Nutritional Status and Household Food Insecurity Among Elderly in Mugu Karmarong Rural Municipality of Western Nepal

Abstract

Little is known about the nutritional status of elderly in Nepal, in particular among indigenous communities in high altitude areas. The main objective of this study was therefore to determine the nutritional status of elderly and their household food security status on the Nepal-China border. The study was conducted in Mugu Karmarong rural municipality, as part of Mugu district that habitats mostly indigenous Tibetan-speaking communities. We used a descriptive cross-sectional design and a total of 128 participants were identified using purposive sampling. Anthropometry and the Mini Nutritional Assessment Short Form (MNA-SF) were used to determine nutritional status and the Household Food Insecurity Access Scale (HFIAS) was used to categorize households according to a food insecurity scale. The mean (range) age of participants was 69 (60–84) years. The majority (81%) of the 128 participants had no any education, they were mostly (86%) Buddhist and 72% were married. Based on the MNA-SF scores, 30.5% had a normal nutritional status, 40.6% were at risk for malnutrition while 28.9% were malnourished. In somewhat contrast, our BMI measurements (using the cut-off values from a national survey) suggested that the majority (79.7%) had BMI values within the normal reference range. Based on the HFIAS, only 30.4% of the households were scored as food secure whereas 29% of the households belonged to the severe food insecurity category followed by 26% being moderately food insecure and 11% being mildly food insecure. Our findings revealed that type of the household, use of iodized salt, seasonal migration and household food security status, were all significantly associated with nutritional status of the elderly. Those living in severely food insecure households were 3.2 times more likely to be malnourished than those from food secured households while those living in moderately insecure household was 1.8 times more at risk of malnutrition than those from food secure households. We found that about 2/3 of the elderly were either at risk of malnutrition or were malnourished. Only 1/3 of the surveyed households were food secure. Hence, there are alarming risks of malnutrition and food insecurity among elderly in this remote, mountainous region. This study was partly sponsored by the University of Oslo.