Hematologic Studies

of the Aged

By O. D. ABBOTT, RUTH TOWNSEND 1 and R. B. FRENCH
In cooperation with
OTIS MARSHALL 2 and ETHYL NEELANDS 3

Many studies of physical and mental conditions of the aged
are based on men and women who are indigent, illiterate, mal-
nourished and chronically ill. It is evident that these people
have been exposed to adverse environments, the effects of which
so cloud the picture that the results of aging per se are obscure.
Clinical hematologic standards are often based upon men
and women 20 to 30 years of age. At present few reports give
data on just how far these standards are applicable to the aged
and what variations from these standards are the results of un-
complicated aging. This suggests that clinical standards must
be established for the aged so that variations therefrom may be
evaluated.
After visiting several homes for the aged it was decided that
the residents of the Memorial Home Community at Penney
Farms, Florida, because of their apparent good health, offered
an opportunity not only for the determination of a hematologic
normal, but also for a study of the dietary regimen. Un-
doubtedly this dietary program has been a contributing factor
to the longevity of these men and women. In the fall of 1952
a project was designed to study the cellular components of the
blood of the residents of this home in relation to dietary prac-
tices.
REVIEW OF THE LITERATURE
Data on physiological and biochemical changes in blood asso-
ciated with aging are not only meager but sometimes contra-
dictory, as shown by the following review. Miller (9), in his
study of hematologic standards of the aged, says, "In the older
groups senile retrogressive changes, arteriosclerosis, pulmonary
emphysema and hypertension are present to a greater or lesser
degree. These degenerative changes are an integral part of the
Professional assistant, Agr. Expt. Sta.
Resident Physician, Penney Farms, Florida.
3 Director of Nursing Service, Penney Farms, Florida.






Florida Agricultural Experiment Stations


aging process and when we speak of normal old men we include
those changes which are peculiar to age and exclude those of
inflammation or neoplastic processes." In contrast to this,
Fowler et al (6), in a study of hematologic changes in elderly
patients 65 to 80 years of age, found that since cataracts, osteo-
porosis and arteriosclerosis were present, these patients were
not accepted as normal. Olbrich (11) studied the blood changes
in men and women 60 to 89 years of age. The hematologic
values were well within the normal range as given by Hepler
(7). However, there was an increase in the number of leu-
cocytes which were older than those found in younger subjects.
In a second report Olbrich et al (12) found the fragility of the
red cell was more variable in the old than in the young. In the
examination of the blood of 160 elderly men, Miller (9) showed
that the erythrocytes and hemoglobin values were lower in this
group than in those of younger men, while the leucocytes and
differential counts were within the normal range. In 1942
Burker (4) reported that hemoglobin values in women increased
with age. Newman and Gitlow (10) showed a statistical dif-
ference between males and females for hemoglobin, hematocrit,
volume index and mean corpuscular volume. In a group of
people varying in age from 61 to 89 years and a group 19 to
30 years, the average results obtained by Meyer, Sorter and
Necheles (8) were, respectively, hemoglobin 75 and 81 percent,
red cell count 3.84 and 4.14 million.
Data on nutritional requirements are likewise meager. Bortz
(3) reported results of a study of nutritional deficiencies and
premature aging of 300 individuals over 65 years of age. He
found that fatigue and weariness, often accepted as a part of
the aging process, were due to deficiencies in protein and the
B complex, and over alimentation of fats and carbohydrates.
From investigations of the aged Alessandrini (2) recommends
a liberal intake of water, especially a large supply of fruits con-
taining 90 percent of water, and a liberal intake of ascorbic
acid. Albanese et al (1), by measurements of nitrogen metabo-
lism and blood protein levels, found that the caloric and pro-
tein needs of 97 "normal" men 60 to 93 years of age were 30
percent lower than those recommended by the National Council.
This low plane of nutrition supported normal hemoglobin and
plasma protein levels. Roberts, Kerr and Ohlson (13) reported
that the nitrogen metabolism of vigorous older women followed
the pattern of normal adults and nitrogen needs were met by






