Gender Disparities in the Food Insecurity-Overweight and Food Insecurity-Obesity Paradox among Low-Income Older Adults.

BACKGROUND

Obesity and obesity-related comorbidities are increasing among older adults. Food insecurity is a nutrition-related factor that coexists with obesity among low-income individuals. The majority of the research on the food insecurity-obesity paradox has been conducted on low-income mothers and children, with research lacking on large diverse samples of older adults.

OBJECTIVE

The purpose of this study was to assess gender disparities in the association between food insecurity and overweight and obesity among low-income older adults.

STUDY DESIGN

Cross-sectional 2011 and 2012 National Health Interview Survey data were used. Food insecurity status was determined by ≥3 affirmative responses on the 10-item US Department of Agriculture Food Security Scale (FSS). Body mass index (BMI) was calculated as outlined by the Centers for Disease Control and Prevention based on self-reported height and weight.

PARTICIPANTS/SETTINGS: Adults included were low-income (≤1.99 federal poverty level [FPL]), older (aged ≥60 years), with a normal BMI (18.5) or greater who had complete data on FSS, BMI, and the following covariates: age, race or ethnicity, marital status, income, nativity status, physical activity, poor health status, health insurance coverage, problems paying medical bills or for medicine, and region of residency (N=5,506).

STATISTICAL ANALYSES PERFORMED

Multivariate logistic regression models were stratified by gender to estimate the association between food insecurity and higher weight status. All models included covariates.

RESULTS

In covariate-adjusted models, compared with low-income, food secure men, low-income, food-insecure men had 42% and 41% lower odds of being overweight and overweight or obese, respectively. Despite the high prevalence rate of obesity among low-income, food-insecure women, food insecurity was not significantly related to overweight, obesity, or overweight or obesity for older adult women in adjusted models.

CONCLUSIONS

Food insecurity-overweight and -obesity paradox appears not to be present in older men. However, food insecurity and obesity coexist among low-income, older women.