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Association of Food Insecurity with Nutrition Status, Food Diversity and Anthropometric Status in Iranian Elderlies: A Cross-sectional Study

Background: Health and nutritional issues of the elderly are different from other age groups. The results of studies cannot be compared and concluded, because these studies have different operational definitions, such as considering food quality rather than the amount of food intake and also limiting some causes of food insecurity in the analysis and the presentation of results in others. Therefore, we investigated the effects of food insecurity on food diversity and the nutritional and anthropometric status of the elderly in Tehran. 
Methods: This cross-sectional study was performed on 300 elderly residents in Tehran, with a mean age of 67.5 ± 5.74. Food insecurity was evaluated using the Household Food Insecurity Access Scale (HFIAS). The nutritional status and health of the elderlies were assessed using the Mini Nutritional Assessment (MNA). Waist circumference, weight, and height were measured and BMI was calculated. All statistical calculations were performed with the SPSS. 
Results: The prevalence of malnourishment was significantly (p < 0.001) higher in the severely food-insecure group (62.5%). A significant inverse relationship was observed between the HFIAS scores and weight (β = -4.38, p < 0.001), body mass index (β = -1.46, p < 0.001), waist circumference (β = -3.37, p = 0.002), and dietary diversity score (DDS) (β = -0.738, p < 0.001). Moreover, we found a significant relationship between HFIAS and MNA scores (β = 0.486, p < 0.001). Participants in the food-insecure group had a greater risk of developing malnourishment (OR, 16.45; 95% CI, 8.55-31.66) and having poor dietary diversity (OR, 7.42; 95% CI, 2.87-19.16) compared with the food-secure group. 
Conclusion: After adjusting for possible confounding factors, we found that food insecurity was associated with MNA score. We also found an inverse association between food insecurity and socioeconomic status, anthropometric measurements, and dietary diversity.