Dietary and Hematologic Studies of the Aged


present diet standards. Calcium requirements of these women
were higher than the proposed standards for adults and at least
1 gram per day was suggested for healthy older women. It
appeared that "the prolongation of adult basal metabolism in
later decades may be one measure of vitality in the aging
woman."
METHODS
Selection of Subjects.-The cooperating group was composed
of the 306 men and women living in the Memorial Home Com-
munity at Penney Farms, Florida. The decision to conduct the
study at this place was based not only on the cooperation
offered by the superintendent and medical director and the eager-
ness of the residents to participate in this study, but also on
the fact that here was a group of well-adjusted elder citizens
who had few financial worries and were in reasonably good
health. All persons, both married and single, had separate
homes or apartments furnished with their personal belongings,
thereby entailing few changes in life pattern and habits. The
majority of them previously had been engaged in some type of
religious work or in teaching. While ages varied from 60 to 91
years, all were ambulatory and participated fully in the social
and religious life of the community. This group should give a
fairly uncomplicated picture of aging under highly favorable
environmental conditions.
Diagnosis and Treatment.-Clinical examinations, diagnostic
procedures and administration of biologicals were under the
direct supervision of the resident physician.
Hematology.-The usual clinical laboratory methods were
used in all determinations. Hemoglobin, total erythrocytes, leu-
cocytes and differential counts were made on capillary blood.
The concentration of hemoglobin was measured on a Fisher elec-
tro-hemometer.
Dietary Records.-Each participant was given oral and writ-
ten instructions for completing a standard seven-day dietary
record. This record included kinds and amounts of each food
(estimated in household measures) eaten at and between meals.
The records were evaluated in terms of calories and eight nu-
trients: protein, calcium, iron, vitamin A, thiamine, riboflavin,
niacin and ascorbic acid. Data were calculated from Composi-
tion of Foods (raw, processed, prepared), USDA Handbook No.
8, and Nutritional Charts, Res. Dept. of H. J. Heinz Company.

















0
TABLE 1.-COMPARISON OF AVERAGE DAILY INTAKE OF DIETARY CONSTITUENTS OF 251 MEN AND WOMEN OF AGES 65 TO 91
YEARS WITH RECOMMENDED DIETARY ALLOWANCES OF THE NATIONAL RESEARCH COUNCIL (5).

SI I A Ribo- Ascorbic
Subjects Number Ages Calories Protein Calcium Iron Vitamin A Thiamine flavin Niacin Acid
SGms. Gms. Mgs. I.U. Mgs. Mgs. Mgs. Mgs.

Men 96 65-87 2,100 65 1.0 13 11,246 1.2 1.7 12.7 194

Women 155 65-91 1,800 55 1.0 11 10,208 1.2 1.6 13.0 190

Recommended Allowances

Men 65 2,600 65 0.8 12 5,000 1.3 1.6 13.0 75

Women 65 1,800 55 0.8 12 5,000 1.0 1.4 10.0 70
____ __________________________________ _______ ________ t / l
-----------------------------------------------------






Dietary and Hematologic Studies of the Aged


All calculations were made by the "long method". Dietary
supplements were not included in the calculations.

