A recent study found that social isolation and loneliness are associated with lower intakes of essential micronutrients in older adults, raising concerns about their impact on healthy aging and the need for targeted nutritional interventions.
Study: Social isolation, loneliness and low dietary micronutrient intake among older people in England. Image credits: De Visu / Shutterstock.com
A recent one Age and aging study determines whether social isolation and loneliness are associated with lower micronutrient intake.
Micronutrient intake in older adults
Micronutrients are essential for multiple biological functions; therefore, their deficiency can affect the health of individuals of all age groups. For example, potassium, magnesium, calcium and vitamin D play an important role in bone health.
Vitamin E, B and folate deficiencies have been associated with an increased risk of cognitive decline and cardiovascular events. Likewise, inadequate iron intake can negatively impact physical capabilities.
An adequate dietary intake of micronutrients is essential for healthy aging. However, multiple cross-sectional and longitudinal studies conducted in high-income countries have found that older adults, regardless of gender, have significant dietary micronutrient deficiencies, particularly iron in those aged 65 years and older, as well as folic acid, vitamin B6 , C and E, calcium and magnesium.
It is critical to identify the different factors that influence dietary micronutrient deficiencies in older populations. Previous studies have shown that lower socioeconomic status, depressed mood, aging, social isolation and loneliness increase the risk of dietary micronutrient deficiencies.
Social isolation is often associated with limited community activities, living alone and infrequent socialization. So many of these people are lonely because of the lack of companionship, which can lead to depression, cardiovascular disease, dementia, disability and death.
Several behavioral and lifestyle factors, including smoking, poor adherence to medical advice and physical inactivity, are associated with loneliness. A 2023 study also found that social isolation was consistently linked to poor fruit and vegetable intake.
About the study
The current study examines whether loneliness and social isolation are associated with micronutrient intake below recommended levels in people aged 50 and over. The contents of nine micronutrients were evaluated, including magnesium, calcium, potassium, folic acid and iron, as well as vitamins C, B6, B12 and E.
The English Longitudinal Study of Aging (ELSA) began in 2002 and included 12,099 men and women between the ages of 50 and 90. In Wave 8 of ELSA, which involved 3,771 individuals, data on measures against social isolation and loneliness were collected between 2016 and 2017.
Social isolation was measured using a scoring system ranging from zero to five, with higher scores indicating greater isolation. This index was also associated with unhealthy lifestyle, mortality and disability.
Loneliness was measured using a scoring system, with scores ranging from three to nine, the latter reflecting greater loneliness. The diet was assessed using a questionnaire covering more than 200 foods and drinks.
Wave 9 was conducted between 2018 and 2019 and focused on covariate factors including age, gender, smoking status, education, marital status and ethnicity, as well as nutritional assessments.
Findings of the study
A total of 2,024 women and 1,689 men with a mean age of 68 years were included in the current study, most of whom were white, with a mean age of completing their education was 16.8 years. Approximately 28% of the study cohort continued their education beyond the age of 19.
About 6% of study participants smoked, while 17.2% reported reduced activities of daily living. The average daily calorie intake of the participants was 2,009 kilocalories (kcal).
Social isolation and loneliness were weakly correlated. After adjustment for age and gender, total energy intake was not associated with social isolation, but weakly negatively associated with loneliness.
Most study participants did not meet recommended micronutrient levels. In addition, a limited number of participants used nutritional supplements: 4.2% and 13.7% took iron and vitamin C supplements, respectively.
Social isolation was associated with an increased risk of low consumption of five of nine micronutrients, including vitamin B6, folic acid, magnesium, vitamin C and potassium. A marginal association was found between social isolation and iron intake.
Basic models adjusted for age, gender and total energy revealed that loneliness was associated with intake of folic acid, magnesium, iron, potassium, vitamin C and vitamin E. However, none of these associations were observed after adjusting for physical activity education, ethnicity , marital status and smoking. Subgroup analysis revealed an association between loneliness and vitamin C intake in the fully adjusted model in younger study participants.
Food insecurity and difficulty reaching stores to purchase healthy food due to mobility problems were not associated with dietary micronutrient deficiencies in older adults.
Conclusions
Current research shows that the older population in England consumes dietary micronutrients in amounts lower than recommended levels.
Social isolation also increased the risk of consuming low levels of magnesium, folic acid, potassium and vitamins B6 and C. Marital status, smoking, education level and physical activity only contributed to micronutrient deficiencies when included as covariates.
Taken together, these findings highlight the need for targeted nutrition strategies for men and women with minimal social contact and limited involvement in community-based social activities.
Magazine reference:
- Steptoe, A., Fong, HL, & Lassale, C. (2024) Social isolation, loneliness and low dietary micronutrient intake among older people in England. Age and aging 53(10). doi:10.1093/aging/afae223