Gastrointestinal discomforts and dietary intake in Chinese urban elders: A cross-sectional study in eight cities of China

doi:10.3748/wjg.v25.i45.6681

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World Journal of Gastroenterology

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World J Gastroenterol. Dec 7, 2019; 25(45): 6681-6692
Published online Dec 7, 2019. doi: 10.3748/wjg.v25.i45.6681

Table 1 Gastrointestinal symptom rating scale scores among Chinese urban elders with different socio-demographic characteristics (mean ± SD)

Socio-demographic characteristic		n	Dyspep-sia	P value	Diarrh-ea	P value	Abdomi-nal pain	P value	Reflux	P value	Constip-ation	P value	Total	P value
Gender	Male	288	5.5 ± 1.6	0.110	3.4 ± 0.8	0.012	3.4 ± 0.7	< 0.001	2.6 ± 0.9	0.002	3.5 ± 0.9	0.041	18.4 ± 2.9	< 0.001
Gender	Female	400	5.7 ± 1.6	0.110	3.6 ± 0.9	0.012	3.7 ± 1.0	< 0.001	2.9 ± 1.1	0.002	3.7 ± 1.1	0.041	19.5 ± 3.8	< 0.001
Educ-ation	Junior high school or below	390	5.7 ± 1.7	0.040	3.5 ± 0.9	0.511	3.6 ± 0.7	0.046	2.9 ± 1.4	0.009	3.7 ± 1.1	0.162	19.4 ± 3.7	0.014
	Senior high school	225	5.4 ± 1.5		3.6 ± 0.9		3.5 ± 0.9		2.6 ± 0.9		3.5 ± 0.9		18.6 ± 3.1
	Bachelor or above	70	5.5 ± 1.5		3.6 ± 0.8		3.5 ± 0.8		2.6 ± 0.9		3.5 ± 0.8		18.7 ± 3.1
Family month-ly income	< 5000 rmb	360	5.8 ± 1.7	0.007	3.5 ± 0.9	0.754	3.6 ± 0.9	0.486	2.8 ± 1.1	0.134	3.7 ± 1.1	0.039	19.4 ± 3.7	0.007
	5000–8000 rmb	138	5.3 ± 1.5		3.5 ± 0.9		3.5 ± 0.8		2.6 ± 0.9		3.5 ± 0.9		18.4 ± 3.1
	> 8000 rmb	189	5.5 ± 1.5		3.5 ± 0.8		3.6 ± 1.0		2.7 ± 0.9		3.5 ± 0.8		18.8 ± 3.1
City level	First-tier cities	240	5.6 ± 1.5	0.778	3.6 ± 0.9	0.287	3.6 ± 0.9	0.877	2.7 ± 0.9	0.563	3.5 ± 0.9	0.236	19.0 ± 3.2	0.183
City level	Non first tier cities	448	5.6 ± 1.6	0.778	3.5 ± 0.9	0.287	3.6 ± 0.9	0.877	2.8 ± 1.1	0.563	3.1 ± 1.1	0.236	19.1 ± 3.6	0.183

Table 2 Gastrointestinal symptom rating scale scores among Chinese urban elders with different health status (mean ± SD)