RESULTS
Results of a study of hematologic values of elderly men and
women as related to diet and to age are given in Tables 1 and
2. Individual diet records were collected from 155 women and
96 men and hematologic determinations were made on 306
women and men divided into the following age groups: 60 to
70, 70 to 80 and 80 to 91 years.
Diets.-An analysis of the data on food intake is presented
in terms of calories and eight essential nutrients in Table 1.
Upon comparison of these values with those recommended for
men and women of 65 years, the data show that with the excep-
tion of an average daily intake of 2,100 calories by men instead
of 2,600 as recommended by the Food and Nutrition Board
of the National Research Council (1953 rev.), all other values
approached closely or exceeded the allowances. The average
consumption of vitamin A and ascorbic acid was more than
twice the recommended allowance.
Hemoglobin.-The frequency distribution of hematologic
values according to sex and age are given in Table 2. The mean
hemoglobin values of the males in the three age groups (60-70,
70-80 and 80-91 yrs.) were 14.2, 14.0 and 13.7 grams per 100
ml. of blood; those of the females in the same age groups were
13.3, 13.7 and 13.1 grams, respectively. Comparison of mean
values ("t" test) in the three age groups of both men and
women show no significant differences due to either sex or
age, and 44 percent of the entire group had as much as or more
than 14 grams of hemoglobin; nearly 10 percent had less than
12 grams. The data show that 80 percent of the subjects with
low hemoglobin were women.
Erythrocytes.-No significant differences in total erythrocyte
counts attributable to either sex or age were noted. There was
however, a slight trend for a decrease in number of these cells
as age advanced. Approximately one-sixth of the group had as
many as or more than 5 million red cells, 57 percent had 4 to
5 million, while 26 percent had less than 4 million per ml. of
blood.
Leucocytes.-Wide variations were found in the distribution
of leucocytes. These values ranged from less than 4,000 to more








TABLE. 2.-FREQUENCY DISTRIBUTION OF HEMATOLOGICAL CONSTITUENTS.


60 to 70 Years


Class Interval


gm./100 ml.

9.5-9.9
10.0-10.4
10.5-10.9
11.0-11.4
11.5-11.9
12.0-12.4
12.5-12.9
13.0-13.4
13.5-13.9
14.0-14.4
14.5-14.9
15.0-15.4
15.5-15.9
16.0-16.4


Total Number .....
Mean ....
S. D .... .....
Millions/ml.

2.5-2.9
3.0-3.4
3.5-3.9
4.0-4.4
4.5-4.9
5.0-5.4
5.5-5.9

Total Number ...
Mean .... ..
S. D. .............


Males
No. c


Females
No. % (


70 to 80 Years


Males
No. %'


Hemoglobin

2 2.9 2

1


16
14.19
.40


2 12.5
8 50.0
3 18.8
2 12.5
1 6.2


16
4.46
.37


1
6
5
3
17
17
2
2
3

59
14.04
.48


70
13.26
.43


1


2


Females
No. %C


80 to 91 Years

Males Females
No. c% No. %


3.4

1.7


1.7
0.2
8.4
5.1
8.8


Erythrocytes

3 4.3 1 1.7
8 11.4
28 40.0 4 6.8
20 28.6 14 23.7
9 12.9 23 39.0
1 1.4 12 20.3
1 1.4 5 8.5

70 59
4.50 4.68
.55 .51


118
13.72
.44


3 4.2
14 11.9
48 40.7
33 28.0
13 11.0
5 4.2

118
4.47
.51


22
13.72
.68


2 9.1
4 18.2
5 22.7
7 31.8
4 18.2


22
4.38
.58


21
13.10
.44


1 4.8
3 14.3
6 28.6
4 19.0
5 23.8
2 9.5


21
4.27
.44










TABLE. 2.-FREQUENCY DISTRIBUTION OF HEMATOLOGICAL CONSTITUENTS.
(Continued)


60 to 70 Years


Class Interval


Thousands/ml.


Males
No. ,


Females
No. % '


70 to 80 Years


Males
No. /'


Females
No. %'


80 to 91 Years

Males Females
No. '% No. %


Leucocytes


3.5-3.9
4.0-4.4
4.5-4.9
5.0-5.4
5.5-5.9
6.0-6.4
6.5-6.9
7.0-7.4
7.5-7.9
8.0-8.4
8.5-8.9
9.0-9.4
9.5-9.9
10.0-and above


Total Number ...
M ean .............
S. D ........


