Food Security Status among U.S. Older Adults: Functional Limitations Matter

How to complement traditional instruments to measure the economic dimension of food security in older people? An application for regions of Argentina

Introduction: One of the dimensions of food security has to do with economic access to food. Aim: Propose a methodology that allows evaluating economic access to food in Argentina for the elderly population. Methods: Dietary guides for the Argentine population are used. Meanwhile, the food consumption patterns observed in the elderly population in Argentina are considered from a household expenditure survey, from which implicit food prices can also be obtained. Results: Six dietary plans corresponding to different regions of the country are designed and evaluated and it is found that they would be affordable only in two of the six regions analyzed. Conclusion: in the Metropolitan, Pampas, Cuyo, and Northeast regions the cost of the ideal basket is higher than food spending, fundamentally in the Northeast region where food spending should increase by 25%.

Prevalence and Correlates of Food Insecurity Among Older Adults in the United States

This study analyzed the 2021 National Health Interview Survey (NHIS) to assess food insecurity among adults aged 65 and older. Among 8,877 older adults, 4 percent (N=287) reported low or very low food security levels. Those who identified as Black or African American and Hispanic or Latino were more likely to experience food insecurity compared to White individuals. The study found that merely surpassing the poverty threshold might not be sufficient to protect against food insecurity. It also underscored socioemotional support's protective role in older adults' food security. Social workers must recognize various factors influencing food security among older adults.

Understanding the relationship between social risk factors and functional limitation among stroke survivors in the US

BACKGROUND

Stroke is the fifth leading cause of death and disability in the United States. Social risk factors contribute to recovery from stroke, however the relationship between social risk factors and functional limitation among stroke survivors remains unknown.

METHODS

Data on 2,888 adults with stroke from the National Health Interview Survey from 2016-2018 was analyzed. The primary independent variables included six social risk factors: economic instability, lack of community, educational deficit, food insecurity, social isolation, and inadequate access to care. The outcome measure was functional limitation count. Negative binomial regression models were run to test the relationship between the independent and dependent variables adjusting for covariates.

RESULTS

Overall, 56% of the study participants were aged 65+, 70% were Non-Hispanic White, and 95% had at least one comorbidity. The mean functional limitation count was 1.8. In the unadjusted model, each social risk factor was significantly associated with functional limitation. In the fully adjusted model, significant association with functional limitation was found in individuals reporting economic instability (Incidence rate ratio [IRR] 1.65, 95% CI 1.33, 2.06), food insecurity (IRR 1.28, 95% CI 1.15, 1.42), and social isolation (IRR 1.64, 95% CI 1.48, 1.82).

CONCLUSIONS

Social risk factors such as economic instability, food insecurity and social isolation are significantly associated with functional limitation in adults with stroke. Interventions designed to address both social and medical needs have the potential to improve physical functioning and other clinical outcomes in stroke survivors.

Food sufficiency status and sleep outcomes in older adults: the National Health and Aging Trends Study (NHATS)

BACKGROUND

Studies investigating the relationship between food insecurity and sleep among older populations are limited. This study aimed to cross-sectionally examine the associations between food sufficiency status and sleep outcomes in a nationally representative sample of older adults.

METHODS

Our study included 1,665 older adults (≥ 65 years), using data from the 2013 and 2014 National Health and Aging Trends Study (NHATS). Food insufficiency was determined via participants' experience and utilization of food assistance programs (FAP). Sleep outcomes, including nighttime and total sleep hours, sleep latency, and sleep quality, were derived from self-reported data. Multivariable linear regression and logistic regression models were used to estimate the associations between food sufficiency status and sleep outcomes.

RESULTS

In 2013-2014, 86.1% of older adults were classified as food sufficient without FAP, 9.85% as food sufficient with FAP, and 4.08% as food insufficient. Adjusting for sociodemographic characteristics, food sufficient older adults with FAP reported more total sleep hours (𝛽 = 0.31, 95% CI: -0.02, 0.64) than those participants who are food sufficient without FAP. Further adjusting for health factors, food sufficient participants with FAP had more nighttime sleep hours and greater total sleep hours compared to those participants food sufficient without FAP. Compared to those deemed as food sufficient without FAP, food sufficient participants with FAP had lower odds of having longer sleep latency (OR = 0.50, 95% CI: 0.28, 0.89), after further adjusting for physical function performance.