		n	Dyspep-sia	P value	Diarrh-ea	P value	Abdomi-nal pain	P value	Reflux	P value	Constip-ation	P value	Total	P value
BMI	< 18.5	14	5.9 ± 1.7	0.332	4.0 ± 1.2	0.093	4.0 ± 1.1	0.058	2.9 ± 1.2	0.479	3.8 ± 1.1	0.055	20.6 ± 4.4	0.136
	18.5-23.9	344	5.7 ± 1.3		3.5 ± 0.8		3.6 ± 0.9		2.7 ± 1.0		3.7 ± 1.0		19.2 ± 3.4
	≥ 24	324	5.5 ± 1.6		3.5 ± 0.9		3.5 ± 0.8		2.8 ± 1.1		3.5 ± 1.0		18.9 ± 3.6
GI related diseas-es¹	No	540	5.6 ± 1.6	0.482	3.5 ± 0.9	0.089	3.5 ± 0.9	0.230	2.8 ± 1.0	0.018	3.6 ± 1.0	0.022	19.0 ± 3.5	0.189
GI related diseas-es¹	Yes	148	5.8 ± 1.6		3.6 ± 0.9		3.6 ± 0.9		2.6 ± 0.8		3.8 ± 1.1		19.4 ± 3.2
Hypert-ension	No	403	5.6 ± 1.6	0.206	5.6 ± 1.6	0.836	3.5 ± 0.9	0.393	2.7 ± 1.0	0.043	3.6 ± 1.0	0.057	19.0 ± 3.4	0.534
Hypert-ension	Yes	284	5.6 ± 1.7		5.6 ± 1.7		3.6 ±1.0		2.8 ± 1.0		3.6 ± 1.0		19.1 ± 3.6
Diabet-es	No	568	5.6 ± 1.6	0.908	5.6 ± 1.6	0.623	3.6 ± 0.9	0.496	2.8 ± 1.0	0.639	3.6 ± 1.0	0.020	19.0 ± 3.6	0.594
	Yes	119	5.5 ± 1.4		5.5 ± 1.4		3.6 ± 0.9		2.7 ± 0.9		3.8 ± 1.1		19.2 ± 2.9
Dyslipi-demia	No	501	5.5 ± 1.5	0.503	5.5 ± 1.5	0.019	3.5 ± 0.9	0.006	2.7 ± 1.0	0.046	3.6 ± 1.0	0.439	18.8 ± 3.4	< 0.001
Dyslipi-demia	Yes	186	5.9 ± 1.7		5.9 ± 1.7		3.7 ± 1.0		2.9 ± 1.0		3.7 ± 1.1		19.8 ± 3.6

¹Gastrointestinal related diseases included gastritis, gallbladder polyp, and fatty liver. GI: Gastrointestinal; BMI: Body mass index.

Table 3 Factor loading of three food patterns among Chinese urban elders with different gastrointestinal symptom rating scale scores (n = 688)

Food pattern¹		GSRS score²			P value
Food pattern¹		≤ 17	18-20	≥ 21	P value
Pattern 1	Median (25^th, 75^th)	0.0. (-0.32, 0.80)	0.34 (-0.30, 0.83)	0.36 (-0.29, 0.84)	0.200
Pattern 1	Adjusted OR (95%CI)³	Ref.	0.09 (-0.10, 0.27)	0.07 (-0.03, 0.16)
Pattern 2	Median (25^th, 75^th)	-0.10 (-0.70, 0.45)	-0.02 (-0.47, 0.44)	-0.18 (-0.75, 0.56)	0.412
Pattern 2	Adjusted OR (95%CI)³	Ref.	0.05 (-0.13, 0.23)	-0.01 (-0.10, 0.08)
Pattern 3	Median (25^th, 75^th)	0.14 (-0.54, 0.65)	-0.07 (-0.62, 0.57)	0.24 (-0.62, 0.81)	0.199
Pattern 3	Adjusted OR (95%CI)³	Ref.	0.08 (-0.10, 0.25)	0.07 (-0.02, 0.16)

¹The first food pattern was characterized by high intake of salt and tea; the second pattern was characterized by more frequent intake of tubers, fruits, aquatic products, and soybean and nuts; the last pattern was associated with high intake of cereal, vegetables, and meat.

²The total GSRS score was divided into three groups according to the tertiles.

³The linear regression was performed and adjusted for gender, education level, and family income. GSRS: Gastrointestinal symptom rating scale; OR: Odds ratio; CI: Confidence interval.

Table 4 Dietary intake amount among Chinese urban elders with different gastrointestinal symptom rating scale scores (n = 688)