1 6.3


6.3

6.3
37.4
18.7
12.5
6.3
6.3


3 2.6
5 4.2
6 5.1
6 5.1
3 2.6
14 11.9
16 13.6
17 14.3
16 13.6
8 6.8
8 6.8
7 5.9
9 7.6


118
7.9
1.70


16
7.3
1.27


55
6.9
1.34


1 5.0
1 5.0
1 5.0
2 10.0
4 20.0
2 10.0
2 10.0
1 5.0
2 10.0
4 20.0


20
8.5
1.71


1 5.6



3 16.6


7 38.8
1 5.6
1 5.6
1 5.6
1 5.6
3 16.6


18
8.1
2.12


59
8.3
1.78







Florida Agricultural Experiment Stations


than 10,000 per ml. of blood. Approximately 20 percent of the
women and 12 percent of the men had less than 6,000 white
cells; 6 percent of the women and 12 percent of the men had
more than 10,000 white cells. Within an age group, only slight
variations were found in the mean values. However, the men
in all age groups had slightly higher counts than did the women
of the same ages. None of these variations were statistically
significant.

TABLE 3.-AVERAGE DIFFERENTIAL LEUCOCYTE COUNTS OF 286 MEN AND
WOMEN AS RELATED TO AGE.

Men I Women
Ages in Years 60-70 70-80 80-87 60-70 | 70-80 I 80-91
Percent

Polymorphonuclears 53.0 54.4 53.7 51.2 51.8 55.1
Stabs .-.....-. ............. 4.2 5.1 6.0 4.6 5.2 3.7
Juveniles .................... 5.0 4.3 4.9 4.5 3.5 2.8
Basophils ...................... 1.4 1.0 1.6 .9 .8 .6
Eosinophils 3.2 2.6 2.9 2.6 2.3 1.3
Myelocytes .7 .8 .7 .8 .6 .7
Monocytes ..--.......... 2.0 2.6 2.0 3.3 3.8 5.3
Large lymphocytes ... 6.0 7.7 6.2 5.5 6.0 4.2
Small lymphocytes .... 24.5 21.5 22.0 26.6 26.0 26.3


Differential Leucocyte Count.-The mean values of the dif-
ferential leucocyte count (Table 3) of this group are within the
normal range and show no variations associated with either
sex or age.
Hematinic Treatment.-Since scatter diagrams showed no
correlation between dietary intake of either iron or protein and
hemoglobin, 15 cases were selected for study. These individ-
uals had either low hemoglobin values, low total erythrocytes
or both. The hemoglobin values ranged from 9.7 to 14.9 grams
and the erythrocytes from 2.8 to 4.6 million. Data in Table 4
show the effectiveness of three months hematinic treatment
with ferrous sulphate, liver-stomach concentrate, B12 and folic
acid on subjects 1 to 7, inclusive, and with the same treatment
plus B complex vitamins on the remaining ones. No signifi-
cant differences were noted in the effectiveness of the two treat-
ments. With one exception there were increases in both hemo-
globin values and total erythrocyte counts, the largest increases
occurring in subjects with the lowest initial values. In subjects
Nos. 7 and 10 the increases in hemoglobin were 36 and 32 per-











TABLE 4:-EFFECTS OF THREE MONTHS OF HEMATINIC TREATMENT ON HEMOGLOBIN AND TOTAL ERYTHROCYTES OF MEN
AND WOMEN 65 TO 75 YEARS OF AGE.

SEstimated Estimated I
Case Intake of Intake of Before Treatment After Treatment
Number I Sex I Dietary Fe Protein Hemoglobin Erythrocytes Hemoglobin Erythrocytes
IMgs./Day Gms./Day i Gms./100 Ml. Millions/M1. Gms./100 Ml. Millions/Ml.