CONCLUSIONS

Among older adults, food sufficiency with FAP is associated with greater total sleep hours, greater nighttime sleep hours, and lower odds of longer sleep latency. Our findings may help inform nutrition food assistance programs targeting older populations.

Factors Associated With Food Insecurity Among a Community-Based Sample of Older Adults in a North Florida County

Food insecurity impacts the lives of 7.6 million U.S. adults aged 60 and older and is linked to numerous life challenges. This study examined the nature of food insecurity among community-based participants ≥65 years in a north Florida county and conceptualized food insecurity as encompassing the lack of food and individual adaptability. Thus, food insecurity was measured using three dependent variables: (1) worrying that food would run out, (2) cutting meal size or skipping meals, and (3) food not lasting. Logistic regression revealed that older participants, those with better-perceived health status, and those who were confident that they could find solutions to their problems had lower odds of reporting food insecurity. However, respondents who lived in low-income, low-access zip codes and those who received food assistance were more likely to report food insecurity. To improve outcomes and reduce healthcare disparities, solutions to food insecurity must vary in focus and approach.

The Relationship of Food Insecurity to Nutritional Risk in Independent Living Older Adults

Understanding the factors that augment optimal health during aging is critical as the US older adult population is increasing. Most research about food insecurity, nutritional risk, and perceived health among older adults are in urban areas or congregate living facilities. Thus, the purpose of this project was to study the relationships among these factors, plus activities of daily living, in community-dwelling older adults in a medium-sized city. Using a qualitative-quantitative study design, a cross-sectional survey was completed by 167 low-income senior apartment residents. Food insecurity in this group was higher than the national and state rate, yet nutrition assistance programs were underutilized and participants under 75 years were more food insecure than their older counterparts. Food insecure residents were at greater nutritional risk, had poorer self-reported health status, were more likely to be depressed, and had a less independent function, including limitations on the ability to shop for and prepare food. The study area is desirable to retirees due to lower cost of living; however, access to services, such as grocery stores, public transportation, and health care providers is limited. This research indicates the need for increased outreach, nutrition assistance, and support services to ensure healthy aging in these regions.

Women's health: optimal nutrition throughout the lifecycle

Sex differences are an important consideration when researching and establishing policies for nutrition and optimal health. For women's health, there are important physiologic, neurologic, and hormonal distinctions throughout the lifecycle that impact nutritional needs. Distinct from those for men, these nutritional needs must be translated into appropriate nutrition policy that aims to not only avoid overt nutritional deficiency, but also to promote health and minimize risk for chronic disease. Through a series of webinars, scientific experts discussed the advances in the understanding of the unique nutritional needs, challenges and opportunities of the various life stages for women across the life course and identified emerging nutritional interventions that may be beneficial for women. Nevertheless, there is concern that existing nutrition policy intended for women's health is falling short with examples of programs that are focused more on delivering calories than achieving optimal nutrition. To be locally effective, targeted nutrition needs to offer different proposals for different cultural, socio-economic, and geographic communities, and needs to be applicable at all stages of growth and development. There must be adequate access to nutritious foods, and the information to understand and implement proven nutritional opportunities. Experts provided recommendations for improvement of current entitlement programs that will address accessibility and other social and environmental issues to support women properly throughout the lifecycle.

Socioeconomic Status and Nutritional Status as Predictors of Food Insecurity in Older Adults: A Case Study from Southern Ecuador

While life expectancy is increasing due to scientific advancement, quality of life in aging depends, among other factors, on the nutritional status and socioeconomic status of older adults. To determine socioeconomic status and its association with nutritional status as a predictor of food insecurity among older adults in southern Ecuador, a cross-sectional study of 188 older adults in urban areas and 212 in rural areas was conducted. Nutritional status, food insecurity, and socioeconomic status were measured. Data were analyzed using SPSS v 15.0 for descriptive statistics and bivariate analysis. Of the older participants, 59% had malnutrition, the majority women, and 24.7% were in poverty. Underweight was associated with low socioeconomic status for adults between 65 and 74 years old (OR = 7.710; CI 95% = 1.691-35.147), while obesity was associated with low socioeconomic status and non-manual labor (OR = 3.048; CI 95% = 1.268-7.326). Over 80% of older adults living in homes without children younger than 18 and at low socioeconomic status had food insecurity. The prevalence of underweight, overweight, and obesity points to widespread nutritional problems, especially in rural areas, that are significantly associated with low socioeconomic status. This demonstrates the need for multidisciplinary programs and government policies that can contribute to reducing food insecurity among the highly vulnerable older population.