Food category		GSRS score¹			P value
Food category		≤ 17	18-20	≥ 21	P value
Cereal	Median (25^th, 75^th) (g/d)	300.0 (200.0, 420.0)	300.0 (200.0, 371.3)	300.0 (180.0, 330.0)	0.159
Cereal	Adjusted OR (95%CI)²	Ref.	1.4 (-34.8, 37.5)	-7.4 (-24.6, 9.8)
Tubers	Median (25^th, 75^th) (g/d)	21.5 (7.2, 42.9)	21.5 (4.5, 48.2)	20.0 (5.0, 42.9)	0.889
Tubers	Adjusted OR (95%CI)²	Ref.	4.5 (-8.0, 16.9)	0.0 (-6.0, 6.1)
Vegetables	Median (25^th, 75^th) (g/d)	300.0 (200.0, 500.0)	300.0 (165.0, 500.0)	300.0 (150.0, 490.0)	0.327
Vegetables	Adjusted OR (95%CI)²	Ref.	-20.7 (-77.2, 35.8)	-21.4 (-48.2, 5.4)
Fruits	Median (25^th, 75^th) (g/d)	100.0 (50.0, 200.0)	150.0 (50.0, 200.0)	100.0 (42.9, 200.0)	0.108
Fruits	Adjusted OR (95%CI)²	Ref.	15.6 (-13.7, 44.9)	-5.0 (-12.1, 2.0)
Meat	Median (25^th, 75^th) (g/d)	50.0 (21.5, 100.0)	42.9 (14.3, 100.0)	40.0 (10.0, 100.0)	0.002
Meat	Adjusted OR (95%CI)²	Ref.	-11.9 (-24.9, 1.0)	-5.0 (-12.1, 2.0)
Aquatic products	Median (25^th, 75^th) (g/d)	0.0 (0.0, 20.0)	0.0 (0.0, 28.2)	0.0 (0.0, 15.3)	0.764
Aquatic products	Adjusted OR (95%CI)²	Ref.	0.2 (-9.8, 10.3)	-3.5 (-7.8, 0.8)
Eggs	Median (25^th, 75^th) (g/d)	50.0 (25.7, 60.0)	50.0 (21.5, 60.0)	50.0 (21.5, 60.0)	0.953
Eggs	Adjusted OR (95%CI)²	Ref.	-0.5 (-7.9, 6.8)	1.5 (-2.8, 5.8)
Bean products	Median (25^th, 75^th) (g/d)	25.0 (7.2, 64.4)	22.9 (6.7, 50.0)	14.3 (5.7, 42.9)	0.077
Bean products	Adjusted OR (95%CI)²	Ref.	-14.3 (-27.3, -1.2)	-7.2 (-14.3, -0.3)
Dairy products	Median (25^th, 75^th) (mL/d)	85.8 (0.0, 250.0)	35.8 (0.0, 203.8)	71.5 (0.0, 230.0)	0.303
Dairy products	Adjusted OR (95%CI)²	Ref.	-24.8 (-50.4, 0.8)	-8.2 (-20.8, 4.4)
Nuts	Median (25^th, 75^th)(g/d)	5.7 (0.0, 20.0)	5.2 (0.0, 20.0)	10.0 (0.8, 25.4)	0.087
Nuts	Adjusted OR (95%CI)²	Ref.	0.5 (-4.5, 5.5)	3.6 (0.2, 7.1)
Oil	Median (25^th, 75^th) (g/d)	24.0 (10.0, 40.0)	24.0 (10.0, 35.5)	24.0 (15.0, 33.5)	0.575
Oil	Adjusted OR (95%CI)²	Ref.	-2.9 (-7.6, 1.3)	-0.6 (-2.8, 1.5)
Salt	Median (25^th, 75^th) (g/d)	8.0 (6.0, 12.0)	9.0 (6.0, 15.0)	9.0 (6.0, 15.0)	0.318
Salt	Adjusted OR (95%CI)²	Ref.	0.2 (-1.9, 2.2)	0.2 (-0.8, 1.2)
Tea	Median (25^th, 75^th) (mL/d)	8.3 (0.0, 420.0)	0.0 (0.0, 200.0)	6.7 (0.0, 250.0)	0.384
Tea	Adjusted OR (95%CI)²	Ref.	-251.7 (-564.8, 61.5)	-102.2 (-257.5, 53.0)
Alcohol drinks	Median (25^th, 75^th) (mL/d)	0.0 (0.0, 0.0)	0.0 (0.0, 0.0)	0.0 (0.0, 0.0)	0.324
Alcohol drinks	Adjusted OR (95%CI)²	Ref.	5.2 (-10.7, 21.1)	-0.5 (-7.8, 6.8)

¹The total gastrointestinal symptom rating scale score was divided into three groups according to the tertiles.

²The linear regression was performed and adjusted for gender, education level, and family income. GSRS: Gastrointestinal symptom rating scale; OR: Odds ratio; CI: Confidence interval.

