Social isolation and loneliness linked to low micronutrient intake in older adults

A recent study reveals that social isolation and loneliness are linked to lower intake of essential micronutrients in older adults, raising concerns about their impact on healthy aging and the need for targeted dietary interventions.

Study: Social isolation, loneliness and low dietary micronutrient intake amongst older people in England. Image Credit: De Visu / Shutterstock.com

A recent Age and Ageing 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 important roles 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 affect physical capabilities.

Adequate dietary micronutrient intake is essential for healthy aging. However, multiple cross-sectional and longitudinal studies conducted in high-income countries have revealed that older adults, irrespective of gender, have considerable dietary micronutrient deficiencies, particularly iron in individuals 65 years of age and older, as well as folate, vitamins B6, C, and E, calcium, and magnesium.

It is crucial to identify the different factors that impact dietary micronutrient deficiencies in older populations. Previous studies have shown that lower socioeconomic status, depressed mood, advancing age, 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. Thus, many of these individuals are lonely due to the lack of companionship, which may lead to depression, coronary heart disease, dementia, disability, and mortality.

Several behavioral and lifestyle factors, including smoking, poor adherence to medical advice, and physical inactivity, are associated with loneliness. A 2023 review also revealed that social isolation is consistently linked with poor fruit and vegetable intake.

About the study

The current study investigates whether loneliness and social isolation are associated with micronutrient intake below recommended levels among people 50 years of age and older. Nine micronutrient contents were evaluated, including magnesium, calcium, potassium, folate, and iron, as well as vitamins C, B6, B12, and E.

The English Longitudinal Study of Ageing (ELSA) started in 2002 and comprised 12,099 men and women between 50 and 90 years of age. In Wave 8 of ELSA, which involved 3,771 individuals, data on social isolation and loneliness measures 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 lifestyles, mortality, and disability.

Loneliness was measured using a scoring system, with scores ranging from three to nine, the latter reflecting greater loneliness. Diet was assessed using a questionnaire that included over 200 food and beverage items.

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 nutrition assessments.

Study findings

A total of 2,024 women and 1,689 men with an average age of 68 years were included in the current study, most of whom were White, with a mean age of completing schooling being 16.8 years. Approximately 28% of the study cohort continued their education beyond 19 years of age.

About 6% of the study participants were smokers, whereas 17.2% reported impaired 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 adjusting for age and gender, total energy intake was not associated with social isolation and was weakly negatively associated with loneliness.

Most study participants did not meet the recommended micronutrient levels. Furthermore, a limited number of participants consumed dietary supplements, as 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 out of nine micronutrients, including vitamin B6, folate, magnesium, vitamin C, and potassium. A marginal association was identified between social isolation and iron intake.

Basic models that were adjusted for age, gender, and total energy revealed that loneliness was associated with folate, magnesium, iron, potassium, vitamin C, and vitamin E intake. However, none of these associations were observed following adjustment for physical activity education, ethnicity, marital status, and smoking. Sub-group analysis revealed an association between loneliness and vitamin C intake in the fully adjusted model in younger study participants.

Food insecurity and difficulty accessing stores to buy healthy food due to mobility issues were not associated with dietary micronutrient deficiency in older adults.

Conclusions

The current study indicated that the older population in England consumes dietary micronutrients in quantities lower than the recommended levels.

Social isolation also increased the risk of consuming low levels of magnesium, folate, potassium, and vitamins B6 and C. Marital status, smoking, educational attainment, and physical activity only contributed to micronutrient deficiency when they were included as covariates.

Taken together, these findings emphasize the need for targeted dietary strategies for men and women with minimal social contacts and limited involvement in community-based social activities.