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Community and International Nutrition

Risk and Presence of Food Insufficiency Are Associated with Low Nutrient Intakes and Multimorbidity among Homebound Older Women Who Receive Home-Delivered Meals¹

Department of Social and Behavioral Health, School of Rural Public Health, Texas A&M University System Health Science Center, College Station, TX

³To whom correspondence should be addressed. E-mail: jrsharkey{at}srph.tamushsc.edu.

This study examined the independent association of food sufficiency status with lowest nutrient intakes and multimorbidity among homebound older women who received home-delivered meals. Baseline data from the Nutrition and Function Study were used to identify three categories of food sufficiency status [food sufficient (FS), risk of food insufficiency (RFI) and food insufficient (FI)], calculate summary measures of musculoskeletal (calcium, vitamin D, magnesium and phosphorus) and overall nutrient intakes, and examine, using multivariable logistic regression models, the association of food sufficiency status with nutrition and health outcomes among 279 women who received regular home-delivered meals service (5 weekday meals/wk) and completed an in-home assessment and three 24-h dietary recalls. Independent of income and other variables, the adjusted odds for reporting lowest intakes in individual and multiple nutrients ( 2 musculoskeletal and 5 overall) were significantly greater among women who reported RFI [odds ratio (OR) = 1.96 to 2.91] and FI (OR = 2.85 to 5.21). In addition, FI women were more likely to report a burden of multimorbidity (OR = 3.69). Considering the importance of home-delivered meals as a primary source of food assistance to homebound older women, the results of this study suggest the need to reevaluate the traditional model of home-delivered meals and to include measures of food sufficiency status as an integral component of program assessment and evaluation for the targeting and monitoring of new, innovative and cost-effective strategies to alleviate risk and the presence of food insufficiency.

KEY WORDS: • food insufficiency • homebound elderly • nutrient intake • home-delivered meal

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