Table 5 Energy and nutrients intake among Chinese urban elders with different gastrointestinal symptom rating scale scores (n = 688)

Nutrient		GSRS score¹			P value
Nutrient		≤ 17	18-20	≥ 21	P value
Energy	Median (25^th, 75^th) (kcal/d)	1576.0 (1196.3, 1966.7)	1403.9 (1131.1, 1925.4)	1454.7 (1093.4, 1964.1)	0.156
Energy	Adjusted OR (95%CI)²	Ref.	-42.5 (-167.2, 82.2)	-15.2 (-78.7, 48.3)
Protein	Median (25^th, 75^th) (g/d)	51.4 (39.2, 67.7)	46.4 (33.0, 68.1)	47.3 (33.3, 64.4)	0.113
Protein	Adjusted OR (95%CI)²	Ref.	-1.1 (-6.4, 4.2)	-0.9 (-3.5, 1.7)
Fat	Median (25^th, 75^th) (g/d)	49.9 (36.7, 74.0)	48.0 (34.1, 64.6)	47.3 (33.6, 69.5)	0.183
Fat	Adjusted OR (95%CI)²	Ref.	-4.3 (-9.9, 1.4)	-1.6 (-4.6, 1.3)
Carbonhydrate	Median (25^th, 75^th) (g/d)	212.8 (159.9, 284.5)	208.7 (152.0, 279.3)	197.8 (140.0, 291.3)	0.341
Carbonhydrate	Adjusted OR (95%CI)²	Ref.	0.8 (-20.7, 22.3)	-0.7 (-11.9, 10.5)
Fiber	Median (25^th, 75^th) (g/d)	8.7 (6.4, 13.2)	8.7 (6.0, 13.9)	8.4 (5.5, 12.6)	0.245
Fiber	Adjusted OR (95%CI)²	Ref.	0.5 (-1.4, 2.4)	-0.2 (-1.1, 0.7)
Vitamin B1	Median (25^th, 75^th) (mg/d)	0.8 (0.6, 1.1)	0.8 (0.5, 1.1)	0.8 (0.5, 1.2)	0.849
Vitamin B1	Adjusted OR (95%CI)²	Ref.	-0.3 (-1.2, 0.6)	0.1 (-0.5, 0.7)
Vitamin B2	Median (25^th, 75^th) (mg/d)	0.7 (0.5, 1.1)	0.8 (0.5, 1.1)	0.7 (0.4, 1.1)	0.689
Vitamin B2	Adjusted OR (95%CI)²	Ref.	-0.2 (-1.1, 0.7)	0.1 (-0.5, 0.7)
Niacin	Median (25^th, 75^th) (mg/d)	10.4 (7.7, 14.5)	10.3 (7.4, 15.5)	10.0 (6.8, 14.6)	0.291
Niacin	Adjusted OR (95%CI)²	Ref.	-0.3 (-2.0, 1.5)	-0.1 (-1.1, 0.9)
Vitamin B6	Median (25^th, 75^th) (mg/d)	0.5 (0.3, 0.7)	0.5 (0.3, 0.8)	0.5 (0.3, 0.7)	0.195
Vitamin B6	Adjusted OR (95%CI)²	Ref.	0.0 (-0.1, 0.1)	-0.0 (-0.1, 0.1)
Vitamin C	Median (25^th, 75^th) (mg/d)	61.5 (32.0, 108.0)	64.5 (33.9, 110.7)	57.9(25.2, 95.6)	0.380
Vitamin C	Adjusted OR (95%CI)²	Ref.	23.0 (-33.5, 79.5)	-4.7 (-13.9, 4.6)
Vitamin A	Median (25^th, 75^th) (μg/d)	229.2 (130.9, 360.9)	232.1 (102.9, 377.9)	196.7 (94.8, 355.4)	0.228
Vitamin A	Adjusted OR (95%CI)²	Ref.	-153.2 (-416.7, 110.3)	-93.0 (-222.7, 36.7)
Vitamin E	Median (25^th, 75^th) (mg/d)	20.6 (13.1, 32.0)	19.2 (13.1, 31.5)	20.2 (12.6, 32.5)	0.825
Vitamin E	Adjusted OR (95%CI)²	Ref.	-0.6 (-4.1, 2.9)	0.5 (-1.5, 2.5)
Calcium	Median (25^th, 75^th) (mg /d)	361.8 (212.6, 396.1)	339.7 (192.6, 571.0)	376.8 (211.5, 608.6)	0.440