1 F 10 57 12.2 3.9 13.7 4.4
2 F 10 77 13.1 4.0 14.4 4.7
3 F 10 47 11.7 4.6 13.9 4.6
4 F 11 43 10.1 4.2 13.3 4.6
5 F 13 40 10.9 3.8 14.4 4.4
6 M 13 58 11.5 4.0 14.0 4.9
7 F 8 53 9.8 4.2 13.3 4.3
8 M 13 77 11.2 3.2 11.2 3.2
9 F 10 46 12.2 4.1 14.7 4.2
10 F 10 65 9.7 4.2 12.8 4.5
11 F 12 75 11.7 4.1 14.0 4.2
12 M 13 78 12.9 4.4 15.2 4.6
13 F 12 63 12.5 4.0 14.4 4.7
14 M 13 47 14.9 2.8 15.9 4.7 .
15 M 13 61 11.9 3.1 13.7 4.0

Treatments 1 to 7, iron, liver-stomach concentrate, B1.., folic acid.
Treatments 7 through 15, iron, liver-stomach concentrate, B12, folic acid and B complex.
No. 8, no change in blood picture, bone marrow damage due to X-ray therapy. (o






Florida Agricultural Experiment Stations


cent, respectively; in No. 14 the erythrocytes increased 68
percent.
DISCUSSION
It is not to be assumed that the participants in this investi-
gation were considered representative of the average population
of elderly people, but rather of a group aging under favorable
environmental conditions. There was the possibility that data
from this group would furnish a norm or standard for use in
evaluating hematologic data and dietary requirements of el-
derly people.
One of the principal handicaps in the study of the relation-
ship of physical status of humans to diet is the lack of accurate
means of recording food intake. Hematologic standards are
based upon precise clinical laboratory methods, while the usual
or survey method for recording food intake at best gives only
an estimation.
The inaccuracies, variations and limitations of the usual sur-
vey method in assessing dietary adequacy were fully appreci-
ated. It was agreed however, that because of the interest, edu-
cation and character of the cooperating group the records would
give a fairly accurate account of individual food intake.
The adequacy of these diets was measured against the 1953
revision of the recommended allowances of the Food and Nutri-
tion Board of the National Research Council (5). These allow-
ances are not considered by the board as either minimal or
optimum but as "desirable goals towards which to strive in
planning diets and food supplies."
The revised allowances recommend 2,600 calories for a man of
65 years of age weighing 65 kg. and 1,800 calories for a woman
of the same age weighing 55 kg. This represents 20 percent
more energy per kilogram allowance for men than for women.
However, in recommending these values, the board points out that
adjustments should be made to meet individual cases. It is
suggested that a 5 percent reduction in calories be made for
each decade after the age of 25 years; that a 5 percent de-
crease in allowance be made for every 10 percent difference in
mean external temperature from the reference base of 100 C.
The average age of the group at the Memorial Home Com-
munity was 75 years. One third of the women weighed from
40 to 50 kilograms (88 to 110 lbs.), while the remainder weighed
from 52 to 64 kilograms (114 to 140.8 Ibs). Approximately







Dietary and Hematologic Studies of the Aged


two-thirds of the men weighed from 59 to 65 kilograms (129.8
to 143 lbs.), while the remainder weighed 67 to 75 kilograms
(147.4 to 165 lbs). About 10 percent of the men have gardens
and about the same number play golf and shuffleboard. The
married women do housework; a few of the single ones play
golf, but with few exceptions this group is more sedentary.
In the present study the men had an average daily intake
of 2,100 calories; the women 1,800. This is an equal caloric
intake per unit of body weight for men and women. According
to the 1953 recommendations, the caloric intake of the men in
this group was approximately 20 percent below requirements,
while that of the women met the requirements. It appears, how-
ever, that on the basis of age, weight, activity and general
good health the caloric intake of both men and women was
adequate.
The average consumption of essential nutrients approached
closely or exceeded the allowances recommended by the National
Research Council. Approximately 90 percent of the group had
from two to three times the recommended intake of ascorbic
acid and only one man and five women had less than the allow-
ance. The intake of vitamin A was likewise two to three times
the allowance and less than 1 percent had diets low in this
vitamin.
Only occasionally were there signs or symptoms indicative of
deficiencies of the B vitamins. A little more than 60 percent
of the diets of men met the recommendations for thiamine,
but only one man had less than one milligram of this vitamin
daily. Neary 86 percent of the women had the recommended
intake of thiamine and only 3 percent had less than 0.8 milli-
gram. The daily recommended allowance of riboflavin was
met in the diets of 68 percent of the men and 71 percent of the
women, while the allowance of niacin was met in the diets of
55 percent of the men and 71 percent of the women.
The average daily intake of protein of 65 and 55 grams by
men and women, respectively, met the recommendations. More-
over, the diets of 80 percent of the men and 70 percent of the
women were as much as or more than recommended. Six
percent of the men and 20 percent of the women had less than
50 grams of protein. For the most part these low-protein diets
were prescribed as indicated in cases of nephritis and hyper-
tension.






