Food insecurity and malnutrition in older adults from the Family Health Strategy in the Northeast of Brazil

doi:10.37527/2022.72.4.005

Authors

Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil. Center of Biological and Health Science – Federal University of the Western of Bahia, Barreiras, Bahia, Brazil. https://orcid.org/0000-0002-5193-3172
Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil. Center of Biological and Health Science – Federal University of the Western of Bahia, Barreiras, Bahia, Brazil. https://orcid.org/0000-0003-2281-8877
Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil. Center of Biological and Health Science – Federal University of the Western of Bahia, Barreiras, Bahia, Brazil. https://orcid.org/0000-0001-8518-5216
Department of Nutrition, School of Public Health – University of São Paulo, São Paulo, Brazil. https://orcid.org/0000-0002-8129-5116
Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil. https://orcid.org/0000-0002-1358-3503
Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil. Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil. https://orcid.org/0000-0002-8614-988X

DOI:

https://doi.org/10.37527/2022.72.4.005

Keywords:

Older Adults, Food Insecurity, Nutritional Status, Malnutrition, Family Health

Abstract

Introduction: Food insecurity (FI) is a state characterized by instability and irregularity of access to food. This condition has negative impacts on dietary intake, affecting nutritional status and health condition. Objective: To evaluate the association between malnutrition and FI among communitydwelling older adults attended to under the Family Health Strategy (FHS). Materials and methods: This is a cross-sectional study conducted using communitydwelling older adults attended to under the FHS in the municipality of Barreiras, in Bahia, Brazil. Between 2017 e 2018, we collected demographic, social, economic, health condition, lifestyle, anthropometric, and food consumption data. We evaluated nutritional status using the Mini Nutritional Assessment (MNA) and we assessed FI with the Brazilian Food Insecurity Scale (EBIA). Besides the chi-squared test, we carried out a binary logistic regression to verify the association between malnutrition and FI, adjusted for possible confounding factors. The significance level was p<0.05. Results: We evaluated 307 older adults with a mean age of 70.4 (±7.5 years). The prevalence of malnutrition/risk of malnutrition was 35.2% and that of FI was 63.5%. Households with older adults in moderate/severe FI presented almost three times more chance (OR 2.97; CI95% 1.37-6.44) of having malnutrition compared with those in food security. Conclusions: The study indicates that there is an association between household FI and malnutrition/risk of malnutrition among older adults from the FHS, especially among those in severe FI. This result attributes to FI the status of determinant of malnutrition in older adults within the context investigated.

Downloads

Download data is not yet available.

References

Inzitari M, Doets E, Bartali B, Benetou V, Di Bari M, et al. Nutrition in the age-related disablement process. J Nutr Health Aging. 2011;15(8):599–604. https://doi.org/10.1007/s12603-011-0053-1

Tavares EL, Santos DM dos, Ferreira AA, Menezes MFG de. Nutritional assessment for the elderly: modern challenges. Rev Bras Geriatr Gerontol. 2015;18:643–50. https://doi.org/10.1590/1809-9823.2015.14249

Peralta M, Ramos M, Lipert A, Martins J, Marques A. Prevalence and trends of overweight and obesity in older adults from 10 European countries from 2005 to 2013. Scand J Public Health. 2018;46(5):522–9. https://doi.org/10.1177/1403494818764810

Meza-Valderrama D, Marco E, Dávalos-Yerovi V, Muns MD, Tejero-Sánchez M, Duarte E, et al. Sarcopenia, Malnutrition, and Cachexia: Adapting Definitions and Terminology of Nutritional Disorders in Older People with Cancer. Nutrients. 2021;13(3):761. https://doi.org/10.3390/nu13030761

Corcoran C, Murphy C, Culligan EP, Walton J, Sleator RD. Malnutrition in the elderly. Sci Prog. 2019;102(2):171–80. doi: 10.1177/0036850419854290.

Simsek H, Meseri R, Sahin S, Ucku R. Prevalence of food insecurity and malnutrition, factors related to malnutrition in the elderly: A community-based, cross-sectional study from Turkey. Eur Geriatr Med. 2013;4(4):226–30. https://doi.org/10.1016/j.eurger.2013.06.001

Pereira MHQ, Pereira MLAS, Campos GC, Molina MCB. Food insecurity and nutritional status among older adults: a systematic review. Nutr Rev. 2022; 80(4):631-644 https://doi.org/10.1093/nutrit/nuab044

Norman K, Haß U, Pirlich M. Malnutrition in older adults—recent advances and remaining challenges. Nutrients. 2021; 13(8): 2764, 2021. https://doi.org/10.3390/nu13082764

Grammatikopoulou MG, Gkiouras K, Theodoridis X, Tsisimiri M, Markaki AG, Chourdakis M, et al. Food insecurity increases the risk of malnutrition among communitydwelling older adults. Maturitas. 2019;119:8–13. https://doi.org/10.1016/j.maturitas.2018.10.009

