Food insecurity and malnutrition in older adults from the Family Health Strategy in the Northeast of Brazil / Inseguridad alimentaria y desnutrición en adultos mayores de la Estrategia Salud de la Familia del nordeste brasileño

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(AU)

Introducción: La inseguridad alimentaria (IA) es un estado caracterizado por la inestabilidad e irregularidad en el acceso a los alimentos. Esta condición tiene impactos negativos en la ingesta de alimentos, afectando el estado nutricional y la condición de salud. Objetivo: Evaluar la asociación entre desnutrición e IA en adultos mayores comunitarios atendidos en la Estrategia Salud de la Familia (ESF). Materiales y métodos: Estudio transversal realizado con ancianos de comunidad atendidos en la ESF del municipio Barreiras, Bahía, Brasil. Entre 2017 y 2018, se recolectaron datos demográficos, sociales, económicos, condición de salud, estilo de vida, antropométricos y de consumo de alimentos. El estado nutricional se evaluó por la Mini Evaluación Nutricional (MEN) y la IA con la Escala Brasilera de Inseguridad Alimentaria (EBIA). Además de la prueba de chi-cuadrado, se realizó una regresión logística binaria para verificar la asociación entre desnutrición e IA, ajustada para posibles factores de confusión. El nivel de significancia fue p<0,05. Resultados: Fueron evaluados 307 ancianos, con una edad media de 70,4 (±7,5 años). La prevalencia de desnutrición/riesgo de desnutrición fue de 35,2% y la de IA de 63,5%. Los hogares con adultos mayores en IA moderada/grave presentaron casi tres veces más chance (OR 2,97; IC95% 1,37-6,44) de tener desnutrición en comparación con aquellos en Seguridad Alimentaria y Nutricional. Conclusiones: El estudio apunta que existe asociación entre la IA domiciliaria y desnutrición/ riesgo de desnutrición entre los ancianos de la ESF, especialmente entre aquellos con IA severa. Este resultado atribuye a la IA un estatus de determinante de la desnutrición en ancianos en el contexto investigado(AU)

Prevalence of sarcopenic obesity and its association with functionality, lifestyle, biomarkers and morbidities in older adults: the Fibra-RJ study of frailty in older brazilian adults

OBJECTIVES: To assess the prevalence of sarcopenic obesity and its association with functionality, lifestyle, biomarkers, and morbidities in older adults. METHODS: The study analyzed cross-sectional data from 270 older adults who participated in phase III of the Frailty in Brazilian Older People Study (Fragilidade em Idosos Brasileiros—Rio de Janeiro, FIBRA-RJ study-2013). They took part in a home interview surveying socioeconomic, demographic, lifestyle, morbidities, and functional data. Blood was collected for biochemical marker analysis and participants' body composition was determined by dual-energy X-ray absorptiometry. For women, the diagnosis of sarcopenic obesity was defined at a body fat percentage ≥38% and appendicular skeletal muscle mass index (ASMMI) <5.45 kg/m2. For men, a fat percentage ≥27% and ASMMI <7.26 kg/m2 was defined as sarcopenic obesity. Multivariate analysis was performed using a multinomial regression model (95% confidence intervals), with sarcopenic obesity as the outcome. RESULTS: The prevalence of sarcopenic obesity was 29.3%. In the final fitted model, the variables that displayed statistically significant association with sarcopenic obesity were lower gait speed, self-reported medical diagnosis of arthrosis or arthritis, and high levels of glycemia. CONCLUSION: The study showed a high prevalence of sarcopenic obesity in non-institutionalized older adults in Brazil. The finding that this condition was associated with modifiable risk factors may provide insights into measures directed at prevention and reduction of the risk of sarcopenic obesity in this population subgroup.