Florida Agricultural Experiment Stations


The average daily intake of calcium for both men and women
was above the recommended amount and only 19 percent of the
men and 30 percent of the women had less than this amount.
It was surprising to find that the consumption of milk was
higher for men than for women. It was no doubt because of
this that only 7 percent of the men had less than 0.7 gm. of
calcium while 30 percent of the women were in this class.
Although the best sources of dietary iron are foods high in
animal protein, in this study it was found that green leafy
vegetables and dried and fresh legumes contributed a signifi-
cant part of the iron which was obviously utilized. Men usually
consumed more foods high in iron than women. For this rea-
son the average daily iron intake of men met the allowance,
while that of the women did not. Nearly 60 percent of the
men and 46 percent of the women had an average daily intake
of 12 or more milligrams of iron, and 15 percent of the men
and 18 percent of the women had less than 10 milligrams of
iron daily.
There was little relationship between blood levels of hemo-
globin and dietary levels of iron. In a well-nourished individ-
ual, increases in the intake of iron had no effect upon hemoglobin
values, which were already within the normal range. There-
fore no correlation would be expected.
High intakes of iron occasionally were found in subjects whose
hemoglobin values ranged from subnormal to anemic. On the
other hand, some subjects with low iron intakes had high hemo-
globin values. Three subjects with intakes of 16, 16 and 25
mgs. of iron had hemoglobin values of 9.8, 11.3 and 12.1 grams.
Four other cases with an estimated daily intake of 6 mgs. of
iron had hemoglobin values of 13.5, 14.5, 15.2 and 16 grams.
In this low-intake group there was the possibility of iron econ-
omy, whereby high hemoglobin values could be maintained on a
low intake of iron. Perhaps a more plausible explanation would
be that in the estimation of iron in the various foods, certain
discrepancies occurred, such as omissions of food items, varia-
tion in size of servings and in methods of preparation.
The favorable response of subjects with high intakes of iron
to hematinic treatment indicated that their low hemoglobin
values probably were due to faulty absorption, impaired utiliza-
tion or to other causes and not to age. It was evident that,
whatever the causes, the hemoglobin values or erythrocyte
counts or both had improved under the treatment. Later it was






Dietary and Hematologic Studies of the Aged


found that the one subject who showed no improvement had
been subjected to intense X-ray therapy previously. This ther-
apy probably damaged the bone marrow, thereby reducing hema-
topoiesis.
The adequacy of the dietary regimen of the groups reported
herein is reflected in their hematologic values and in the mental
and physical health which is continuing into old age. Whether
these hematologic values can be considered as a norm or stand-
ard for the aged is offered for deliberation. A review of the
literature on normal hemoglobin values shows wide variations.
Such values for men vary from 13 to 18 gms. per 100 ml. of
blood; and for women from 11 to 15 gms. For clinical pur-
poses the normal ranges for men are 12 to 17 gms.; for women,
11 to 15 gms. (7). The average values reported in the present
study are well within these ranges and it appears that hema-
tologic standards based on younger groups are applicable to
this group of elderly people.