Leung CW, Wolfson JA. Food Insecurity Among Older Adults: 10‐Year National Trends and Associations with Diet Quality. J Am Geriatr Soc. 2021;69(4): 964-971. https://doi.org/10.1111/jgs.16971

Gkiouras K, Cheristanidis S, Papailia TD, Grammatikopoulou, MG, Karamitsios N, Goulis DG, Papamitsou T. Malnutrition and food insecurity might pose a double burden for older adults. Nutrients. 2020;12(8): 2407. https://doi.org/10.3390/nu12082407

Kandapan B, Pradhan I, Pradhan J. Food Insecurity and Malnutrition among Indian Older Adults: Findings from Longitudinal Ageing Study in India, 2017-18. J Popul Ageing. 2022;1-21. https://doi.org/10.1007/s12062-022-09378-2

Kwon S-O, Oh S-Y. Associations of Household Food Insecurity with Socioeconomic Measures, Health Status and Nutrient Intake in Low Income Elderly. Korean J Nutr. 2007;762–8.

Macinko J, Mendonça CS. The Family Health Strategy, a strong model of Primary Health Care that delivers results. Saúde debate. 2018; 42: 18-37. https://doi.org/10.1590/0103-11042018S102

Soratto J, Pires DEP, Dorneles S, Lorenzetti J. Family health strategy: a technological innovation in health. Texto Contexto Enferm. 2015; 24: 584-592. https://doi.org/10.1590/0104-07072015001572014

Lafortune C, Huson K, Santi S, Stolee P. Community-based primary health care for older adults: a qualitative study of the perceptions of clients, caregivers and health care providers. BMC Geriatr. 2015;15:57. https://doi.org/10.1186/s12877-015-0052-x

Kessler M, Thumé E, Marmot M, Macinko J, Facchini LA, Nedel FB, et al. Family Health Strategy, Primary Health Care, and Social Inequalities in Mortality Among Older Adults in Bagé, Southern Brazil. Am J Public Health. 2021;111(5):927. https://doi.org/10.2105/AJPH.2020.306146

Rosa TEC, Mondini L, Gubert MB, Sato GS, Benício MHD. Food security in households headed by elderly, Brazil. Rev Bras Geriatr Gerontol. 2012;15:69–77. https://doi.org/10.1590/S1809-98232012000100008

Vargas Puello V, Alvarado Orellana S, Atalah Samur E. Food insecurity among elderly people in 15 districts of the Great Santiago area; an unresolved issue. Nutr Hosp. 2013;28(5):1430–7. doi: 10.3305/nh.2013.28.5.6663

Legesse M, Abebe Z, Woldie H. Chronic energy deficiency and associated factors among older population in Ethiopia: A community based study. PLoS ONE. 2019;14(4):e0214861. https://doi.org/10.1371/journal.pone.0214861

Brazilian Institute of Geography and Statistics. Cities and states [Internet]. 2021 [2 nov 2021]. Available in: https://www.ibge.gov.br/cidadese-estados/ba/barreiras.html

Secretariat for Assessment and Information Management. Pessoas em situação de extrema pobreza inscritas no Cadastro Único [Internet]. 2021 [2 nov 2021]. Available in: https://aplicacoes.mds.gov.br/sagi/vis/data3/dataexplorer.php.

Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: The Mini Nutritional Assessment as part of the geriatric evaluation. Nutr Rev. 1996;54(1 Pt 2):S59-65.

Guigoz Y, Vellas B, Garry PJ. Mini nutritional assessment: a practical assessment tool for grading the nutritional state of elderly patients. The mini nutritional assessment: MNA. Nutrition in the elderly. 1997;15–60.

Guigoz Y. The Mini Nutritional Assessment (MNA) review of the literature--What does it tell us? J Nutr Health Aging. 2006;10(6):466–85; discussion 485-487. PMID: 17183419

Pereira DS, Oliveira ACS, Pereira MHQ, Pereira MLAS. Mini Avaliação Nutricional: Utilização e panorama nos diferentes cenários de atenção do idoso. Rev Saúde Com. 2017;13(1):824–32. http://dx.doi.org/10.22481/rsc.v13i1.426

Guigoz Y, Vellas B, Garry PJ. Mini Nutritional Assessment: a practical assessment tool for grading the nutritional state of elderly patients. Facts Res Gerontol. 1994;15–60.

