Association between dietary diversity, health and nutritional status of older persons in rural Zambia

Abstract

Objective: The purpose of the study was to assess the association between dietary diversity, health and nutritional status of older persons aged 50 years and above in Milenge district of Luapula province, Zambia. Design: A cross-sectional, descriptive study was conducted. Subjects and setting: The study was conducted among 135 older persons (≥ 50 years) comprising 67 men and 68 women who were randomly selected from three communities in Milenge district, Luapula province. Outcome measures: Anthropometric measurements (weight and height) were used to determine the prevalence of malnutrition among the respondents by calculating the body mass index (BMI). Food consumption was assessed using a non-quantified food frequency questionnaire and dietary diversity scores were used to determine the adequacy of food intake, while a health questionnaire was used to determine self-perceived health status of the respondents. Results: Based on the WHO BMI classification, 30.4% of older persons were underweight, whilst 8.1% were overweight. There was a significant difference in mean BMI between male and female older persons (p < 0.01). More men had severe underweight, whilst more women were found to be overweight and obese. The mean dietary diversity score (DDS) was 3.6 ± 1.1. Dietary assessment showed that 64.4% of the respondents had dietary diversity scores that were below the mean value, while 35.6% had scores above the mean value. The Spearman rho correlation test revealed a positive correlation (r = 0.184, p = 0.028) between BMI categories and dietary diversity scores. The majority (74%) of respondents reported having at least one health condition including high blood pressure (42.6%), coronary heart disease (8.9%), malaria (24.4%), tuberculosis (35.6%) and pneumonia (24.4%), while only 26% perceived themselves to be healthy. Conclusion: The study revealed a high prevalence of undernutrition and low dietary diversity among older persons. A positive association was found between nutritional status and dietary diversity. Although the majority of the respondents reported having health conditions, there was no relationship between nutrition-related health conditions and dietary diversity.

Keywords

• dietary diversity
• food security
• health status
• nutritional status
• older persons