Calcium	Adjusted OR (95%CI)²	Ref.	-30.3 (-99.7, 39.2)	18.2 (-23.3, 59.7)
Phosphorus	Median (25^th, 75^th) (mg/d)	807.4 (626.6, 122.5)	739.5 (575.9, 1037.9)	753.1 (555.3, 1015.3)	0.179
Phosphorus	Adjusted OR (95%CI)²	Ref.	-9.5 (-86.3, 67.3)	-9.5 (-47.6, 28.6)
Potassium	Median (25^th, 75^th) (mg/d)	1429.7 (1045.8, 1906.6)	1349.8 (982.0, 1942.8)	1262.4 (985.9, 1745.3)	0.070
Potassium	Adjusted OR (95%CI)²	Ref.	53.9 (-119.4, 227.2)	-47.1 (-123.5, 29.2)
Sodium	Median (25^th, 75^th) (mg/d)	3833.3 (2650.7, 5167.8)	4022.7 (2664.9, 5168.9)	3859.7 (2834.8, 5101.9)	0.874
Sodium	Adjusted OR (95%CI)²	Ref.	-441.2 (-1237.1, 354.7)	-251.0 (-643.4, 141.4)
Magnesium	Median (25^th,75^th) (mg/d)	229.0 (180.2, 329.2)	224.5 (155.6, 313.8)	226.8 (160.2, 325.5)	0.442
Magnesium	Adjusted OR (95%CI)²	Ref.	23.8 (-14.1, 61.7)	0.8 (-12.4, 14.0)
Iron	Median (25^th, 75^th) (mg/d)	16.8 (12.8, 22.1)	15.5 (11.4, 22.4)	15.5 (11.8, 22.4)	0.195
Iron	Adjusted OR (95%CI)²	Ref.	1.5 (-3.0, 6.0)	0.4 (-1.1, 1.8)
Zinc	Median (25^th, 75^th) (mg/d)	8.8 (6.7, 11.4)	8.3 (6.0, 11.4)	8.2 (6.2, 11.2)	0.440
Zinc	Adjusted OR (95%CI)²	Ref.	6.3 (-4.6, 17.1)	0.0 (-0.6, 0.6)
Selenium	Median (25^th, 75^th) (μg/d)	34.4 (22.4, 47.1)	30.6 (20.4, 48.5)	31.5 (22.2, 46.3)	0.482
Selenium	Adjusted OR (95%CI)²	Ref.	4.7 (-14.1, 23.6)	0.9 (-5.3, 7.0)
Copper	Median (25^th, 75^th) (mg/d)	1.5 (1.1, 2.2)	1.5 (1.1, 2.2)	1.4 (1.0, 2.1)	0.512
Copper	Adjusted OR (95%CI)²	Ref.	0.3 (-0.1, 0.6)	-0.0 (-0.1, 0.1)
Manganese	Median (25^th, 75^th) (mg/d)	4.6 (3.4, 6.3)	4.4 (0.3, 6.6)	4.3 (2.8, 6.3)	0.201
Manganese	Adjusted OR (95%CI)²	Ref.	0.7 (-0.9, 2.3)	-0.0 (-0.3, 0.3)

¹The total gastrointestinal symptom rating scale score was divided into three groups according to the tertiles.

²The linear regression was performed and adjusted for gender, education level, and family income. GSRS: Gastrointestinal symptom rating scale; OR: Odds ratio; CI: Confidence interval.

Citation: Zhao A, Wang MC, Szeto IMY, Meng LP, Wang Y, Li T, Zhang YM. Gastrointestinal discomforts and dietary intake in Chinese urban elders: A cross-sectional study in eight cities of China. World J Gastroenterol 2019; 25(45): 6681-6692
URL: https://www.wjgnet.com/1007-9327/full/v25/i45/6681.htm
DOI: https://dx.doi.org/10.3748/wjg.v25.i45.6681