SUMMARY AND CONCLUSIONS
Results of a study of dietary practices of men and women 60
to 91 years of age in relation to their hematologic values are
presented.
Dietary intakes are expressed in terms of calories and eight
essential nutrients; hematologic values in terms of hemoglobin,
total erythrocytes, total and differential leucocyte counts.
With the exception of a 20 percent lower caloric intake by
men, the average consumption of the eight essential nutrients ap-
proached closely or exceeded the Recommended Daily Allow-
ances of the Food and Nutrition Board of the National Research
Council for men and women 65 years of age.
The mean hemoglobin values of both men and women in the
three age groups were within the normal range. Comparison
of these values ("t" test) showed no significant differences due
to age.
No significant differences in total erythrocytes, total leuco-
cytes or differential leucocyte counts due to either sex or age
were noted.
There was little relationship between hemoglobin levels and
dietary levels of iron. Increases in iron had little effect upon
hemoglobin values already in the normal range. High intakes
of iron occasionally occurred in subjects whose hemoglobin







Florida Agricultural Experiment Stations


values ranged from subnormal to anemic and the reverse was
also found.
The response of individuals with low hemoglobin values, low
erythrocytes or both to hematinic treatment showed that these
low values were probably due to faulty absorption, impaired
utilization or to some other factor or factors and not due to
aging.
The adequacy of the dietary regimen of this group of elderly
people is reflected by normal hematologic values and good mental
and physical health which is continuing into old age.

LITERATURE CITED

1. ALBANESE, A. A., R. A. HIGGONS, B. VESTAL, L. STEPHANSON and M.
MALSCH. Protein requirements of old age. Geriat. 7: 109-116. 1952.
2. ALESSANDRINI, P. The diet in old age. Paper presented 2nd Int.
Geront. Congress, St. Louis, Mo. 1951. Abst. Jour. Geront. 6: 55.
1951.
3. BORTZ, E. L. Nutritional deficiencies and premature aging. Paper pre-
sented 2nd Int. Geront. Congress, St. Louis, Mo. 1951. Abst. Jour.
Geront. 6: 64. 1951.
4. BURKER, K. Total hemoglobin, body surface and basal metabolism of
the aged. Z. Altersforsch. 4: 65-8. 1942.
5. Food and Nutrition Board. Recommended dietary allowances. Rev.
1953. National Academy of Sciences-National Research Council,
Washington, D. C. Pub. 302. 1953.
6. FOWLER, WILLIS M., R. L. STEPHENS and R. B. STUMP. The changes in
hematological values in elderly patients. Amer. Jour. Clin. Path.
11:700-5. 1941.
7. HEPLER, OPAL E. Manual of Clinical Laboratory Methods. 4th Ed.
Rev. 3rd printing. Charles C. Thomas, Springfield, Ill. Chapter
on Hematology, Pages 33-55. 1951.
8. MIYER, JACOB, H. SORTER and H. NECHELES. Studies on old age. VI.
Blood enzymes in the aged. Amer. Jour. Digest. Dis. 9: 160-2.
1942.
9. MILLER, ISADORE. Normal hematologic standards in the aged. Jour.
Lab. Clin. Med. 24: 1172-76. 1939.
10. NEWMAN, BERNARD, and SAMUEL GITLOW. Blood studies in the aged.
The erythrocyte in the aged male and female. Amer. Jour. Med.
Sci. 205: 677-87. 1943.
11. OLBRICH, OSCAR. Blood changes in the aged. Edinburgh Med. Jour.
54: 306-21. 1947.
12. OLBRICH, OSCAR. Blood changes in the aged. 11. Fragility. Edin-
burgh Med. Jour. 54: 649-56. 1947.
13. ROBERTS, HARRIET P., CHARLOTTE H. KERR and MARGARET OHLSON. Nu-
tritional status of elderly women. Jour. Amer. Diet. Assn. 24: 292-
99. 1948.




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