Community and International Nutrition

In most industrialized countries the number of elderly people is increasing due to an improvement in health care and a reduction in birth rates during the past decades (WHO 1989). Population aging is not only occurring in industrialized countries, but also in developing countries. It is estimated that in the Southeast Asian region the proportion of individuals older than 60 y will increase from 5% in 1950 to 11.5% in 2050,`equivalent to a four-fold increase in absolute numbers (Gopalan 1992). The aging process is associated with physiological, psychological and socioeconomic changes leading to nutritional excess,

such as obesity, and deficit, such as micronutrient deficiency, and their related health outcomes, such as coronary atherosclerosis, diabetes mellitus, certain cancers and anemia. These changes and outcomes are evidenced from various studies of elderly people living in industrialized countries (de

Groot et al. 1991, Hartz et al. 1992, Kromhout et al. 1990, Wahlqvist et al. 1995a and b). So far, a limited number of studies have been undertaken to observe the nutritional status of the elderly living in developing countries.

The Western Pacific study (Andrews et al. 1986) described sociocultural factors, but not nutritional factors, of free-living, elderly people living in Fiji, the Republic of Korea, Malaysia and the Philippines. Recently, Wahlqvist et al. (1995a) reported the food habits, lifestyles and health status

among the aged in developed and developing countries. Elderly people living in developing countries have, up to a certain degree, an inadequate intake of micronutrients, such as vitamin A, thiamine, riboflavin and vitamin C (Wahlqvist et al. 1995b). However, for certain micronutrients, intakes are not reflected in plasma or serum levels. In free-living, middleto upper-class, US elderly, 24% of the men and 39% of the

women had vitamin B-12 intakes below three-fourth of the recommended dietary allowance (RDA)5; most of these people were able to maintain normal levels of serum vitamin B-12 despite the low intakes (Ahmed 1992). Little information is available about nutritional status of the elderly in Indonesia, but it is expected that inadequate food intake is common (Horwath 1989). This was confirmed by a recent study showing

a high prevalence of low body mass index (BMI) (Rabe et al. 1996) among elderly from Jakarta. A low food intake

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