Nutrient deficiencies further show a relationship between undernutrition and nutritional intake, supported by several studies.17-20 The undernourished had a lower intake of energy, protein, fat, fiber and water. In general, the linoleic acid intake was insufficient in 39% and fiber intake overall was insufficient in 59%. The micronutrient intake showed deficiencies in vitamin B6 (32%), vitamin C (18%), nicotinic acid (71%), sodium (61%) and iron (84%). Deficient intake of vitamins A, B1, B2 and B6 was related to the undernourished group;
nicotinic acid and vitamin C were deficient in the whole group. In the undernourished, low sodium intake was more pronounced and that was also seen to a minor extent in the whole group. Sodium, potassium, calcium and phosphate intake were deficient only in the undernourished. Interestingly, iron intake was not different between the undernourished and the well-nourished group, in keeping with the laboratory assessments. Iron intake did not correlate with serum hemoglobin, serum iron and vitamin C intake. Calcium intake and milk intake showed no correlation with serum iron level. Low use of antacids was not correlated with serum iron level. Despite iron supplementation, serum iron remained deficient. Anemia occurred in 9% and, low serum iron in 24%. Anemia was more common in the undernourished (83% vs. 50%) as was the use of iron medication (67% vs. 22%) and also medication for gastroesophageal reflux (25% versus 16%). The iron resorption was not influenced by low levels of vitamin C, or high levels calcium, milk or antacid intake. The more severe the anemia, the more reflux medication was given. It is suggested that the anemia and low iron level were more related to intestinal blood loss due to reflux esophagitis than to the nutritional variations.
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Gastroesophageal reflux disease is the medical term for what we know as acid reflux. Acid reflux occurs when the stomach releases its liquid back into the esophagus, causing inflammation and damage to the esophageal lining. The regurgitated acid most often consists of a few compoundsbr acid, bile, and pepsin.