Segall-Corrêa AM, Marin-Leon L. Food Security in Brazil: the proposal and application of the Brazilian Food Insecurity Scale from 2003 to 2009. Segurança Alimentar e Nutricional. 2009;16(2):1–19. https://doi.org/10.20396/san.v16i2.8634782

Morais DC, Lopes SO, Priore SE. Evaluation indicators of Food and Nutritional Insecurity and associated factors: systematic review. Cien Saude Colet. 2020; 25: 2687-2700. https://doi.org/10.1590/1413-81232020257.23672018

Sardinha LMV, Jannuzzi P dM, Cunha JVQ, Pinto AR. Escala Brasileira de Insegurança Alimentar – EBIA: análise psicométrica de uma dimensão da Segurança Alimentar e Nutricional. [Internet]. Brasil: Ministério do Desenvolvimento Social e Combate à Fome; 2014 p. 15. Report No.: 01/2014. Available in: https://aplicacoes.mds.gov.br/sagi/pesquisas/lista-s.php?tp=etec&stk=ano&id=73

Segall-Corrêa AM, Marin-León L, Melgar-Quiñonez H, Pérez-Escamilla R. Refinement of the Brazilian Household Food Insecurity Measurement Scale: Recommendation for a 14-item EBIA. Rev Nutr. 2014;27:241–51. https://doi.org/10.1590/1415-52732014000200010

Paradela EMP, Lourenço RA, Veras RP. Validation of geriatric depression scale in a general outpatient clinic. Rev Saúde Pública. 2005;(39);918-923. https://doi.org/10.1590/S0034-89102005000600008

Lameu EB, Gerude MF, Corrêa RC, Lima KA. Adductor policis muscle: a new anthropometric parameter. Rev Hosp Clin. 2004;59:57–62. https://doi.org/10.1590/S0041-87812004000200002

Gonçalves TJM, Horie LM, Bailer MC, Barbosa-Silva TG, Barrére APN, Barreto PA, et al. Diretriz BRASPEN de terapia nutricional do envelhecimento. BRASPEN Journal. 2019;34(2):68.

Fess EE. Grip strength. American Society of Hand Therapists; 1992.

Ganhão-Arranhado S, Paúl C, Ramalho R, Pereira P. Food insecurity, weight and nutritional status among older adults attending senior centres in Lisbon. Arch Gerontol Geriatr. 2018;78:81–8. https://doi.org/10.1016/j.archger.2018.06.004

Seibel R. Determinação da acurácia da utilização da circunferência do braço na Mini Avaliação Nutricional versão reduzida (MNA®-SF) para rastreio nutricional de idosos atendidos na Estratégia Saúde da Família. 2016 [4 nov 2021]; Available in: http://tede2.pucrs.br:80/tede2/handle/tede/7123

Cabral JF, Silva AMC, Mattos IE, Neves ÁQ, Luz LL, Ferreira DB, et al. Vulnerability and associated factors among older people using the Family Health Strategy. Ciênc Saúde Colet. 2019;24(9):3227–36. https://doi.org/10.1590/1413-81232018249.22962017

Cereda E, Pedrolli C, Klersy C, Bonardi C, Quarleri L, Cappello S, et al. Nutritional status in older persons according to healthcare setting: A systematic review and meta-analysis of prevalence data using MNA®. Clin Nutri. 2016;35(6):1282–90. https://doi.org/10.1016/j.clnu.2016.03.008

Marín-León L, Segal-Corrêa AM, Panigassi G, Maranha LK, Sampaio M de FA, Pérez-Escamilla R. Food insecurity perception in families with elderly in Campinas, São Paulo, Brazil. Cad Saude Publica. 2005;21(5):1433–40. https://doi.org/10.1590/S0102-311X2005000500016

Souza BFNJ, Marín-León L. Food insecurity among the elderly: cross-sectional study with soup kitchen users. Rev Nutr. 2013;26(6):679–91. https://doi.org/10.1590/S1415-52732013000600007

Brady PJ, Askelson NM, Ashida S, Nothwehr F, Janssen B, Frisvold D. The Relationship between Political, Economic, Social, and Cultural Vulnerability and Food Insecurity among Adults Aged 50 Years and Older. Nutrients. 2021;13(11):3896. https://doi.org/10.3390/nu13113896

Estrada-Restrepo A, Giraldo-Giraldo NA, Deossa-Restrepo GC. Inseguridad alimentaria en hogares donde habitan adultos mayores. Medellín, Colombia. Rev FacuL Nac de Salud Pública. 2022; 40(1) 2022. https://doi.org/10.17533/udea.rfnsp.e342583

Jih J, Stijacic-Cenzer I, Seligman HK, Boscardin WJ, Nguyen TT, Ritchie CS. Chronic disease burden predicts food insecurity among older adults. Public Health Nutr. 2018; 21(9):1737-1742. doi:10.1017/S1368980017004062

Zarei M, Qorbani M, Djalalinia S, Sulaiman N, Subashini T, Appanah G, et al. Food Insecurity and Dietary Intake Among Elderly Population: A Systematic Review. Int J Prev Med. 2021;12:8. doi: 10.4103/ijpvm.IJPVM_61_19

Palmeira PA, Bem-lignani J, Salles-costa R. Access to governmental programs/benefits and food insecurity in urban and rural areas of Northeast Brazil. Cien Saude Colet. 2022; 27:2583-2595. https://doi.org/10.1590/1413-81232022277.21592021EN

Lignani JB, Palmeira PA, Antunes MML, Salles-Costa R. Relationship between social indicators and food insecurity: a systematic review. Rev Bras de Epidemiol. 2020;23:e200068. https://doi.org/10.1590/1980-549720200068