the high prevalence of anemia in elderly people is usually associated with a decline in 
 activities of daily living and loss of motivation to go out . therefore , it is important for community health professionals to screen elderly people for 
 anemia and provide patients with appropriate treatment . because elderly people with anemia often do not show subjective signs of illness or display 
 symptoms that may be observed by a doctor another clue 
 suggesting possible anemia is decreased food intake causing protein - energy malnutrition 
 ( pem ) . a deeper 
 understanding of the eating patterns that contribute to anemia in elderly people may 
 encourage a more effective screening for anemia and ultimately lead to the development of 
 appropriate preventive and treatment strategies for this condition . however , whether the 
 presence of unhealthy eating habits is an effective indicator of anemia among older people 
 is still unclear . the aim of the present study was to explore this issue with elderly 
 japanese people by using a database from an observational study performed in a rural 
 area . we used data from the kyushu - asakura project ( kap ) , a prospective observational cohort 
 study of users who underwent an annual health check at a public clinic in asakura city 
 ( kyushu region , western japan ) . the subjects of the present study 
 were 150 users aged 75 years and older who underwent the checkup between january and 
 september 2010 . we abstracted information on past or present illness and lifestyle , 
 including eating habits , from the kap self - administered questionnaires . as for eating 
 habits , subjects were asked three yes or no questions :  are you normally careful not to 
 overeat ?   do you eat at regular times on a daily basis ?  and do you eat vegetables on a 
 daily basis ?  as for exercise habits , subjects were asked a single yes or no question :  do 
 you exercise regularly ?  eleven subjects whose data were missing were excluded from the present analysis . thus , we 
 finally analyzed a total of 150 subjects aged 75 years and older . the subjects were first 
 divided by gender and further separated into anemic and non - anemic subgroups according to 
 their estimated anemia prevalences : hb < 130 g / l for 
 females . for each category , we compared the subjects lifestyles including eating habits 
 between the anemic and non - anemic groups . a statistical analysis was performed using the 
 unpaired t - test for continuous data and the chi - square test for all other items . all statistical analyses were 
 performed on a personal computer using the statistical package for the social sciences 
 ( spss ) for windows ( ibm spss statistics for windows , version20.0 , ibm corp . , this study was carried out with the consent of the nagoya university school of 
 medicine ethics committee . the results of the study subjects are shown in tables 
 1 and 2table 1characteristics of the male subjects with and without anemia ( n=84)non - anemiaanemiap - valuen%n%6172.6 2327.4age ( yearsd)78.83.479.93.20.187body mass index ( sd)232.921.82.80.095exercising regularlyyes5143.61854.50.697avoiding salty foodyes4941.91648.50.348being careful not to overeatyes5849.62060.60.307eating at regular times on a daily 
 basisyes5647.91957.60.709eating vegetables on a daily basisyes5143.62060.60.821table 2characteristics of the female subjects with and without anemia ( n=66)non - anemiaanemiap - valuen%n%5684.81015.2age ( yearsd)78.53.077.62.80.408body mass index ( sd)22.33.023.73.30.108exercising regularlyyes4987.5770.00.069avoiding salty foodyes4783.9770.00.293being careful not to overeatyes5292.9990.00.582eating at regular times on a daily 
 basisyes5089.3990.00.779eating vegetables on a daily basisyes5496.4 990.0 0.369 . both among the women and the men aged 75 and over , there were no significant 
 differences in any items including eating habits between the two subgroups . because the number of samples and the study area were limited , we would need to conduct 
 further , larger - scale studies in order to generalize our results . however , we believe that 
 despite this limitation , our study results provide valuable data for community health - care 
 professionals and researchers . while some studies have suggested that eating habits are linked with anemia among younger 
 populations , our results suggest that this is not the case 
 among both male and female elderly people . slightly hypoplastic or dysplastic marrow , which is common among the elderly , may 
 contribute to senile anemia in older populations . this may be one of the reasons why eating habits were not 
 linked with anemia in our results . in addition , elderly people often develop anemia for 
 reasons other than poor eating habits ; this is referred to as unexplained anemia caused by 
 advanced age . the wide range 
 of causes of anemia among elderly people may explain why our results failed to indicate a 
 link between eating habits and anemia . moreover , a few of our subjects had pem , which contributes 
 to anemia . unexpectedly , there seemed to be little connection between eating habits and pem 
 among our subjects . in order to generalize our results , we would need to carry out 
 additional studies based on more detailed questionnaires focusing on food intake and 
 nutrition . we explored whether the presence of unhealthy eating habits is an effective indicator of 
 anemia among older people or not by using a database from an observational study performed 
 in a rural area . as a result , we found that the presence of unhealthy eating habits is not 
 an effective indicator of anemia among older people .
objective : the aim of the present study was to explore whether the presence 
 of unhealthy eating habits is an effective indicator of anemia among older people or 
 not.methods : we used data from a prospective observational cohort study of all 
 users who underwent an annual health checkup at a public clinic in a rural area . 
 the 
 subjects of the present study were 150 users aged 75 years and older who underwent the 
 checkup between january and september 2010 . 
 the subjects were first divided by gender and 
 further separated into anemic and non - anemic subgroups according to their estimated anemia 
 prevalences : hb < 130 
 g / l for males and hb < 120 
 g / l for females . for each category 
 , 
 we compared the subjects lifestyles including eating habits between the anemic and 
 non - anemic groups.results : both among the women and the men aged 75 and over , there were no 
 significant differences in any items including eating habits between the two anemic 
 subgroups.conclusion : our results suggest that the presence of unhealthy eating habits 
 is not an effective indicator of anemia among older people .